To kick off the celebration of PLOS Medicine‘s 15th Anniversary, Specialty Consulting Editor Sanjay Basu discusses the journal’s contributions to scientific communication and his favorite article from the past 15 years.
It’s fitting that one of PLOS Medicine’s most viewed and cited articles remains the cult classic, Why Most Published Research Findings Are False (2005). The article codifies the challenge taken up as a mantle by the contributors and editors of PLOS Medicine for the last 15 years: to make science more transparent, reproducible, and trustworthy.
Thirteen years after first highlighting the problem of research that was nonsensical or misleading– often due to p-hacking and other practices that slice and dice results to find a “significant” outcome– PLOS Medicine also published a new framework for maximizing the value of clinical research (Academic response to improving value and reducing waste: A comprehensive framework for INcreasing QUality In patient-oriented academic clinical REsearch (INQUIRE), 2018). The framework flew under the radar by comparison to articles concerning the problem of low-value clinical research, but the article remains one of my favorite PLOS Medicine articles of the last 5 years. It stands out as having applied a Delphi process among key stakeholders across 16 countries to generate consensus among patient advocacy groups, academics, and even pharmaceutical industry representatives to rigorously apply key criteria before implementing new research studies. In that spirit, the article’s methods essentially allowed all of the key stakeholders to agree to say, “stop producing more papers–first, have a better plan to avoid publishing more nonsense”–a somewhat bizarre, but refreshing, message to see in a medical journal.
Some of the key results from the Delphi process are surprising to see, as they would eliminate many current research grants and published articles. They include evaluation dimensions and criteria such as: whether the analysis code is open, clearly documented, and reproducible; whether junior scientists such as students and fellows are appropriately acknowledged for their contribution to the research; whether statisticians were involved early on and given discretion to avoid reporting subgroup slices as “significant” findings; and whether the results are made accessible (both in terms of avoiding a paywall, and in terms of readability and language) to the broad public–including policy-makers, trial participants, and patients affected by the results.
But perhaps more compelling is that the INQUIRE framework was not just presented and agreed upon, but actually adopted and implemented in Switzerland. The Swiss Clinical Trial Organization network and its affiliated researchers have applied INQUIRE to help ensure that Swiss research funding is not wasted on clinical research that fails to produce useful insights.
This article, like so many published in PLOS Medicine over the past 15 years, highlights how research that furthers Open Access science and medical publishing can meaningfully impact large, systematic problems such as the perverse incentives that exist in medical research. As PLOS Medicine continues on its path towards another fifteen years of publishing success, we can look forward to more articles that make an impact on the quality of medical science, and the need to look inwards at our industry to ensure its processes and incentives align further with the concerns of patients and the needs of public health.