Sunshine, research and waste at the 2015 REWARD/EQUATOR Conference

Kelsall_Diane_01 croppedDiane Kelsall is Deputy Editor at CMAJ, and Editor of CMAJ Open. She's currently attending the Increasing value and reducing waste in biomedical research conference in Edinburgh, Scotland.

 

Edinburgh is wall-to-wall sunshine. Yet hundreds of researchers, editors, publishers, funders and others are gathered inside. Listening to talks, reading posters and sharing ideas.

What could be more important than enjoying the wonders of Edinburgh on a gorgeous fall day?

Waste.

Not just any waste. Research waste. All the time, effort and money that is thrown away when researchers ask the wrong questions, when study designs are inadequate or inappropriate for the question under study, when studies are not reported appropriately, or when studies are either not published or published in the wrong place.

“Surely most research doesn’t fit into that category,” you say. “There’s lots of great research out there.”

You are both right and wrong. There are many well-conducted studies that answer useful research questions well and are easily accessible to those who need that information to make decisions.

However, it’s estimated that 85% of research is wasted. Money and time and effort that leads to nothing useful. Billions of dollars that could be spent in more productive ways. For higher quality studies - sure - but perhaps the money and effort could also be put to use addressing socioeconomic determinants of health or other factors that could lead to improved lives—or even to save lives.

And that is why those of us attending or presenting at the 2015 REWARD EQUATOR conference are sitting inside for not just one, but three, fabulous sunny days.

What have we learned?

Some presenters focused on the size of the problem. This is sobering. In 2014 in Australia alone, there were 625 years of researcher time lost in preparing grant applications that may have gone nowhere, said Adrian Barnett in his presentation. Doug Altman used the example of p53 as a prognostic marker in bladder cancer. Despite 168 published studies, that used the goodwill and participation of more than 10 000 patients, the evidence was insufficient to conclude whether p53 was useful or not in prognosis. A few examples that illustrate a big problem.

The scope of the problem was also up for discussion. Presenters noted the many places in the research-publishing continuum that contribute to waste. A common theme was the “publish or perish” mantra that rules in so many educational institutions. This attitude, tied in with a continued reverence for the impact factor, results in many studies that add little to our understanding. Some presenters focused on a later phase—the publication process—which is sometimes so cumbersome that studies, such as systematic reviews, are outdated by the time they are publicly available.

We can’t assume, of course, that all this waste is a result of poor research design, ignorance or poor processes. Greed—for money, for prestige for advancement—is an important contributing factor. In the words of Gordon Gecko in Wall Street, “greed works,” as we've seen in the dramatic rise of the predatory journal and prevalent academic misconduct.

It's said that the first step towards healing is acknowledging that there is a problem. Consider this problem acknowledged.

So what's next?

Fixing this isn’t going to be simple. Research waste is a big problem and big problems usually need big solutions. Given the breadth of its causal and contributing factors, solving the problem of research waste will likely need a host of solutions of different sizes for different aspects of waste for different groups. Solutions that focus on methods, reporting, reproducibility,  evaluation, research incentives and more.

Some projects will be large. The EQUATOR network (http://www.equator-network.org/) is working to promote reporting guidelines—282 and counting—for the publication of studies. Improving grant review processes in a system, or changing attitudes around promotion in universities, or enforcing research standards to enhance value are big projects.

Other initiatives will be small. Perhaps a local group of researchers will consult together to ensure that they are asking the right questions. Others may use a reporting guideline to write up an article for publication.

I should probably back track at this point. I said earlier that the problem of research waste was acknowledged. It is—but not as widely as it needs to be if there is going to be any change.

Those sitting inside on a sunny day in Edinburgh are convinced that there is a big problem. What’s needed now is an acknowledgement by those who touch research at any point—that's  funders, patients, clinicians, editors, researchers and others—that research waste exists at a grand scale. It's worth investigating. It's worth pouring money, time and effort into fixing this problem of rampant waste.

Are you convinced? Want to be part of the solution? Check out the Research Waste website and the conference twitter feed for more on the conference, the REWARD statement and ways that you can be involved.

 

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