{"id":1408,"date":"2017-09-26T14:42:15","date_gmt":"2017-09-26T14:42:15","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/?p=1408"},"modified":"2017-11-01T15:52:13","modified_gmt":"2017-11-01T15:52:13","slug":"using-systematic-reviews-to-reduce-research-waste-who-really-cares","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/09\/26\/using-systematic-reviews-to-reduce-research-waste-who-really-cares\/","title":{"rendered":"Systematic reviews to reduce research waste"},"content":{"rendered":"
The global spend on biomedical research and development is about $250 billion, so why is so much of it still wasted, asks\u00a0Kamal R. Mahtani<\/a>.<\/em><\/h6>\n

The global spend on biomedical research and development\u00a0is estimated to be<\/a>\u00a0about $250 billion (\u00a3203 bn; \u20ac233 bn) each year\u2014a not insignificant figure. In fact,\u00a0it roughly equates to<\/a>\u00a0the amount that the UK government spends each year on its combined education, defence, and welfare budget.<\/p>\n

But suppose you heard that the UK government\u2019s budget for education, defence, and welfare was being wasted and provided no public benefit at all\u2014what would your reaction be? Surprise? Indignation? Anger?<\/p>\n

Chalmers and Glasziou\u2019s revelation<\/a>\u00a0that about 85% of biomedical research may be wasted should evoke at least as great an outraged response. This estimate of wastage is derived from a number of factors\u2014including failure to conduct, describe, and publish research to standards that make the outputs useful. This is particularly concerning, given that much of this research is expected to provide some form of patient benefit.<\/p>\n

Among the\u00a0proposed steps<\/a>\u00a0to reduce this waste is a recommendation that new research should not be conducted until a systematic assessment of existing research has been performed. There are at least\u00a0two reasons<\/a>\u00a0why this makes total sense. Why would you want to conduct a new study if the answer was already available? And, more importantly, if the answer was available already,\u00a0would it even be ethical<\/a>\u00a0to enter participants into a new study when some might fare worse?<\/p>\n

Some public funders of research, such as the UK\u2019s National Institute for Health Research (NIHR), which manages an annual budget of about \u00a31 billion for applied research,\u00a0recognise the importance of<\/a>\u00a0systematic reviews in reducing research waste.\u00a0As one example of this<\/a>, new applicants seeking funding from the NIHR to support primary research must now ensure that their request is informed by knowledge of the existing evidence.<\/p>\n

But what about other funders? The aim of\u00a0a recent survey<\/a>\u00a0of the websites of 11 international research funding organisations was \u201cto indicate the extent to which each organisation adopted waste reducing policies and processes.\u201d The authors extracted information on whether the funder involved members of the public in setting research priorities; made full protocols for funded research publicly accessible; and had specific funding streams for methods research. The survey also identified information about how the funders supported the conduct of systematic reviews.<\/p>\n

Although the authors reported that they used their judgment in the interpretation of their findings, they do also report that they checked the accuracy of their findings with each organisation. According to their survey results, only two of the funders, the NIHR and the Canadian Institutes of Health Research, had clearly dedicated streams to fund systematic reviews. The survey also concluded that only one funder,\u00a0the NIHR<\/a>, made it a prerequisite that all applications for support should be informed by a systematic review of the existing evidence.<\/p>\n

Scientific, ethical, and economic reasons\u00a0make it essential<\/a>\u00a0to conduct a systematic review of existing evidence before considering a new study. Failure to do this is simply poor practice. This recent survey shows that there is still work to be done to ensure that this principle is clearly and demonstrably supported. Given their large budgets and major influence on what does and does not get financial support, funding agencies have a particular responsibility to lead this initiative.<\/p>\n

\n

Kamal R. Mahtani is an NHS GP and deputy director of the Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford. You can follow him on Twitter\u00a0@krmahtani<\/a>.<\/em><\/p>\n

This blog was originally posted on\u00a0BMJ Opinion<\/a>.<\/em><\/p>\n

Acknowledgements: Jeffrey Aronson and Sir Iain Chalmers for helpful discussions.<\/em><\/p>\n

Image:\u00a0CCHSR<\/a><\/em><\/p>\n

Declared interests: I have received funding from the NHS National Institute for Health Research to conduct independent research, including systematic reviews. I am also the director of the\u00a0evidence-based healthcare MSc in systematic reviews<\/a> and a founding member of\u00a0the EBM manifesto team<\/a>, which advocates better evidence for better healthcare.<\/em><\/p>\n

The views expressed in this commentary represent the views of the author and not necessarily those of his host institution, the NHS, the NIHR, or the Department of Health.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

The global spend on biomedical research and development is about $250 billion, so why is so much of it still wasted, asks\u00a0Kamal R. Mahtani. The global spend on biomedical research and development\u00a0is estimated to be\u00a0about $250 billion (\u00a3203 bn; \u20ac233 bn) each year\u2014a not insignificant figure. In fact,\u00a0it roughly equates to\u00a0the amount that the UK […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":1409,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14372],"tags":[],"class_list":["post-1408","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-kamal-mahtani"],"yoast_head":"\nSystematic reviews to reduce research waste - BMJ EBM Spotlight<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmjebmspotlight\/2017\/09\/26\/using-systematic-reviews-to-reduce-research-waste-who-really-cares\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Systematic reviews to reduce research waste - BMJ EBM Spotlight\" \/>\n<meta property=\"og:description\" content=\"The global spend on biomedical research and development is about $250 billion, so why is so much of it still wasted, asks\u00a0Kamal R. Mahtani. The global spend on biomedical research and development\u00a0is estimated to be\u00a0about $250 billion (\u00a3203 bn; \u20ac233 bn) each year\u2014a not insignificant figure. 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