Editor—The spectrum of appropriate recommendations for future research cover more than described in the recent very useful article.1 The recommendation “no further research is needed” is necessary to protect patients from harmful or useless research and to save limited resources for clinical research. This extreme of research recommendations is especially important for systematic reviews of any kind—information assessment, health technology assessment, summing clinical evidence, or Cochrane reviews.
I searched Cochrane reviews for their recommendations, and found that only 17% of reviews do not recommend further research. Reviewers recommend further research even when they have serious reservations about the intervention.2 Authors of reviews may abstain from definitive recommendations when they find strange, probably fabricated or manipulated data.
The most serious reason for not recommending “no further research” does not seem to be the absence of the appropriate format of recommendations, but rather the desire to avoid harm to the authors of the original research and damage to the field of their own research. The discussion about the famous example of the excessive research of aproytinin shows that a decision to recommend not to do further trials may be difficult.3
More research is needed and more detailed guidelines need to be created on criteria for recommending “no further research is needed.”
Competing interests: None declared.
References
- 1.Brown P, Brunnhuber K, Chalkidou K, Chalmers I, Clarke M, Fenton M, et al. How to formulate research recommendations. BMJ 2006;333: 804-6. (14 October.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Vlassov VV. Further research is needed? Cochrane Colloquium, Abstracts. 2004. Ottawa.
- 3.Fergusson D, Glass KC, Hutton B, Shapiro S. Randomized controlled trials of aprotinin in cardiac surgery: could clinical equipoise have stopped the bleeding? Clin Trials 2005;2: 218-29. [DOI] [PubMed] [Google Scholar]