Wait a minute...did someone actually publish an article on how most clinical medical research isn't useful, AND that we should change how we perform clinical research? Yes, colleagues, and not just anyone...this work comes to us from the Meta-Research Innovation Center (METRICS) at Stanford. If you're a fan of statistics, quality improvement, & the art involved with "the literature" you already know that they're correct! Here, then, is a new favorite article for your bank of clinical articles. Please don't take this to mean that we can't learn and improve or that all literature is bunk. Take it to mean that we must be very careful about what clinical research we allow to change what we do. After all, as a wise clinician once taught me: if 80% of articles ask the wrong question, another 80% use the wrong methods to answer the question they ask, and another 80% draw the wrong conclusions from the results they get (of course, some articles have two or three of these issues at once), shouldn't we be very selective in which work we accept as valid? And, because we know that, shouldn't we work to change how we do things as a profession to focus on more meaningful & applicable clinical research?
Any of the features that make clinical research useful can be identified, including those relating to problem base, context placement, information gain, pragmatism, patient centeredness, value for money, feasibility, and transparency. Many studies, even in the major general medical journals, do not satisfy these features, and very few studies satisfy most or all of them. Most clinical research therefore fails to be useful not because of its findings but because of its design. The forces driving the production and dissemination of nonuseful clinical research are largely identifiable and modifiable.