Bathing in good evidenceBMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1934 (Published 03 May 2018) Cite this as: BMJ 2018;361:k1934
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The quoted claim that over 80% of research is wasted might surprise, if not distress, many. However, the various factors pointed out by Tom Moberly appear factual and real, more so in the context of the U.S. and some Western European countries. One of the significant factors in clinical trials tends to be the role played by industry: it is obvious and abundantly clear that new drug development is expected to generate profit. Occurrence of bias is likely in trials of healthcare interventions and may often favour sponsors' products. (1) Transparency and methodological limitations could be issues in industry trials. Better constructive partnerships should develop between industry and academics (2) promoting EBM in its true sense judged by Cochrane review, generally accepted.
Amazing profundity in clinical diagnostic acumen, with the contributory intuitive component and 'empirical' treatment that was effective - defying and imperfecting the algorithms of AI of today - was a feature of leading faculty of medical institutions in India, now in their seventies and beyond. With sound and accurate understanding of the clinical realities, multidimensional innovations and the concept of integral nature (3), policy can be shaped. Research efforts in India are now more focussed and relevant. Viewing the global scenario, it is clear that several areas / regions of the world require enunciation, formulation and execution of meaningful research when epigenetics with its modulations and 'precision' medicine and advances in vascular biology fascinate the clinical-scientific community.
1. Jorgensen AW , Hilden J , Gotzsche PC. Cochrane reviews compared with industry supported metanalyses and other metanalyses of the same drugs: systematic review. BMJ 2006. October 14 ;333 (7572) :782. PM IS 17028106.
2. Laterre PF, Francois N. Clinical Microbiolgy and Infection. Vol 21 , Issue 10 , October 2015 , 906 -909.
3. Yeolekar ME. Editorial. Medical and Health Research in India: Issues and Directions. J Assoc. Physicians of India. Vol 55 , August 2007, 545-46.
Dr Murar E Yeolekar, Mumbai.
Competing interests: No competing interests