Should I stop a clinical trial early if the results indicate quickly and definitively that one of the treatments being tested is better than the other?
What should I do if I worked with 8 other researchers on a study, but the journal where I want to publish caps the number of authors at 5?
Or what about if editors of a journal say they like my submission, but want me to cut it down so it can be published as a letter-to-the-editor, not a research article?
These questions and many more, about the pitfalls and triumphs of clinical research, fill the latest book by Stanford anesthesiologist John Brock-Utne, MD: Clinical Research: Case Studies of Success and Failures.
The most important parts of the book are the answers that accompany the questions, often straight from Brock-Utne’s clinical and laboratory experience. “I’ve been doing research since 1968,” Brock-Utne told me. “Now, when I sit back and look at all of what has been produced, I know I’ve made a lot of mistakes. The idea was to collect some of the cases, both successes and failures, so the next generation of researchers will avoid the sometimes elementary mistakes I made.”
This intention comes through in the tone of the answers; they read as letters of advice from a trusted mentor. For example, in Case 22, Brock-Utne writes about a “hypothetical” case where “You have submitted a paper to a large North American Medical Journal. It is the opinion of you and your coworkers that it is a great paper… But the paper is not accepted. The criticisms are vague; the tone of the review is disrespectful and the language damning. In short, you are told that the results would be of very little interest to practicing clinicians. You do not agree but feel the editor and the reviewers must be correct. Based on the above you do not attempt to resubmit it to another journal. Less than 2 years later, a paper dealing with the same question is published in the same journal... What did you do wrong?”
The answer? “You should have resubmitted to another journal. Never give up, especially if you think it’s a worthwhile paper.” Brock-Utne goes on to explain that this happened to him and his colleague in the ’80s, and states exactly how they (mis)handled it, and what he would suggest other researchers do differently.
The ultimate lesson that Brock-Utne has taken from his clinical career also probably helps with large projects of other natures, like writing a book:
Planning is absolutely everything. Without it, you can get yourself into big doodoo, and waste a lot of time… For a researcher, getting published makes your career, and a lack of planning could be the end of you.
Previously: Advice for young docs from psychiatrist David Spiegel: Find a mentor and pursue your passion and The 10 biggest pitfalls in scientific presentations and how to avoid them
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