![]() ![]() “Useful clinical research” means that it can lead to a favorable change in decision making (when changes in benefits, harms, cost, and any other impact are considered) either by itself or when integrated with other studies and evidence in systematic reviews, meta-analyses, decision analyses, and guidelines. ![]() Experimental intervention studies (clinical trials) are the major design intended to answer such questions, but observational studies may also offer relevant evidence. The term “clinical research” is meant to cover all types of investigation that address questions on the treatment, prevention, diagnosis/screening, or prognosis of disease or enhancement and maintenance of health. ![]() Practicing doctors and other health care professionals will be familiar with how little of what they find in medical journals is useful. Altering our approach could easily produce more clinical research that is useful, at the same or even at a massively reduced cost. The forces driving the production and dissemination of nonuseful clinical research are largely identifiable and modifiable.Most clinical research therefore fails to be useful not because of its findings but because of its design. Many studies, even in the major general medical journals, do not satisfy these features, and very few studies satisfy most or all of them.Many 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.It should make a difference for health and disease outcomes or should be undertaken with that as a realistic prospect. Blue-sky research cannot be easily judged on the basis of practical impact, but clinical research is different and should be useful.Provenance: Commissioned externally peer-reviewed Proprotein convertase subtilisin-kexin type 9 Patient-Centered Outcomes Research Institute PCSK9, The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The author is a member of the editorial board of PLOS Medicine. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: The Meta-Research Innovation Center at Stanford (METRICS) is funded by a grant from the Laura and John Arnold Foundation ( ). Citation: Ioannidis JPA (2016) Why Most Clinical Research Is Not Useful. ![]()
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