Clinical research in primary care needs urgent boostBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7548.1036-b (Published 27 April 2006) Cite this as: BMJ 2006;332:1036
- Roger Jones, Wolfson professor of general practice ()
EDITOR—Let us hope that the cogent arguments advanced by Rothwell in support of more and better clinical research in the United Kingdom begin a serious dialogue that will correct the asymmetries in research funding, kudos, and leadership that have developed over the past 5-10 years.1 Rothwell's arguments apply with even greater force to the need for a clinical research effort in primary care and in health services research on topics such as the natural history of common diseases; the value of interventions, both therapeutic and preventive; and critically, as Rothwell points out, the difficulties of individualising risk and benefit in a single patient on the basis of large scale trials.
In addition to the clinical research networks described in the new NHS research and development strategy, adequate project and programme funding must be made available to support the research that Rothwell identifies. This includes follow-up studies of large cohorts of patients after the completion of therapeutic trials, health economic evaluations of interventions, studies of the success or otherwise of getting newly proved interventions into practice, research aimed at improving understanding of patients' willingness to accept therapeutic and preventive interventions, and high quality health services research to define the optimum ways of providing new services.
There is an urgency about this. The impending research assessment exercise has led to quick-fix institutional solutions, including playing the research star transfer market and redistributing clinical academic funding to support laboratory based research. Non-clinical researchers underestimate the need for clinical research, partly because they simply can't see it and partly because it is likely to be uncomfortable in terms of their own priorities. They need to understand that translational doesn't simply mean getting the protein out of the test tube into the zebra fish, but getting the therapeutic intervention into the patient and the population.
Competing interests None declared.