Value and waste in research

- The Lancet (2014) series on Value and Waste

- Different types of scientific research (basic,
translational and organizational)
- Biased research priorities (clinicians, patients,
payers)
- Lack of use of previous literature
- The replicability problem (transparency regulations
and use of registered protocols)
- The publication bias against negative results
- Lack of interdisciplinary research
- Funding and the careers of researchers (bias)
- Mapping the research portfolio
Health services research – Unibo – Gianluca Fiorentini
 References 1

- Chalmers, Bracken, Djulbegovic, Garattini,

Grant, Gülmezoglu, Howells, Ioannidis, Oliver,
“How to increase value and reduce waste when
research priorities are set”, Lancet 2014
- Ioannidis, Greenland, Hlatky, Khoury, Macleod,
Moher, Schulz, Tibshirani, “Increasing value and
reducing waste in research design, conduct, and
analysis”, Lancet 2014
- Ioannidis, “Why Most Clinical research is not
useful”, PLoS Med 2016

Health services research – Unibo – Gianluca Fiorentini

 References 2

- Ioannidis, “Defending biomedical science in an

era of threatened funding”, JAMA 2017

- Ivanov, Kaczkowska, Khan, Ho, Tavakol ,

Prasad, et al. ”Review and analysis of
publication trends over three decades in three
high impact medicine journals” PLoS ONE,
2017

Health services research – Unibo – Gianluca Fiorentini

 Lancet 2014: Value and waste in research
- Funding for health research is high, but not
increasing, at least not in the US
- Several scholars and other stakeholders believe
that a large part (60-70%) of biomedical research
funds are wasted due to the choice of irrelevant
topics, low methodological quality and lack of
replicability
- The most influential criticism of how (publicly
financed) health research is organized is the
Lancet 2014 series on «Value and Waste» in
research
- The series includes 5 highly quoted papers and
Health services research – Unibo – Gianluca Fiorentini
 Moses et al. JAMA 2015 – Funding USA

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 Value and waste in research

Health services research – Unibo – Gianluca Fiorentini

 Chalmers: Value and waste in research

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 Chalmers: Different types of research

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 Chalmers: Basic research is relevant?

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 Chalmers: funding for types of research

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 Chalmers: Poor value of basic research?

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 Chalmers: translational research

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 Chalmers: funding for different type of
research

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 Chalmers: priorities and burden of diseases

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 Chalmers: needs-led (bed to bench) research

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 Chalmers: Potential users’ needs are ignored

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 Chalmers: lack of reference to previous
literature

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 Chalmers: originality and previous literature

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 Chalmers: the previous literature

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 Chalmers: Priority setting in research

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 Chalmers: No systematic review

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 Chalmers: No systematic review

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 Chalmers: the replicability problem

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 Chalmers: funding replications

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 Chalmers: positive results bias

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 Chalmers: interdiscipl. & clinical reserch

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 Chalmers: mapping the research portfolio

Health services research – Unibo – Gianluca Fiorentini

 Chalmers: mapping the research portfolio

Health services research – Unibo – Gianluca Fiorentini

 Chalmers: mapping the research portfolio

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 Chalmers: James Lind Alliance

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 Chalmers: Value and waste in research

Health services research – Unibo – Gianluca Fiorentini

 Chalmers: Value and waste in research

Health services research – Unibo – Gianluca Fiorentini

 Ioannides et al 2014: Value and waste in
research

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 Ioannidis et al 2014: conflicts of interest

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 Ioannidis et al 2014: conflicts of interest

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 Ioannidis 2014: Protocols for systematic
reviews

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 Ioannidis et al 2014: Recommendations

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 Ioannidis et al 2014: Recommendations

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 Ioannidis JAMA 2015: Reform is needed

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 Ioannidis 2015: Fighting fruitless research

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 Ioannidis 2015: Negative selection for
researchers

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Ioannidis: Funds for «implementation» research

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 Ioannides: Funding and careers

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 Clinical studies - Ivanov et al. Plos One 2017

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 Ivanov et al. Plos One 2017 – Clinical studies

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 Ivanov et al. Plos One 2017 – Clinical studies

Health services research – Unibo – Gianluca Fiorentini

 Ivanov et al. Plos One 2017 – Clinical studies

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