BMJ  2006;333:917 (28 October), doi:10.1136/bmj.333.7574.917

Letter

How to formulate research recommendations

Format is not enough

EDITOR—The spectrum of appropriate recommendations for future research cover more than described in the recent very useful article.¹ The recommendation "no further research is needed" is necessary to protect patients from harmful or useless research and to save limited resources for clinical research. This extreme of research recommendations is especially important for systematic reviews of any kind—information assessment, health technology assessment, summing clinical evidence, or Cochrane reviews.

I searched Cochrane reviews for their recommendations, and found that only 17% of reviews do not recommend further research. Reviewers recommend further research even when they have serious reservations about the intervention.² Authors of reviews may abstain from definitive recommendations when they find strange, probably fabricated or manipulated data.

The most serious reason for not recommending "no further research" does not seem to be the absence of the appropriate format of recommendations, but rather the desire to avoid harm to the authors of the original research and damage to the field of their own research. The discussion about the famous example of the excessive research of aproytinin shows that a decision to recommend not to do further trials may be difficult.³

More research is needed and more detailed guidelines need to be created on criteria for recommending "no further research is needed."

Russian branch of the Nordic Cochrane Centre, Cochrane Collaboration, PO Box 13, Moscow 109451, Russia vlassov{at}cochrane.ru

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Competing interests: None declared.

References

1. Brown P, Brunnhuber K, Chalkidou K, Chalmers I, Clarke M, Fenton M, et al. How to formulate research recommendations. BMJ 2006;333: 804-6. (14 October.)[Free Full Text]
2. Vlassov VV. Further research is needed? Cochrane Colloquium, Abstracts. 2004. Ottawa.
3. Fergusson D, Glass KC, Hutton B, Shapiro S. Randomized controlled trials of aprotinin in cardiac surgery: could clinical equipoise have stopped the bleeding? Clin Trials 2005;2: 218-29.[Abstract/Free Full Text]

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Related Article

How to formulate research recommendations

Polly Brown, Klara Brunnhuber, Kalipso Chalkidou, Iain Chalmers, Mike Clarke, Mark Fenton, Carol Forbes, Julie Glanville, Nicholas J Hicks, Janet Moody, Sara Twaddle, Hazim Timimi, and Pamela Young
BMJ 2006 333: 804-806. [Full Text] [PDF]