How to increase value and reduce waste when research priorities are set

被引:960
作者
Chalmers, Iain [1 ]
Bracken, Michael B. [2 ,3 ]
Djulbegovic, Ben [4 ,5 ,6 ]
Garattini, Silvio [7 ]
Grant, Jonathan [8 ]
Guelmezoglu, A. Metin [9 ]
Howells, David W. [10 ]
Ioannidis, John P. A. [11 ,12 ,13 ,14 ]
Oliver, Sandy [15 ]
机构
[1] James Lind Initiat, Oxford OX2 7LG, England
[2] Yale Univ, Sch Publ Hlth, New Haven, CT USA
[3] Yale Univ, Sch Med, New Haven, CT USA
[4] Univ S Florida, Div Internal Med, Ctr Evidence Based Med & Hlth Outcomes Res, Tampa, FL USA
[5] Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Hematol, Tampa, FL 33612 USA
[6] Univ S Florida, Coll Med, H Lee Moffitt Canc Ctr & Res Inst, Dept Hlth Outcomes & Behav, Tampa, FL 33612 USA
[7] Ist Ric Farmacol Mario Negri, IRCCS, Milan, Italy
[8] RAND Europe, Cambridge, England
[9] WHO, UNDP UNFPA UNICEF WHO World Bank Special Programm, CH-1211 Geneva, Switzerland
[10] Florey Inst Neurosci & Mental Hlth, Melbourne, Vic, Australia
[11] Stanford Univ, Sch Med, Dept Med, Stanford Prevent Res Ctr, Stanford, CA 94305 USA
[12] Stanford Univ, Sch Med, Dept Hlth Res & Policy, Div Epidemiol, Stanford, CA 94305 USA
[13] Stanford Univ, Dept Stat, Sch Humanities & Sci, Stanford, CA 94305 USA
[14] Stanford Univ, Meta Res Innovat Ctr Stanford METRICS, Stanford, CA 94305 USA
[15] Univ London, Inst Educ, London WC1N 1AZ, England
关键词
RANDOMIZED CONTROLLED-TRIALS; SYSTEMATIC REVIEWS; SCIENTIFIC BASIS; HEALTH-CARE; CANCER; METAANALYSES; PATIENT; AGENDA; UNCERTAINTIES; EPIDEMIOLOGY;
D O I
10.1016/S0140-6736(13)62229-1
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
The increase in annual global investment in biomedical research-reaching US$240 billion in 2010-has resulted in important health dividends for patients and the public. However, much research does not lead to worthwhile achievements, partly because some studies are done to improve understanding of basic mechanisms that might not have relevance for human health. Additionally, good research ideas often do not yield the anticipated results. As long as the way in which these ideas are prioritised for research is transparent and warranted, these disappointments should not be deemed wasteful; they are simply an inevitable feature of the way science works. However, some sources of waste cannot be justified. In this report, we discuss how avoidable waste can be considered when research priorities are set. We have four recommendations. First, ways to improve the yield from basic research should be investigated. Second, the transparency of processes by which funders prioritise important uncertainties should be increased, making clear how they take account of the needs of potential users of research. Third, investment in additional research should always be preceded by systematic assessment of existing evidence. Fourth, sources of information about research that is in progress should be strengthened and developed and used by researchers. Research funders have primary responsibility for reductions in waste resulting from decisions about what research to do.
引用
收藏
页码:156 / 165
页数:10
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