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Healthy Skepticism Library item: 7082

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Vlassov V.
How to formulate research recommendations: format is not enough.
BMJ 2006 Oct 28; 333:(7574):917
http://www.bmj.com/cgi/content/full/333/7574/917


Abstract:

EDITOR-The spectrum of appropriate recommendations for future research cover more than described in the recent very useful article.1 The recommendation “no further research is needed” is necessary to protect patients from harmful or useless research and to save limited resources for clinical research. This extreme of research recommendations is especially important for systematic reviews of any kind-information assessment, health technology assessment, summing clinical evidence, or Cochrane reviews.

I searched Cochrane reviews for their recommendations, and found that only 17% of reviews do not recommend further research. Reviewers recommend further research even when they have serious reservations about the intervention.2 Authors of reviews may abstain from definitive recommendations when they find strange, probably fabricated or manipulated data.

The most serious reason for not recommending “no further research” does not seem to be the absence of the appropriate format of recommendations, but rather the desire to avoid harm to the authors of the original research and damage to the field of their own research. The discussion about the famous example of the excessive research of aproytinin shows that a decision to recommend not to do further trials may be difficult.3

More research is needed and more detailed guidelines need to be created on criteria for recommending “no further research is needed.”

Keywords:
Biomedical Research/organization & administration* Evidence-Based Medicine

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909