Intended for healthcare professionals

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Feature Essay

Research waste is still a scandal—an essay by Paul Glasziou and Iain Chalmers

BMJ 2018; 363 doi: (Published 12 November 2018) Cite this as: BMJ 2018;363:k4645

Linked opinion

Is 85% of health research really “wasted”?

Linked opinion

Funders and regulators are more important than journals in fixing the waste in research

Rapid Response:

Re: Research waste is still a scandal—Authors' Responses

We agree with Sharp and Curlewis: All health care students, including medical students, should learn to be critical readers and users of research ("users") [1,2]; few students will wish or need to be able to lead research ("do-ers"). We waste students' time and serve them poorly by assuming that teaching them all to be do-ers will make them good users.

Our experience is the reverse: teaching all health care students and workers to be proficient users of research is essential to them all, and is a great start for the few who will become do-ers. And ideally the do-ers should learn about good - and poor - research from critical appraisal, and ideally by doing at least one systematic review [3], and by working with experienced researchers, as in the STARSurg (STudent Audit and Research in Surgery) multicentre research model.

As pointed out by Sreeharan and Ahmed and colleagues, change will require reduced incentives - for students and academics - to publish what they refer to as "low level publications". Incentives to publish can undermine incentives to "research for the right reasons" (Doug Altman). Poor research is not simply a waste in itself; it also distracts and distorts our institutional, clinical, and publication systems for doing research for the right reasons.

1. Glasziou P, Burls A, Gilbert R. Evidence based medicine and the medical curriculum. BMJ. 2008 Sep 24;337:a1253
2. Albarqouni L, Hoffmann T, Straus S, et al. Core Competencies in Evidence-Based Practice for Health ProfessionalsConsensus Statement Based on a Systematic Review and Delphi Survey. JAMA Netw Open.2018;1(2):e180281. doi:10.1001/jamanetworkopen.2018.0281
2. Mahtani KR. All health researchers should begin their training by preparing at least one systematic review. J R Soc Med. 2016 Jul;109(7):264-8.

Competing interests: Prof Glasziou is co-Director of an EQUATOR Centre and Chair of the REWARD Alliance.

03 December 2018
Paul Glasziou
GP Researcher
Iain Chalmers, James Lind Initiative
Bond University
University Drive, Robina, Australia