Challenges for the research physician

Medical knowledge is constantly evolving. However, scientific research is not only characterized by progress: there are risks of misleading results and conclusions that cannot be trusted. So how can we ensure that medical research is reliable, transparently reported, and delivers the greatest possible clinical benefit? This pivotal theme deals with important challenges for the clinician as both a consumer and a research leader.

According to the VA Scale (https://va.se), the public has high search confidence. But in Sweden and in the world around us, scandals have affected trust in medical research. Misconduct as well as flaws in research procedures and inadvertent errors threaten research integrity. Systematic trials in various branches of biomedical research have shown that a large proportion of published results cannot be confirmed when studies are repeated. This indicates that there is significant room for improvement in the implementation and reporting of research. The researcher does not have to face this challenge alone, but universities, research funders, and journals need to take on their institutional responsibility.

Today’s massive research output has made the clinically active physician increasingly dependent on research overviews and clinical guidelines. However, the process of accumulating knowledge can be undermined by conflicts of interest and various kinds of distortion (bias). Systematic reviews and meta-analyses relied on comprehensive reporting of study findings, regardless of the nature of the findings. However, it is still common practice for ‘negative’ results not to be published, which is why treatment effects tend to be overestimated in meta-analyses.

How the researcher chooses to analyze the data is also important. There can be plenty of room to analyze the data until you reach a result that is desirable for some reason, eg because it shows a statistically significant effect. This analytical flexibility combined with selective reporting further contributes to the overestimation of effects in medical research.

Metascience is called the branch of research that, using quantitative empirical methods, examines the research itself: how it is carried out, reported, funded, and evaluated.

This topical issue addresses a series of highly topical meta-scientific topics and aims to bring to the attention of clinicians and researchers the challenges related to transparency and reproducibility in medical research today.

We wish you a rewarding reading!