Why Most Clinical Research Is Not Useful

PLoS Medicine
http://www.plosmedicine.org/
(Accessed 25 June 2016)

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Essay
Why Most Clinical Research Is Not Useful
John P. A. Ioannidis
Essay | published 21 Jun 2016 | PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002049
Summary Points
:: Blue-sky research cannot be easily judged on the basis of practical impact, but clinical research is different and should be useful. It should make a difference for health and disease outcomes or should be undertaken with that as a realistic prospect.
:: Many of the features that make clinical research useful can be identified, including those relating to problem base, context placement, information gain, pragmatism, patient centeredness, value for money, feasibility, and transparency.
:: Many studies, even in the major general medical journals, do not satisfy these features, and very few studies satisfy most or all of them. Most clinical research therefore fails to be useful not because of its findings but because of its design.
:: The forces driving the production and dissemination of nonuseful clinical research are largely identifiable and modifiable.
:: Reform is needed. Altering our approach could easily produce more clinical research that is useful, at the same or even at a massively reduced cost.
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Research Article
Exclusive Breastfeeding and Cognition, Executive Function, and Behavioural Disorders in Primary School-Aged Children in Rural South Africa: A Cohort Analysis
Tamsen J. Rochat, Brian Houle, Alan Stein, Hoosen Coovadia, Anna Coutsoudis, Chris Desmond, Marie-Louise Newell, Ruth M. Bland
| published 21 Jun 2016 | PLOS Medicine
http://dx.doi.org/10.1371/journal.pmed.1002044