Registration of health and medical research

Registration of health and medical research is an effective way of improving the transparency and credibility of evidence. Registration involves pre-specifying the research objectives, design, methods and analytic plan on a publicly accessible repository before conducting the study. Registration can reduce bias and improve the transparency and credibility of research findings. Registration is mandated for clinical trials, but it is also relevant to systematic reviews, observational and preclinical experimental research. This paper describes how researchers can register their research and outlines possible barriers and challenges in doing so. Widespread adoption of research registration can reduce research waste and improve evidence-informed clinical and policy decision making.

Identify, quantify, act: tackling the unused potential of ecological research

‘Ignorance is expensive’. The statement also applies to ignorance of research inefficiencies that can generate huge waste: 85% of health research, amounting to $170 billion annually, is avoidably wasted. This alarming finding elicited a number of responses that have since reduced the waste in health research. Commonality of research and dissemination practices implies that other scientific fields could also benefit from identifying and quantifying waste and acting to reduce it. Yet, no estimate of research waste is available for other fields. Given that ecological issues interweave most of the UN sustainable development goals, we argue tackling research waste in ecology should be prioritized.Our study leads the way. We estimate components of waste in ecological research, based on a systematic review and a meta-analysis. Shockingly, our results suggest only 11%-18% of conducted ecological research reaches its full informative value. Our duty towards science, environment, organisms we study, and the public dictates that we should urgently act and reduce this considerable yet preventable loss, and harness the full potential of ecological research. We propose to achieve this through actions from researchers, funders, journals, and academic institutions. Finally, we call for other research fields to adopt our framework and derive comparable estimates across scientific disciplines.

Identifying the gaps, reducing the waste, and setting priorities in Cochrane gynaecology research

Objective The aim of this project was to identify gaps and research waste in the dissemination of Cochrane gynaecology evidence in the Cochrane database of systematic reviews (CDSR). Design A research article Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Trials looking at benign gynaecological conditions, contained in the CGF specialised register, published between the years 2010-2011. Methods Gynaecology trials from the CGF specialised register were matched, by the specific gynaecological issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 740 trials, published from 2010 to 2011, were exported from the specialised register, after removing duplicates and out of scope trials, 185 of these trials were found to be already included in Cochrane reviews. 422 trials were found to be unused, however 192 (26%) of these could be included in an existing CGF SR if it were updated. 230 trials (32%) were not matched to any review title and from these 21 new review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Plant and herbal extracts for symptoms of menopause’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for women with gynaecological problems.

Major Mistakes and Errors in the Use of Trial Sequential Analysis in Systematic Reviews or Meta-analyses – Protocol for a Systematic Review

Background: Adequately conducted systematic reviews with meta-analyses are considered the highest level of evidence and thus directly defines many clinical guidelines. However, the risk of type I and II errors in meta-analyses are substantial. Trial Sequential Analysis is a method for controlling these risks. Erroneous use of the method might lead to research waste or misleading conclusions. Methods: The current protocol describes a systematic review aimed to identify common and major mistakes and errors in the use of Trial Sequential Analysis by evaluating published systematic reviews and meta-analyses that include this method. We plan to include all studies using Trial Sequential Analysis published from 2018 to 2021, an estimated 400 to 600 publications. We will search Medical Literature Analysis and Retrieval System Online (MEDLINE) and the Cochrane Database of Systematic Reviews (CDSR), including studies with all types of participants, interventions, and outcomes. The search will begin in July 2021. Two independent reviewers will screen titles and abstracts, include relevant full text articles, extract data from the studies into a predefined checklist, and evaluate the methodological quality of the study using the AMSTAR 2 (Assessing the methodological quality of systematic reviews). Discussion: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). The identified mistakes and errors will form the basis of a reviewed guideline for the use of Trial Sequential Analysis. Appropriately controlling for type I and II errors might reduce research waste and improve quality and precision of the evidence that clinical guidelines are based upon.

Identifying the gaps, reducing the waste and setting priorities in Cochrane fertility research: Research article

Objective The aim of this project was to identify gaps and research waste in the dissemination of fertility evidence in the Cochrane database of systematic reviews (CDSR). Design A research article. Setting The Cochrane Gynaecology and Fertility (CGF) Group’s specialised register of random controlled trials (RCTs). Sample Infertility trials contained in the CGF specialised register, published between the years 2010-2011. Methods Infertility trials from the CGF specialised register were matched, by the specific fertility issue and treatment, to existing Cochrane reviews. Unmatched trials were categorised to develop and prioritise new review topics. Main outcome measures Proportions Results 564 trials, published from 2010 to 2011, were exported from the specialised register and after removing duplicates, 318 trials were found to be already included in a Cochrane review. 187 (37%) of trials were found to be unused, however 115 (23%) of these could be included in an existing CGF SR, if it were updated. 72 trials (14%) were not matched to any review topic and from these, eight new Cochrane review titles were developed. The topic with the largest number of associated ‘unused’ trials, was ‘Traditional Chinese Medicine for women undergoing assisted reproductive techniques’. Conclusions This project was used to consider unused trials, prioritise new review topics and identify those reviews that need to be updated, thereby identifying the gaps in evidence for couples with fertility problems. Keywords research waste, gaps, fertility, infertility, randomized controlled trials, systematic reviews, prioritisation.