Medical Research Ignores & Duplicates Previous Research: Ignorance Can Kill

"Few principles are more fundamental to the scientific and ethical validity of clinical research than that studies should address questions needing to be answered, and that they are designed in a way that will produce a meaningful answer.  A prerequisite for either of those goals is that relevant prior research be properly identified."  This quote come from a paper published this month (click image) showing that about 1/4 of medical research cites NO relevant previous clinical trials done by other labs, another 1/4 cite only 1 previous trial, and on average researchers cite only 2 trials, when in reality there are anywhere from 4 to 60 previous clinical studies (average of 10) that they should cite. 

This paper goes on to say what we all know but do not follow: "Accurate representation of the prior cumulative evidence is necessary both to ethically justify a trial and to make proper inferences.  Studying prior research also can lead to designs more likely to fill evidence gaps.  Although the presence of a trial citation does not tell us how information from that trial was used, the absence of a citation almost guarantees that it was not."  It gets better:  "The findings here show not just that the prior evidence is understated but also that it is barely acknowledged."

And when you thought it couldn't get any worse: "Our finding of very limited citation is particularly concerning because it indicates that evidence is missing and because selection of the few trials that are cited is likely to have been biased." 

Ignorance leads to hubris as scientists believe their ideas and research are new and unique when they are not: "When we examined the introduction and discussion sections in the reports of 30 trials...we found that reports were not...integrating their findings with the trials they did cite, and several claimed to be the first trial even when many trials preceded them."  In other words, medical researchers completely ignore most published research similar to their work, select a few references that bolster their work, but even in that case do not integrate the results of the references they cite with their own, choosing instead to duplicate and interpret their work within the vacuum of their isolated mind.

Ignorant hubris leads to immorality: "An incomplete picture of preexisting evidence violates the implicit ethical contract with research participants [meaning patients participating as subjects] that the information they provide [as well as their time, effort, consumption of medications, and suffering they endure for the trial] is necessary and will be useful to others."

As you can read for yourself in the abstract (click image), the "potential implications include ethically unjustifiable trials, wasted resources, incorrect conclusions, and unnecessary risks for trial participants."  Put more harshly, if we worked together a little more by paying attention to each other's efforts (this is true for researchers and for all of us in most areas of our lives, including myself), we would not only get more done but maybe even live longer and be happier in the process.  With respect to medical research, wasted effort, resources and time obviously equates to lost years of life for patients.  Stupidity is not always harmless: It can be lethal.  As is discussed in a 2005 paper in the journal called 'Clinical Trials', this is "an ongoing scandal in which research funders, academia, researchers, research ethics committees and scientific journals are all complicit."