Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Public disclosure of the cost of research
- Ludovic Reveiz, MD, MSc (28 April 2006)
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Globalisation & Metamorphosis in Healthcare
- Narasimhaiah Srinivasaiah (2 May 2006)
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Assessment of academic research in New Zealand
- Jonathan M Hughes (5 May 2006)
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Medical research: losing the bearings
- Dr. Rajesh Chauhan (5 May 2006)
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prescriptive psychiatric screening
- william alan johnstone (12 May 2006)
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Ludovic Reveiz, MD, MSc, Coordinator General Practice - Epidemiologist Instituto de Investigaciones- Fundación Universitaria Sánitas
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To the Editor, The prospective, universal registration of all studies at their inception has been proposed as a solution to reduce duplication of work, inequitable funding of research and neglected diseases; to avoid research on irrelevant issues or measuring irrelevant outcomes; and to enhance ethical issues and transparency (1,2). Controversy surround scientific and ethic transparency to mitigate publication bias and selective reporting. However disclosure of the cost of research (numerical data) and what portion of that cost is made up with public funding has never formally been published in biomedical journals. Financial support should be disclose with a proper understanding of the costs of the work, provisions for the recovery of those costs, numbers of research students and the ownership of intellectual property (among others) when published in a peer review journal. Public disclosure of cost of research in biomedical journals may contribute to enhance research quality assessment. 1.World Health Organization (WHO). The International Clinical Trials Registry Platform (ICTRP). Available at http://www.who.int/ictrp/en/ . Accessed in September 2005. 2. Krleza-Jeric K, Chan AW, Dickersin K, Sim I, Grimshaw J, Gluud C (for the Ottawa group). Principles for international registration of protocol information and results from human trials of health related interventions: Ottawa statement (part 1). BMJ. 2005; 330(7497):956-8. Competing interests: None declared |
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Narasimhaiah Srinivasaiah, Academic Research Fellow University of Hull, Castle Hill Hospital, Cottingham ,East Yorkshire HU16 5JQ
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Dear Editor, I read with interest the editor’s choice by Fiona Godlee on Where next for the research assessment exercise? In this era of globalisation – metamorphosis is the norm. RAE is going through this process now, and it certainly looks that applied or practice based research & the much in talk qualitative research will bear the brunt of disadvantage. I certainly agree with Roger Jones who is calling for better funding for primary care and health services research, which has been neglected for a good period. I am certainly an advocate to assess research based on the methodology and techniques that improve patient care and revolve around it. I feel we have got a bit too much into the habit of counting numbers, & it is time now to look beyond numbers & have a feel for qualitative research & Mixed methodology. This gives the answer to the Question. Should we screen for depression? And YES is the answer without a doubt. I would like to take a neutral stand on the issue of rewards to the GPs for screening for depression. Psychosocial parameters and assessments should be able to guide & predict which students will struggle at medical school. Increasing Debts & Redundancies is heard more often in the NHS. The move of healthcare from globalisation to regionalisation with the introduction of new immigration laws for Non EU doctors has evoked a feeling of inequality & unhappiness among that section of the workforce. Movement of patients overseas seeking better treatment. All these are indicators of failing healthcare reforms. Bill gates at the World Economic Forum at Davos said "The World is Flat" (which is the title of Mr Friedman's most recent book on globalisation). And it is certainly an irony that when the whole world is moving towards Globalisation Tony Blair & his government are sowing the seeds of regionalisation. If not looked into sooner,the "old monolithic NHS" - the second largest employer in the world will be irretrievable. Competing interests: Qualitative research |
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Jonathan M Hughes, Senior Policy Advisor New Zealand Vice-Chancellor's Committee, Wellington, New Zealand
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One point in your 29 April editorial on the Research Assessment Exercise requires clarification. You state that "Only Hong Kong replicates the intensity of the research assessment exercise, though some countries such as New Zealand intend to adopt similar evaluations." New Zealand's intentions are in fact a reality: the first quality evaluation under our Performance-based Research Fund (PBRF) was held in 2003 and work is well under way for the second (2006) evaluation. Although modelled on the Bristish model, there are a number of differences between the RAE and the PBRF, the most noticeable being that the unit of measure under the PBRF is the individual academic, not the department. Jonathan Hughes
Competing interests: None declared |
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Dr. Rajesh Chauhan, Consultant, Family Medicine, Communicable Diseases & Hospital Administration 309/9 A.V. Colony, Sikandra, AGRA - 282007. INDIA.
