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Clinical research’s flaws highlighted by Stanford’s John Ioannidis

research-66365_1920In a new paper with a provocative title, "Why most clinical research is not useful," John Ioannidis, MD, DSc, makes the case that despite its name, much research that aims to improve outcomes in the clinic falls short, in part, because it isn't designed to lead "to a favorable change in decision making... either by itself or when integrated with other studies and evidence."

Ioannidis — who directs the Stanford Prevention Research Center, co-directs the Meta-Research Innovation Center at Stanford (METRICS), and is well known for his critiques of medical research — lays out eight features that characterize "useful" clinical research in the paper, which appears today in PLOS Medicine. Useful research must satisfy questions like: "Does the research reflect real life?" and "Is there a health problem that is big/important to fix?", Ioannidis writes. Research should also benefit patients, he emphasizes.

Very few studies meet these standards, he says. But the goal of the paper is not to castigate: "The problem of non-useful research should not be seen as a blame game against a specific group (e.g., clinical researchers) but instead should be seen as an opportunity to improve."

Ioannidis also has high hopes:

With millions of brilliant people engaged in research, I am very optimistic about the future. We have to continue doing things amazingly wrong to make no major progress! I am sure we can avoid this sad scenario.

Previously: On communicating science and uncertainty: A podcast with John IoannidisA conversation with John Ioannidis, "the superhero poised to save" medical research, Stanford anesthesiologist's book tackles common clinical research dilemmas and Shake up research rewards to improve accuracy, says Stanford's John Ioannidis
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