Angry scientists, angry analysts and angry novelists

Abstract

To the Editor: Professor Bonora has written a critique looking back at his career in diabetes research since the 1970s and we reflect on his critique by also looking back at our careers in clinical endocrinology (Professor Doi) and clinical epidemiology (Prof Doi and Dr Abdulmajeed). Prof Bonora starts off by flagging the proliferation of papers that are repetitive, redundant and unable to provide relevance to the reader [1]. He goes on to claim that this is because of the contribution of meta-analyses to such research waste, even though the situation is no better for ‘primary’ research given that 85% of all research funding is actually wasted due to inappropriate research questions, faulty study design, flawed execution, irrelevant endpoints, poor reporting and/or non-publication [2-4]. He then observes that, in the past, meta-analyses were virtually non-existent (implying that they were initially well regulated and subsequently became dysregulated) [1]. The reality is that meta-analysis was formalised relatively recently (by G. Glass) in 1977 [5, 6] and later updated by DerSimonian & Laird in 1986 [7] and finally by Doi et al in 2015 [8, 9]. There can therefore be no expectation that, in the field of diabetes, there would be many studies reporting a meta-analysis earlier than the 1990s. We agree that, today, there is an increased publication rate for meta-analyses, but this is also seen for study designs that collect primary data, and many of these publications similarly lack value when compared with existing ones on the same topic. Therefore, far from this being a problem with meta-analyses, such waste is happening because those tasked with research in diabetes, especially clinicians, are not well trained in clinical epidemiology, which is the science behind good clinical research and evidence-based clinical decision making.