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EVIDENCE-BASED-HEALTH  June 2006

EVIDENCE-BASED-HEALTH June 2006

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Subject:

Re: Fwd: Re: evidence based oncology

From:

Craig Lockwood <[log in to unmask]>

Reply-To:

Craig Lockwood <[log in to unmask]>

Date:

Tue, 20 Jun 2006 07:47:21 +0930

Content-Type:

text/plain

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text/plain (57 lines)

Dear Ben, Roy et al   :)
what a great discussion, very inspiring. Research agendas are frequently
dictated by where the dollars come from, but really what we should consider
doing is identifying research agendas that arise from global health needs, and
that subsequently feed back in to the improvement of global health. The methods
for feeding back in to  improving health should be based on  evidence, and aim
to use evidence to inform priorities specific to the nature and purpose of
service delivery settings and the client base of those varied settings. In
supportive care there is good evidence for a range of therapies. My question is
- do we know what is happening in practice with [b]existing[/b] evidence?

Sorry if im off topic a bit, but would like to see this discussion extend beyond
primary research and include gaps in practice that could/should be addressed.

Cheers
Craig

Quoting Roy Poses <[log in to unmask]>:

> Ben Djulbegovic wrote:
> >Felice, this is a key (if not THE key) issue in modern practice of
> >medicine (oncology including): WHAT should we study? In other words, who
> >should be controlling the RESEARCH AGENDA? As you have alluded, there is
> >increasing dissonance between what is studied and what is actually needed
> >(by patients and practitoners like you and me). Sponsors typically favor
> >generation of one type of evidence, while the users of evidence need
> >different types of answers. Increasingly, calls are being made to define
> >research priorities. Unfortunately, I don't see this happening any time
> >soon. In the mean time, I am afraid you will be proved correct: we will
> >have another permutation on the theme (of trastuzumab, in this case) with
> >no real answers.
> >I wonder what other folks on the list think about defining research
> >priorities? Perhaps this list can help catalyze such a list and then share
> >with the rest of scientific community? So, I am proposing that others
> >respond to your challenge: in your field of interest, what is the research
> >problem (priority) that you'd like to be addressed?
> >thanks for your stimulating thoughts
>
> Right, but aren't we pulling punches a bit here?  Isn't the concern also
> that some commercial sponsors are only interested in certain questions, and
> are most interested if the answer comes out a certain way, i.e., favoring
> their commercial interests?  This was the issue raised by the article by
> Richard Smith in PLoS Medicine:
>
http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0020138
> (Admittedly, other kinds of sponsors may also be driven by financial and
> ideological interests into favoring other kinds of questions, but have not
> been often accused of also trying to manipulate the research and its
> dissemination to produce particular answers.)
>
>
> Roy M. Poses MD
> Clinical Associate Professor
> Brown University School of Medicine
> <[log in to unmask]>
>

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