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Issue #03 (January 2015)

From the Editor

“However, more research is needed ...”

Have you ever seen that line in a journal article? Of course you have. It’s a part of almost every article that we review for NERD. Is more research ever not needed?

A fellow researcher and I would talk about how ubiquitous this phrase was, and whether it really meant anything. He eventually wrote a letter to the editor[1] of an epidemiology journal, including some analysis on how often the phrase was used in major journals. Three years later, I still run across the phrase a dozen times a day. This may never change.

Why is this phrase important? Well, it ties in to one of the most important, yet least talked about issues in health research: when are new trials justified, and what exactly should new trials test? There’s a field of research called “value of information analysis[2],” which places a dollar amount on the public health value of each unit of new research on a given topic.

There are only so many research dollars available. Not every topic can get funding for a large randomized trial, and many important topics go unresearched. I’d like to know whether taking vitamin D in the morning causes different effects than night-time ingestion. Will we see research on this topic? Probably not.

Major issues that have already been addressed by animal studies and observational trials often are next in line for randomized trials, such as the impact of (INSERT NUTRIENT OR DRUG HERE) on heart disease biomarkers in (INSERT POPULATION HERE). Treatment is funded more often than prevention, and multimodal prevention is funded much less often than interventions investigating a single method or pharmaceutical.

Maybe that seems backwards. But it’s not easy to test the combined impact of getting regular sleep, eating mostly unrefined foods, getting time outside in the sun, and carving out time to relax and get some perspective. Actually, it’s pretty difficult to test even one of those interventions. Plus there’s much less money to be made on prevention, especially when it comes to free interventions, than there is to be made by selling treatments.

There’s a phrase that refers to the inherent nature of human existence, including choices and difficulties: The Human Condition. Sometimes, I think there is a counterpart in The Research Condition. Health research is complex and shifting, and somewhat inherently flawed. Single trials can’t conclusively answer questions. Subtle differences in methods and samples lead to different results. Research doesn’t really flip flop very often — it’s just a much more iterative and grueling process than the public knows. And it’s why more research is always needed.


Kamal Patel,
Editor-in-chief, Nutrition Examination Research Digest

See other articles in Issue #03 (January 2015) of Study Deep Dives.

References

  1. ^ James M Gaylor. An overused phrase: interpreted with caution. J Clin Epidemiol. (2013)
  2. ^ Laura Ginnelly, et al. Using value of information analysis to inform publicly funded research priorities. Appl Health Econ Health Policy. (2005)