CORRESPONDENCE: LETTER TO THE EDITOR
Quantity and Quality in Medical Research
Iyad N. Daher, MD* and
Syed Wamique Yusuf, MD
* Department of Cardiology, University of Texas M.D. Anderson Cancer Center, 1400 Pressler, Unit 1451, Houston, Texas 77030 (Email: indaher{at}mdanderson.org).
We read with interest the papers by Kaul et al. (1) and Stone et al. (2), published in a recent issue of the Journal. Both highlight vividly the all too commonly found errors and limitations in current medical literature. While the causes of such a state of affairs are multiple, we believe the sheer volume of scientific papers published nowadays is a major contributor.
To illustrate this point, a PubMed listings search using the criteria "human, randomized controlled trial" reveals an astounding growth in the number of studies published in each 10-year strata, starting February 4, 1950: 1950 to 1960, no items found; 1960 to 1970, 1,076 studies found; 1970 to 1980, 9,622 studies; 1980 to 1990, 36,066 studies; 1990 to 2000, 91,194 studies; and 2000 to 2010, 136,109 studies found. In the past year alone, 11,276 such papers were found using PubMed.
While such a rate of growth may be partly due to widespread use of standardized methodology and the establishment of a worldwide scientific community, less exalted factors such as industry pressures (3) and the "publish or perish" drive (4) may also be at play. It is, therefore, difficult to argue that each or even most of these studies will be sound in their conceptual development, performance, analysis, and interpretation.
In truth, the scientific enterprise has in many ways become the scientific industry, and the challenges we now face transcend technical or methodological limitations. Rather than quantity, we must now focus on quality and its indispensable antecedents, competence and integrity.
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References
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1. Kaul S, Diamond GA. Trial and error. How to avoid commonly encountered limitations of published clinical trials. J Am Coll Cardiol 2010;55:415-427.[Abstract/Free Full Text]2. Stone GW, Pocock SJ. Randomized trials, statistics, and clinical inference J Am Coll Cardiol 2010;55:428-431.[Abstract/Free Full Text] 3. Lanier WL. Bidirectional conflicts of interest involving industry and medical journals: who will champion integrity? Mayo Clin Proc 2009;84:771-775.[Free Full Text] 4. Neill US. Publish or perish, but at what cost? J Clin Invest 2008;118:2368.[CrossRef][Web of Science][Medline]
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Trial and Error: How to Avoid Commonly Encountered Limitations of Published Clinical Trials
- Sanjay Kaul and George A. Diamond
J. Am. Coll. Cardiol. 2010 55: 415-427.
[Abstract]
[Full Text]
[PDF]
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Randomized Trials, Statistics, and Clinical Inference
- Gregg W. Stone and Stuart J. Pocock
J. Am. Coll. Cardiol. 2010 55: 428-431.
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