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Feature Essay

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

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4645 (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—an essay by Paul Glasziou and Iain Chalmers

There is no argument with the reasons for rigour in research; the need to fulfil requirements and follow proper procedures is not in doubt. Where this rigour is not available is in the occasional chance finding; when an outcome is so unexpected that the normal preliminaries could not have been followed because the actual result was considered impossible. Clearly in this circumstance one cannot go back in time to provide the basic information required if the outcome is to be reported for others to research in more detail.

It can be argued that single serendipitous findings are rare, and so they are, but if they cannot be reported because of lack of rigour and process then progress will be slowed or not made at all.

Two examples:

1. A recent case of regression of symptoms of vascular dementia with Alzheimer's and return to near-normal cognition requires strong prior assessments and diagnostic procedures to avoid suggestions of incorrect diagnosis as a reason for the event. These cannot be done retrospectively but are not done routinely in the NHS where the diagnosis was made. Yet the outcome is worthy of report for follow-up by someone with foresight and funds.

2. A case of rapid resolution of trigeminal neuralgia without drug intervention relied on an accurate diagnosis in the first instance but it cannot be returned to after resolution has occurred. Fortunately this has now been taken to clinical trial in India.

It will be a shame if unachievable standards stop publication and potential follow-up of such events.

Competing interests: No competing interests

10 December 2018
Andrew J C Carmichael
Charity researcher
Parkinson's Improvement Programme
Preston