A deluge of poor quality research is sabotaging an effective evidence based response
The medical research world is responding to the covid-19 pandemic at breathtaking speed. There has been a maelstrom of global research, with mixed consequences. Positives include the greater provision of open access to covid-19 studies, some increased collaboration, expedited governance and ethics approvals of new clinical studies, and wider use of preprints. But many problems have become evident. Before the pandemic, it was estimated that up to 85% of research was wasted because of poor questions, poor study design, inefficiency of regulation and conduct, and non or poor reporting of results.1 Many of these problems are amplified in covid-19 research, with time pressures and inadequate research infrastructure contributing.
A fabulous editorial piece by Paul P Glasziou, et al about all the …noise/junk… being rushed to publication about COVID-19. An important read. We have included links to 21 related reads. Who is hurt by this questionable behaviour? Us as we wait tensely for a cure.
An extraordinary number of covid-19 trials have been registered since the pandemic started. The National Library of Medicine registry ClinicalTrials.gov lists 1087 covid-19 studies, and though some will provide useful information, many are too small and poorly designed to be helpful, merely adding to the covid-19 noise. Of the 145 registered trials of hydroxychloroquine, for example, 32 have a planned sample size of ≤100, 10 have no control group, and 12 are comparative but non-randomised. Outcome measures vary widely, and only 50 seem to be multicentre. Strikingly, only one provides a protocol, and even limited registry details reveal unjustified outcome switching.2
The imbalance in trial topics is worrying, in particular the paucity of trials on non-drug interventions. Despite non-drug interventions being the mainstay of current mitigation,3 we could find just two trials of masks on ClinicalTrials.gov and none examining social distancing, quarantine effect or adherence, hand hygiene, or other non-drug interventions. Covid-19 research funding mirrors this woeful imbalance. A search of Covid-19 Research Project Tracker, a live database of funded covid-19 projects, found almost no primary research of the effects of non-drug interventions on transmissibility, compared with hundreds of drug intervention projects worth at least $74m (£60m; €67m).
Glasziou, P. P., Sanders, S. & Hoffmann, T. (2020) Waste in covid-19 research. BMJ 2020; 369 :m1847