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Lancet publishes landmark series on ‘waste’ in biomedical research

Misguided research questions, poorly designed experiments and consistent failure to report negative findings are all to blame for causing “avoidable waste” in research, according to a series of papers published in medical journal The Lancet.

The series, published on 8 January, identifies five categories of what it calls inefficiencies, ranging from the selection of research questions to how results are reported.

The package of content, which consists of five peer-reviewed papers and two comment articles, also makes recommendations for funders, publishers, educators and professional bodies encouraging them to recognise and tackle the problems described.

The series was prompted by a previous viewpoint article published by The Lancet in 2009. This claimed that up to 85 per cent of the money spent on research was being ‘wasted’. Waste in this context includes research that is not reliable or useful; knowledge that does not represent a sufficient advance from what we already know, and an over-burdensome regulatory regime.

That 2009 piece was written by Iain Chalmers, coordinator of the James Lind Initiative, which promotes the use of randomised controlled trials in healthcare; and Paul Glasziou, then director of the University of Oxford’s centre for evidence-based medicine. Both authors also contributed to the 2014 series, along with 42 other authors drawn from 13 countries.

In terms of funding the right research questions, Chalmers and co-authors say, in the first paper of the series, that funders bear the main responsibility to make sure that good decisions are being made about what research to fund. They recommend that more work should be done to find out what factors lead to research that can be replicated and translated into health care.

They also say that funders should be more transparent about how funding decisions are made. Funders should demand that requests for primary research funding be justified by literature reviews and they should provide more information about the research they are funding while it is in progress.

Efficient regulation of research is the focus of the third paper in the series. University of Edinburgh neurologist Rustam Al-Shahi Salman and colleagues address the burdens involved in getting approval for studies.

“Obtaining regulatory and governance approval has become increasingly burdensome and disproportionate to the conceivable risks to research participants,” they say. They recommend that regulators make sure they are taking steps to reduce various sources of research waste in the projects they are monitoring; and that they work with researchers, patients and health care providers to develop more streamlined regulations; They also stress that research needs to be incorporated better into everyday clinical practice.

Introducing the series, editor of The Lancet Richard Horton and senior executive editor Sabine Kleinert conclude that the articles they have published raise questions about whether the scientific enterprise should change to produce reliable and accessible evidence to address the many health and biomedical challenges faced by people and societies.

The series was launched at an event in London that was co-sponsored by The Lancet and the Department of Health.