October 28, 2015

Reaping the REWARDS of practical research


Dr. Eric B. Larson, Group Health vice president for research, comments on what GHRI can do in The Lancet campaign to reduce research waste.

Welcome to Notes from the Vice President for Research. I’ll be using this new platform to communicate monthly with GHRI, Group Health leaders, and interested community leaders about issues important to our work together.
—Dr. Eric B. Larson, MD, MPH

What a contrast! This fall, the clinical journal The Lancet launched the REWARD campaign, for REduce research Waste And Reward Diligence. REWARD asks everyone involved in funding, conducting, and reporting biomedical science to get better value from our research dollars. At the same time, the Nobel Prizes were announced, celebrating high-value science. With research being lauded by accolades as renowned as the Nobel Prizes, should we care about the REWARD movement?

My answer is “yes.” Of the one-third of a trillion dollars annually invested worldwide in biomedical research, much is unintentionally wasted, The Lancet reports. You can read about the inefficiencies such as poor study design, analysis, and reporting in articles from REWARD. While the common cry of research universities, institutes, scientists, and many politicians is that research is underfunded, in 2010, global expenditure on life science research (mostly biomedical) was $240 billion. The United States is the largest funder, with about $70 billion in commercial and $40 billion in governmental and nonprofit funding annually: slightly more than 5 percent of U.S. health care spending. Recent national budgets for science have been flat, but at least we are over the economic challenges of 2012 and 2013. Yet passionate researchers naturally seek more resources for their work.

I believe that a more critical issue than total dollars for research is how we set funding priorities and make decisions to attain high-value results. Initiatives like REWARD can guide us toward getting a better return on our biomedical research investment, measured as impact on our health. Here at Group Health Research Institute (GHRI), our research already goes a long way to meeting REWARD suggestions. For example, one source of waste is projects that are not important to end users. GHRI works closely with users of our research—health care systems, clinicians, and patients—to address issues of high priority to them. In fact, because we do practical research that is ideally “shovel ready” to be translated into clinical care, we are in an excellent position to achieve value for the research dollars we are granted.

What is research value?

Recognizing value may be the key to getting the best return on our research investment. A recent editorial by John P.A. Ioannidis, MD, DSc, that capped a nine-month JAMA series on "Scientific Discovery and the Future of Medicine" asked, "Is It Possible to Recognize a Major Scientific Discovery?" Dr. Ioannidis notes that most research resulting in Nobel Prizes and Lasker Awards does not meaningfully extend average lifespan. Although this year’s Nobel Prize for the discovery of drugs to treat parasitic diseases such as malaria may be an exception, I agree with Dr. Ioannidis: rather than new prescription drugs, what usually gives people longer and better lives is reducing smoking, increasing physical activity, improving diet, optimizing pregnancy and perinatal care, and ensuring a healthy environment. Dr. Ioannidis also cites the importance of addressing violence and socioeconomic inequalities.

I hope these issues sound familiar. For more than 30 years, applied research at GHRI has contributed to advances in many of these areas. We will continue to work to help people enjoy better health, avoiding disease when possible, and improving the management of diseases and chronic conditions when they arise.

Please watch for future messages from me that will describe GHRI’s efforts to contribute to REWARD and the relevant lessons we're learning in partnership with our health care system, clinicians, and patients. I'll suggest research priorities that are likely to provide great value for our health and well-being and I’m interested in hearing your ideas as well.