Education And Debate

What do I want from health research and researchers when I am a patient?

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6990.1315 (Published 20 May 1995) Cite this as: BMJ 1995;310:1315
  1. Iain Chalmers, former clinician and health services researchera
  1. a Oxford OX2 6HX

    I have attempted to adopt the perspective of a patient—albeit one with a rather atypical background—to explore what I want from health research and researchers. This has left me with the impression that health researchers could serve the interests of the public more effectively in a variety of ways, and that they would be helped to do so by greater lay involvement in planning and promoting health research.

    Three years ago—a couple of decades after I first coauthored a research report—I was presented with an opportunity to wind up my career in health services research. An unexpected consequence has been that I have found it easier to ask myself how health research and researchers might serve lay people more effectively. I have begun to ask “What do I want from health research and researchers?”

    Any personal view is inevitably shaped by personal experiences. Fairly soon after I qualified as a clinician I began to realise that my attempts to apply some of the therapeutic principles taught at medical school were sometimes resulting in unnecessary deaths. This sobering experience led me to be sceptical of received wisdom, an attitude that was reinforced when, as a health services researcher, I became aware of the quality of the evidence on which many therapeutic claims are based. It is against this background that, as a patient, I want decisions about my health care to be informed by reliable evidence.

    What do I want from research?

    People are bound to vary in what they regard as reliable evidence. A leap of faith will always be required to make causal inferences about the effects of health care. For example, after about five treatments from a chiropractor to whom she had been referred by her general practitioner, my wife began to believe that chiropractic could help relieve her chronic shoulder and back pain. …

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