Research: increasing value, reducing waste

Abstract

The Lancet Series on reducing waste in research is an important contribution from scientists working in institutions in high-income countries.1Macleod MR Michie S Roberts I et al.Biomedical research: increasing value, reducing waste.Lancet. 2014; 383: 101-104Summary Full Text Full Text PDF PubMed Scopus (576) Google Scholar For scientists working in institutions in low-income and middle-income countries (LMICs), one source of relevant waste is the scarcity of opportunities to implement research projects derived from original ideas. Funding is needed to test ideas stemming from scientists, stakeholders, and the general public to identify interventions that can improve the health of their populations. Global investments in health research and development reached US$240 billion in 2010, of which $26 billion were spent in LMICs.2Rottingen J-A Regmi S Eide M et al.Mapping of available health research and development data: what's there, what's missing, and what role is there for a global observatory?.Lancet. 2013; 382: 1286-1307Summary Full Text Full Text PDF PubMed Scopus (190) Google Scholar There are many reasons for this inequitable distribution, such as country-specific fund designations, complex application requirements, and the poor competitiveness of institutions in LMICs. Moreover, scarce research funds in some LMICs are channelled mainly to pure basic research—the “Marie Curie quadrant” mentioned by Iain Chalmers and colleagues in their paper.3Chalmers I Bracken MB Djulbegovic B et al.How to increase value and reduce waste when research priorities are set.Lancet. 2014; 383: 156-165Summary Full Text Full Text PDF PubMed Scopus (805) Google Scholar One example is Argentina, an upper-middle-income country that dedicates only 6% of its biomedical research funds to applied clinical and public health research.4Agencia Nacional De Promoción Científica Y Tecnológica (Anpcyt)Informe De Gestión 2012 (In Spanish).http://www.agencia.mincyt.gob.ar/frontend/agencia/post/916Google Scholar If wasting of research resources is unacceptable for high-income countries, it is outrageous for LMICs. A relevant strategy to reduce waste on research in LMICs is to strengthen centres of excellence on applied research.5Nobre CA Lahsen M Ometto JP Global environmental change research: empowering developing countries.An Acad Bras Cienc. 2008; 80: 523-529Crossref PubMed Scopus (8) Google Scholar, 6UnitedHealth Group/National Heart, LungBlood Institute Centres of ExcellenceA global research network for non-communicable diseases.Lancet. 2013; (published online Oct 3.)http://dx.doi.org/10.1016/S0140-6736(13)61808-5Google Scholar LMICs need strong, sustainable, multidisciplinary, and independent research institutions that are capable of designing and doing studies to assess original, feasible, and appropriate priority interventions. These centres of excellence should have: excellent knowledge of research consumers' needs and expectations; solid infrastructure to undertake innovative and feasible research studies with the goal of generating new knowledge and implementing findings into practice; and the responsibility of building capacity in research methods and expanding the number of research studies by training professionals. We declare that we have no competing interests. Biomedical research: increasing value, reducing wasteOf 1575 reports about cancer prognostic markers published in 2005, 1509 (96%) detailed at least one significant prognostic variable.1 However, few identified biomarkers have been confirmed by subsequent research and few have entered routine clinical practice.2 This pattern—initially promising findings not leading to improvements in health care—has been recorded across biomedical research. So why is research that might transform health care and reduce health problems not being successfully produced? Full-Text PDF How to increase value and reduce waste when research priorities are setThe increase in annual global investment in biomedical research—reaching US$240 billion in 2010—has resulted in important health dividends for patients and the public. However, much research does not lead to worthwhile achievements, partly because some studies are done to improve understanding of basic mechanisms that might not have relevance for human health. Additionally, good research ideas often do not yield the anticipated results. As long as the way in which these ideas are prioritised for research is transparent and warranted, these disappointments should not be deemed wasteful; they are simply an inevitable feature of the way science works. Full-Text PDF Research: increasing value, reducing waste – Authors' replyWe are pleased by the interest in the Series on increasing value and reducing waste in research. The correspondence confirms the importance of the problems we identified and offers additional suggestions about causes and solutions. Full-Text PDF