Saturday, August 3, 2013

A website to track global health research

In an article in Lancet, the leaders of several large research and funding organizations introduce an intriguing and potentially very useful project to track international research activities in global health:
As the heads of nine major research-funding and research organisations, we have recognised the need to develop a public means to track these international research activities and partnered investments, and to share our results with the broader research and funding community. Such tracking should allow us to analyse and understand the landscape of research, to identify gaps in funding and areas where there might be a duplication of effort, and to work more effectively to synergise our investments. Local investigators could also become more aware of programmes supported in their institutions to develop local networks and collaborations; some African researchers have reported first learning about studies done in their own country by reading about them in scholarly journals. The ultimate goal of this analysis is to encourage an increase in vibrant, productive, competitive, and self-sustaining research communities in these settings.
The website, World RePORT (which is still in beta), has already turned up some interesting tidbits:
The value of the illustrative map and data table is immediately evident when seeking locations and institutions where research endeavours are concentrated and where there are gaps. For example, a search with the keyword “malaria” identifies more than 200 separate research efforts across 17 countries, funded by all nine organisations that provided data. By contrast, a search with the keyword “diabetes” reveals only 16 research activities in seven countries, funded by five organisations. Other diseases seem to receive little funding, including some that are particularly problematic in Africa, such as the neglected tropical diseases (eg, Buruli ulcer, yaws, and human African trypanosomiasis), the non-communicable diseases that are a global priority, and other diseases that are especially burdensome in African populations (eg, sickle-cell disease). World RePORT gives an overview of the clusters of investments in countries. These clusters can then be used to identify research institutes and universities that are well supported centres of excellence, and find gaps where little research is funded by our nine organisations.

Sunday, July 28, 2013

Why Health Systems Are an Unworkable Mess -- Reason #423: Medical Data Is Poorly Understood and Improperly Utilized

Scientists reviewed each issue of The New England Journal of Medicine from 2001 through 2010 and found 363 studies examining an established clinical practice. In 146 of them, the currently used drug or procedure was found to be either no better, or even worse, than the one previously used. The report appears in the August issue of Mayo Clinic Proceedings.
More than 40 percent of established practices studied were found to be ineffective or harmful, 38 percent beneficial, and the remaining 22 percent unknown. Among the practices found to be ineffective or harmful were the routine use of hormone therapy in postmenopausal women; high-dose chemotherapy and stem cell transplant, a complex and expensive treatment for breast cancer that was found to be no better than conventional chemotherapy; and intensive glucose lowering in Type 2 diabetes patients in intensive care, which not only failed to reduce cardiovascular events but actually increased mortality.
From the NYTimes' Well Blog.  The pharmaceutical industry is not mentioned, but it's hard to look at this data and not think of the claims that many pharmaceutical companies spend more on marketing and sales than on R&D.