What is Valid Research?
We use peer-reviewed research articles to base our nursing practice on, and it’s called Evidence-Based Practice (EBP). Peer-reviewed means that scholarly experts in the subject have analyzed the information for validity. For example, the protocol for sepsis is based on EBP. Over time, as more research is conducted, the protocol may be updated as new treatments emerge. However, there are several issues within the medical research community that should give us pause when we are looking at information. In other words, we should not take it for granted that everything we read is completely accurate and unbiased.
There are several concerns about medical research, such as wasted money, quality vs. quantity, reporting bias, and cultural issues.
There is a lot of waste in the research field according to the article, “Reducing Bias and Improving Transparency in Medical Research: A Critical Overview of the Problems, Progress, and Suggested Next Steps” (2020, Bradley, et al). In fact, they claim that 85% of the money used for research is not spent on something that the medical community needs, but rather on what individual medical researchers are given incentives for (2020, Bradley, et al). Because of this bias, studies are not conducted properly, and a lot of the research cannot be replicated (2020, Bradley, et al). And if you remember from science class, an experiment is not valid unless it can be duplicated.
Take for example the research that has come out the past year about Covid-19. There were many publications that published non-peer-reviewed studies (2020, Dobler). When this happens, inaccurate information can be contained in the article, which is then spread over every media outlet like it’s the gospel truth (2020, Dobler). Unfortunately, there are low medical literacy viewers that believe everything that they see and hear on television. This is not their fault, it is the publishers of the misinformation. Often these studies have very small sample sizes and poor study designs (2020, Dobler). Other faults in rushed research are that they have no group to compare results with, and no protocol that is publicly available (2020, Dobler). When no protocols are available, there is no accountability.
Some of the research done on Covid-19 was performed by people who had no experience with respiratory infections, let alone any associates that could help produce authentic work (2020, Dobler). As a result, many gross misunderstandings were accepted by the public. To help us understand the disproportionate accurate versus inaccurate research trials we will look at the trials that took place last year. Out of 1528 studies registered in 2020 with using NIPPV (Noninvasive Positive Pressure Ventilation) for Covid patients, only 3 were randomized. (2020, Dobler). Randomization in medical research using human subjects is a must in order for the results to be unbiased and accurate.
Quality Vs Quantity
Academics are pressured to publish regardless if there is interest or not (2020, Bradley, et al). As you may already know, what is published, studied, and the conclusions are widely based on financial incentives (2020, Bradley, et al). This creates a culture within research to conduct studies that are not objective. For example, the pharmaceutical companies (that we know are rolling in money) often have an institution do a study for them, creating a conflict of interest (2020, Bradley, et al). Pharmaceutical companies evidently can opt-out of proclaiming conflicts of interest,
Every day that we look at a news article, or watch it on television, information is cherry-picked according to the message that they want to convey. The same thing happens with research published by journals or scholarly publications (2020, Bradley, et al). In many cases, if the results of a study have a negative result, then that study is not published (2020. Bradley, et al). What may happen, is that a spin is applied to the information so that it comes across in a more positive, or different manner.
When a study goes through peer review, and the scholars report a bias or that the study does not state the limitations of the study, the report can be ignored (Bradley). And even worse, some researchers are developing their hypothesis after the study is conducted in order to match the results of the study (2020, Bradley, et al).
Some of you may remember when cardiac research was done, it only included men in the study. How then can the results be applied to women? It doesn’t make any sense. Just as doing research without including minorities creates health disparities (2021, Heath). According to the article by Sara Heath, “Why Poor Diversity in Medical Research Threatens Health Equity”, an oncology study in 2019 was broken down as follows:
Due to this process, the complete awareness of a disease process is not being learned.
Ways to Improve
As stated before, in order for the study to be taken seriously, it has to be reproducible. Bradley writes that transparency and positive guidance will improve honesty (2020). He also thinks that there should be a limit on how many studies can be submitted for institutional assessment (2020, Bradley, et al). Also, they need to register their hypothesis, methods, and analysis before a conclusion is found (2020, Bradley, et al). There is a problem, however, with producing individual patient information, so sometimes the data is private and cannot be revealed.
As nurses, we must recognize that there are flaws in the research process that can cause misunderstandings in the patient community. Hopefully, in the future, there will be more regulation of studies performed as well as what is published as unbiased facts.
Bradley, S.H., Devito, N.J., Lloyd, K.E., et al (2020). Reducing Bias and Improving Transparency in Medical Research: A Critical Overview of the Problems, Progress, and Suggested Next Steps. Journal of the Royal Society of Medicine, 113(11).
Dobler, C., (2020). Poor Quality Research and Clinical Practice During Covid-19. Breathe: Practice-Focused Education for Respiratory Professionals, 16(2).
Heath, S., (2021). Why Poor Diversity in Medical Research Threatens Health Equity PatientEngagementHit.