- Asking the wrong questions
- Doing studies that are unnecessary or poorly designed
- Failure to publish results, especially when they are negative
- Biased or unusuable reports
I was especially interested in what they said about their first point, asking the wrong questions. It seems that researchers often have only a dim idea about the questions patients and clinicians wonder about, so those questions are not being answered no matter how much money is spent. Research also focuses on certain areas of medicine, especially drugs and surgery, for obvious financial reasons. According to the authors, there is little research on the effectiveness of physical therapy, leaving patients and doctors guessing what sort of regime will help the most, or help at all.
We have entered a period in the history of medicine in which what we can do far outruns our knowledge of what will actually help people. This has led many policy makers, such as Obama's medical advisers, to call for more research. You can consider this editorial a cautionary note: unless that additional research is carefully designed, it will not really help us plan our health care better.