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27 Are all researches adequately researched?
  1. Shabana Ali
  1. Practicing Clinician; Ex-Student of Terna Medical College, MUMBAI, India


Misrepresentation of medical-research by mass-media is common as thousands of medical journals compete for attention. ‘Brushing teeth twice a day could prevent erectile dysfunction while bad oral hygiene may triple the risk of impotency!’ read a newspaper headline. In this example, distortion of research-results is probably an effect of poor understanding of relative-risk, confounding and/or interactions. Anyone can be a publisher read by millions of followers; bypassing professional editors and peer-review from submission process, thus, leaving presented outcomes and methods unchallenged. Ability to prove results distinguishes blogger from researcher and expert. The ‘crisis of expertise’ affects clinical research which is often undermined by underpowered design, poor reproducibility of chosen methods, extrapolation and over-interpretation of data, under-reporting of negative results and publication-bias. Transparency and Accountability are key to good research. Reporting of ‘conflicts of interest’ is associated with involvement of pharmaceutical companies and policymaking bodies as suggested by BMJ publications in ‘the weekend effect on mortality’. After Lancet retracted article linking autism to MMR vaccines, citing ‘public interest in the issue’, it was apparent to the wider research community that even most respected journals and institutions are not immune to fraudulent research. It’s concerning that this case was exposed as a result of journalistic investigation, rather than academic-vigilance. Unfortunately, even Randomised-Controlled Trials (RCTs) can be affected by potential biases of poor-design or selection-bias. The peer-review process serves as a great filter to improve research standards. Improving selection, incentives and comprehensive training on methodology & statistics of those involved in research-process may help in execution of high scientific standards and reporting of clinical research. Systematic-reviews should take precedence over just-experience. Data-monitoring committees and independent expert-panels reviewing trial-data regularly ensure RCT-trial integrity. However, standards and competencies of these bodies are not universal. Global platforms like EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network help to enhance the reporting standards and credibility of research articles. New Systematic-review data-repositories will allow access to raw data for early research-comparison. ‘Artificial Intelligence’ software with automatic-machine-learning-algorithms can filter flawed researches from genuine ones by identifying outliers early. The rising competition between journals and media’s insatiable hunger for newer scientific discoveries has laid a lot of pressure on the researchers. Media sensationalism should be resisted to avoid uncertainties and reduce pressure over scientists. Government funding agencies and Universities can pull the brakes to statistical malpractices by cutting-off support and rewards for trials with flawed structures. The cornerstones of evidence-based medicine rely on adequate-appraisal, systematic-review and authenticating-evidence.

Conclusions A good clinical study must be non-biased, with a core of ethics and laced with scientific advancements. Peer-review, Refined Reporting-standards, Raw-data publication in open-access journals, Systematic-review repositories, Data-synthesis and comparison, Independent-funders, multi-site studies and limiting conflicts of interests can safeguard rational research. Not all researchers or funding-bodies intend to fraud. But, too many temptations along the route incite them to indulge in scientific-misconduct which is a critical waste of funds. It is, therefore, essential to promote the agenda of ‘Transparency-or-Perish’ rather ‘Publish-or-Perish’!

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