Health Care Research Done Right

Leaving "Whodunnit" to Agatha Christie:
Why I Wrote Health Care Research Done Right

When I was a consultant working for a large pharmacy benefits management company some 20 years ago, I noticed two commonly expressed viewpoints about research methods. Although one came from researchers and the other from nonresearchers, both concerned me. And both negatively affect the quality of the medical services we receive and how much we pay for them.

From the vantage point of researchers, especially recent graduates, achieving excellence in health care studies seems daunting at times. First as a principal investigator and then as a journal editor, I would sometimes encounter authors who wanted to abandon otherwise publishable papers after peer review because responding to reasonable journal peer reviewer requests was "too hard." Listening to their answers to my questions about why it was too hard, I learned that many of these researchers had not performed an adequate literature

review, had not developed and vetted a plan prior to starting the project, did not know how to use data management techniques to make reanalysis relatively easy, and/or did not appreciate the value of even misguided peer reviewer comments in lighting the path toward clearer writing. These researchers were skilled in their fields; they just had not been taught the practical techniques needed to make excellence easier.

The nonresearchers' viewpoint was and is, in many respects, more concerning. From the vantage point of some nonresearchers whom I encountered—even those who had to make decisions based on study findings—research was a mystery best left to experts. Lacking formal training in research methods or statistics, decision makers sometimes assumed they were incapable of evaluating the quality of research studies and instead chose to rely on the "whodunnit" method: if a study was written by prestigious authors, was published in a reputable journal, or was funded by a seemingly trustworthy source, it was viewed as valid. Quality assessment was based on "whodunnit."

The problem with "whodunnit" is that none of those factors is a reliable indicator of high-quality research. "Whodunnit" leaves us dependent on the good will of "experts" who may or may not have the best skill sets or the interests of public health in mind. It is my goal to work toward eradicating the "whodunnit" approach to research assessment and help empower both researchers and nonresearchers to evaluate research quality using more reliable metrics. There are signs of research quality that even nonresearchers can understand and use. I'll continue to share those on this blog and elsewhere. Meanwhile, more information about Health Care Research Done Right is available at my website.