The prognosis for research

The costs of mistakes in biomedical research include the opportunity cost of misallocated resources and direct harm that leads to suboptimal prevention and treatment. Some scientists have recently questioned the quality of clinical and epidemiological research1 2 3; in the linked article (doi:10.1136/bmj.b4184), Hemingway and colleagues highlight “the tide of low quality, low impact, prognosis research.”4 They outline 10 steps to improving such research, and they include in their recommendations the advance registration of study protocols and new guidelines for reporting the results of prognosis research.

The main areas of clinical research encompass studies of diagnosis, prognosis, and treatment. Why should prognosis research be singled out? If the overall aim of clinical research is to improve prognosis, the path towards that end involves accurate diagnosis and effective treatment. With improving diagnostic techniques and evolving treatments, prognosis research may always be in flux and out of date. Indeed, if prognosis research for a disease is current and accurate, it might imply that prevention and treatment for that disease are stagnant.

No doubt the quality of much prognosis research could be improved, but we wonder why this area merits special mention. Problems affecting the quality of research are not restricted to studies of prognosis. Among the many factors that influence research quality throughout the spectrum of biomedical studies are the consistency and quality of training, …