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Dear Editor, Your editorial is indeed thought provoking [1]. At the outset, let us acknowledge that researchers are a different personality altogether. All kudos to them and they well deserve the credit for all the better understanding and immense rapid progress that we see all around. The genes and a particular bent of mind with logic, vision, insight, and craving go into making a researcher and environmental influences tend to bring out the best from them. Well-established research institutions providing congenial environment probably serve as a potent stimulant for them, which should be encouraged. Nevertheless, smaller institutes and very insignificant at that may come out with exceptionally bright ideas and must invoke our assistance and commitment. Then at times certain circumstances may be appealing and quite intriguing by themselves and can prod even an uninterested on to do further research – at one’s own behest, irrespective of any institutional support, funding, etc, and all that in one’s own private time. Maybe some encouragement, recognition, and support ought to be reserved for the last category as well. We need not continue reinventing the wheel. However, research on pure sciences is akin to that being done for building blocks, over which future directions and researches would be based. Therefore to think it as a waste must be reconsidered. Additionally, team work should be encouraged. Maybe with better coordination and team work, even the riskier and long term research projects can be undertaken and accomplished successfully. Facilities of internet and other rapid innovations of information technology have already opened up new vistas, creating potentials for multi-centre trials and research with improvement in cross- professional contact and sharing of innovations and research ideas. Riskier and longer term researches can and should also be undertaken more deliberately. The propensity by a few to tarnish the image by plagiarism, falsifying data, outcome and results, unethical research practices, competing interests, etc, must be checked and discouraged. Maybe our system is at fault to a certain extent that provides a fast track based on the quantum of publications. Therefore in the bid to outdo others certain areas are transgressed or bypassed, bringing in a bad repute. Probably yet another skill being honed in is the “football-style transfer market”, that’s mentioned [1], by institutions for the sake of refurbishing the reputation, maybe with wanton desire to sway the benefactors decisions in their favour. Who do you blame- the institution, the “expert footballer”, gullible benefactors, or the changed system and then the question of where to start to set the things right (if we ever consider it)? With warm regards. Reference: 1. Fiona Godlee. Where next for the research assessment exercise? BMJ 2006;332, doi:10.1136/bmj.332.7548.0-f Competing interests: None declared |
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william alan johnstone, retired general practitioner bd11 2je
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In response to your Leader - "Where next for the research assessnent exercise"- I am submitting an opinion which might be a bit dated but may still have relevance. In 1976, 1000 consecutive patients were assesed in my general practice surgery and screened for Minor Psychiatric Disorders using the General Health Questionnaire. When the questionnaires completed by patients attending with physical or situational problems were inspected, it was found that a number of them had,unexpectedly, scored highly. It was arranged to form a index and control series from this group. I found that those with a score over a cutting level could be divided into mild and severe disturbances. A year later, those with mild disturbances had all recovered; all they received in treatment was a sympathetic ear. Those with severe disturbances and treated, were significantly better than those untreated who remained at risk from suicide and chronicity. ( Johnstone,A., and Goldberg, D., Lancet 1976., 1. 605 - 608) This exercise was made in a busy practice and did not require more demands on my services. In screening for any disorder, certain strict criteria must be adhered to before any decision about cost efectiveness can be decided. (Wilson and Jugner, 1968. Principles and Practice of Screening for Disease WHO Geneva p28) These principles were fulfilled for psychiatric screening in general practice. William Alan Johnstone
Competing interests: None declared |
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