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• Dr.
  Alan Hsi-Wen Liao
  Published on: 13 January 2023

• Published on: 13 January 2023

  Dr.

  • Alan Hsi-Wen Liao, Anaesthesiologist Taipei Medical University Hospital, Center for Evidence Based Medicine

  I would like to congratulate Dr. Abbott and her team in generating this piece of important and interesting article, which applied the methods of meta-science to the early systematic review articles and the infodemics related to COVID-19.

  Indeed, the COVID-19 pandemic came quick and ferocious, starting early 2020 and lasted till recently and with new possible variants emerging, it still presents the medical community and indeed the scientific circles with challenging question. Thankfully to the selfless work of researchers, patients and frontline medical staffs, we now have some valuable means to deal with this Pandemic.

  The research community was presented with a rather challenging task of designing and conducting researches to answer important questions relating to the new infectious diseases at the time of early 2020. The “new” corona virus was ravaging parts of our world without checks. So studies were conducted at pace, which unfortunately resulted in much duplicated and poor methodological studies conducted. But on the other hand, the sheer volume of studies itself may be useful as it generated evidence to inform us of what does and what does not work in terms combating the COVID-19. For example, dexamethasone (RECOVERY trial) was found to be essential for severe COVID-19 patients and the use of Hydroxychloroquine is ineffective for COVID-19.
  Having said this, I must state that I am not in support of the generation of poor quality clinical studi...

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  I would like to congratulate Dr. Abbott and her team in generating this piece of important and interesting article, which applied the methods of meta-science to the early systematic review articles and the infodemics related to COVID-19.

  Indeed, the COVID-19 pandemic came quick and ferocious, starting early 2020 and lasted till recently and with new possible variants emerging, it still presents the medical community and indeed the scientific circles with challenging question. Thankfully to the selfless work of researchers, patients and frontline medical staffs, we now have some valuable means to deal with this Pandemic.

  The research community was presented with a rather challenging task of designing and conducting researches to answer important questions relating to the new infectious diseases at the time of early 2020. The “new” corona virus was ravaging parts of our world without checks. So studies were conducted at pace, which unfortunately resulted in much duplicated and poor methodological studies conducted. But on the other hand, the sheer volume of studies itself may be useful as it generated evidence to inform us of what does and what does not work in terms combating the COVID-19. For example, dexamethasone (RECOVERY trial) was found to be essential for severe COVID-19 patients and the use of Hydroxychloroquine is ineffective for COVID-19.
  Having said this, I must state that I am not in support of the generation of poor quality clinical studies, but what I am saying is that different clinical / public health circumstances may call for different overall research strategies, sometimes we need quick answers to important clinical questions, then unfortunately, quality is often sacrificed/overlooked for the sake of the generation of "rapid" evidence, and the early phase of the COVID-19 pandemic may fall into this category. A relative lake of research capacity and resources may also contributed to this unfortunate phenomenon as we just do not have the means to generate massive amount of high quality researches in a short period of time.

  It is my view that medical research can perhaps be broadly divided into four categories:
  1). Very Important and urgent: such as the COVID-19 or any past or future public health emergencies
  2). Important but not urgent: hypertension, diabetes etc.
  3). Not as important but urgent: diagnosis or care of rare genetic diseases etc.
  4). Least important and not urgent: patient flow, drug compliance issues etc.

  I would concur with Dr. Abbott and her team and both the authors and the editors of the scientific community share the "duty" of ensuring and also improve the quality of systematic reviews. As an educator, we are equally responsible for providing future clinicians and scholars with the knowledge and skills to conduct high quality studies. Furthermore, meta-researches are as important to provide us with a scoping view of the evidences of review articles and to remind us of the need of research vigilance. Lastly it is perhaps also the responsibility of the policy makers and governments to ensure the persistent and appropriate resources are channeled into the research community, especially in times of future public health emergencies.

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  Conflict of Interest:
  None declared.

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