Year : 2021 | Volume
: 33 | Issue : 2 | Page : 107--108
Original research or research waste?
Department of Ophthalmology, Government Medical College, Thrissur, Kerala, India
Dr. V Sudha
Department of Ophthalmology, Government Medical College, Thrissur, Kerala
|How to cite this article:|
Sudha V. Original research or research waste?.Kerala J Ophthalmol 2021;33:107-108
|How to cite this URL:|
Sudha V. Original research or research waste?. Kerala J Ophthalmol [serial online] 2021 [cited 2021 Dec 5 ];33:107-108
Available from: http://www.kjophthal.com/text.asp?2021/33/2/107/324194
“Skepticism is in the nature of science”
The COVID pandemic has spewed a torrent of research on its varied manifestations, detection techniques, treatment protocols, and its dreaded complications. Due to the urgency of information, many papers were released in the preprint stages itself and some prominent ones were later retracted due to the lack of rigor in analysis or because the data set could not be independently verified, as pointed out by scientists from the world over. This constitutes not just a problem for the integrity of science and medicine, it is problematic for the notion of clinical trials and evidence generation, and definitely a black mark for the journals involved.
Research Can Both Communicate and Miscommunicate
Useful research is more likely to make a good difference to our knowledge. However, in most cases, the usefulness of an article can be ascertained only after its publication. For example, presently, there are an increasing number of published case reports regarding post-COVID patients affected with ocular opportunistic infections, vascular occlusions, and other issues.,,, But are these infections really in excess among the COVID-treated patients as compared to other patients who experienced similar hospitalization? Can we attribute these to the cytokine storm or autoimmune attributes of the disease or to the treatment protocols? Or are they only an apparent increase because of better reporting of COVID symptomatology? Equally problematic is the attributing of rare complications to COVID-19 vaccines. Raging controversies exist on the true incidence of these and whether they can be considered evidence enough to declare the particular vaccine unsuitable for use.
What Constitutes Evidence?
Scientific evidence is a set of observations or results, which support or refute a hypothesis. Interpretation of the results is an important step and should be done in a scientific manner. The author has to defend his findings against all arguments from his peers and prove beyond doubt that no other explanations can give the same results. The evidence and the ways of making it are often closely scrutinized. A factual claim on the basis of personal observation collected in a casual manner is only anecdotal evidence and needs to be further analyzed. Thus, case reports should be interpreted not as evidence in a study of a disease but only as pointers to the need for further higher level analytical studies such as cohort studies and randomized controlled trials.
But do Trials Tell the Whole Story?
There are numerous research trials occurring all over the world. Many of them do not get published. Out of those which do, how strong should we consider their results? Studies of published trial reports showed that the poor description of interventions meant that 40%–89% were nonreplicable; comparisons of protocols with publications showed that most studies had at least one primary outcome changed, introduced, or omitted; and investigators of new trials rarely did a systematic review of existing literature, and cited a very small and biased selection of previous relevant trials. Although best documented in reports of controlled trials, inadequate reporting occurs in all types of studies – animal and other preclinical studies, diagnostic studies, epidemiological studies, clinical prediction research, surveys, and qualitative studies.
Hence, the quality of information provided in published articles is variable and often incomplete. Inaccessibility of complete data is another common problem. This introduces bias, and has a detrimental impact on patient care and research. And such incomplete studies constitute research waste due to poor quality. Availability of full information on study methods facilitates critical appraisal, interpretation of study results, and appropriate replication. Proper reporting of results can improve clinical practice and policy, prevent unnecessary duplication, and help to inform ongoing and future research. Because the original article with clinical implications can create an enduring impression by their conclusions, writing the reports requires great care, and careful peer review and critical analysis is a must.
The Role of Journals
Journal publication is traditionally the primary means of communicating research results to the scientific community. So by what criteria should a journal judge the quality of a submitted research paper? One of the important ways to look at it is that a good and useful work is “stable,” i.e., not likely to be soon contradicted. A stable interpretation is one which has a satisfactory answer to the question, “Why this interpretation rather than another?” Are there more likely, almost or equally as likely, or other possible explanations (including methodological error in the work in question)?
Selection biases shown by journals can be a major cause of skewed information. It has been found that clinical trials with positive results appear in journals about 1 year earlier than nonpositive trials. New interventions will be accepted as effective, even though contrary evidence may already have been gathered but not yet published. And policy and treatment guidelines based on these new interventions will take priority.
Thus, the “burden of proof” lies on the researcher to show irrefutable evidence of his conclusions to his peers before and after publication. Published literature needs corroboration and repeatability, time and again. And journals with their team of editors and reviewers, as gatekeepers to this valuable evidence-based information, have a great responsibility to upkeep.
There are no shortcuts to good evidence. Are we equipped for it...?
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