"Modern medical advances have helped millions of people live longer, healthier lives. We owe these improvements to decades of investment in medical research."
“Research” is defined as “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to knowledge.”
1. Introduction
The types of medical research are varied, and include-
• biomedical research
• epidemiological studies
• health services research
• studies of behavioral, social, and profitable factors affecting health
➢ Significance of health research: Health research is of high value to society, as enumerated in the following paragraphs:
a. Helps understand the epidemiology of the disease-
It can provide important information about the trends in conditions and diseases, associated risk factors, treatment or public health intervention outcomes, functional abilities, patterns of care, and health care costs and use. The different approaches to research give in-depth perceptivity.1
b. Efficacy and Adverse Effects of medical interventions-
Clinical trials going on in the ICMR (Indian Council of Medical Research) and various clinical research organizations can give important information about the efficacy and adverse effects of medical interventions.
There are ongoing clinical trials in the Indian Council of Medical Research, on numerous medical areas, such as Ayurveda, Allopathy, Siddha, Physiotherapy, Unani, and Stem Cell Therapy.2
A Contract Research Organization or Clinical Research Organization (CRO) is a service organization that provides support to the pharmaceutical and biotechnology industries in the form of pharmaceutical research services. They provide services like Clinical Research Services, Consulting, Outsourcing Services, Medical Communications, and Medical Affairs.3
Although, feedback from real-world clinical experience is also pivotal for comparing and perfecting the use of drugs, vaccines, medical devices, and diagnostics.1
c. Helps discover and develop new curative therapies-
Tracking clinical experience with the drug, after the drug has been approved, is important for identifying relatively rare adverse effects and determining effectiveness in different segments of the population or in varying circumstances.
As Doctors, it is vital to record and assess your valuable clinical practice experience to develop recommended guidelines for top practices and ensure high-quality patient care.
Jointly, these forms of health research are leading to significant discoveries, the development of new curative and palliative therapies, and a remarkable enhancement in health care and public health.1
d. Benefits for public health and the national economy-
Economists have found that medical research impacts human health and longevity, enormously and that the resulting enhanced productivity of the population contributes significantly to the national economy (Hatfield et al., 2001; Murphy and Topel, 1999), in addition to the individual benefits of bettered health. If the research is hampered, overall interests are affected.1
2. Need for clinical research knowledge by doctors
➢ Clinical trials hold mammoth potential for benefiting patients, improving therapeutic regimens, and ensuring development in evidence-based medical practice.
➢ In order to gain public trust in clinical trial data, it is important for transparency, accountability, and accessibility. This is achievable only if all clinical trials conducted are registered in a centralized clinical trials registry.
➢ The Clinical Trials Registry- India (CTRI), launched in 2007 (www.ctri.nic.in) and hosted at the ICMR's National Institute of Medical Statistics (http://icmr-nims.nic.in), is a completely free and electronic public record system for the registration of clinical trials in India. Initiated as a voluntary measure, trial registration in the CTRI has been made mandatory by the Drugs Controller General (India) (DCGI) (www.cdsco.nic.in). Additionally, Editors of Biomedical Journals of 11 major journals in India declared that only registered trials would be considered for publication.
➢ Any researcher who plans to conduct a trial involving human participants, of any intervention such as drugs, surgical procedures, preventive measures, lifestyle modifications, devices, educational or behavioral treatment, rehabilitation strategies as well as trials being conducted in the purview of the Department of AYUSH (http://indianmedicine.nic.in/) is expected to register the trial in the CTRI prior to enrollment of the first participant.
➢ Trial registration includes public declaration and identification of trial investigators, sponsors, interventions, and patient population, before the enrollment of the first patient. Submission of Ethics approval and DCGI approval (if applicable) is essential for trial registration in the CTRI. Multi-country trials, where India is a participating country, must also be registered in the CTRI.4
3. How can research benefit patients and their health?
➢ Advanced patient safety
Numerous medical errors are not the result of human error, but rather, due to the lack of a system designed to prevent errors in new situations—something which medical research can give.
➢ Better patient outcomes
Institutions that participate in and share medical research are more likely to follow clinical guidelines and apply new therapies swiftly, resulting in better outcomes than those of patients treated, conventionally in a non-research setting. A 2008 study concluded that compliance with clinical guidelines was better, and mortality among patients with acute coronary syndromes ran lower in institutions that took part in medical research.
➢ Higher patient engagement
When patients are given the chance to take part in clinical trials, they gain a further understanding of their condition and how to manage it. They also form a stronger connection with their physician, resulting in increased patient retention.5
4. How can medical research benefit healthcare practice?
➢ Use of clinical research in the medical field
Physicians involved in medical research are frequently invited to co-author papers about the trial results in scientific journals. Participation in clinical trials also allows healthcare providers to stay on the cutting edge of medicine and provides openings to unite and collaborate, as well as network with healthcare professionals from around the world.
➢ Superior treatment options
The data from clinical trials is evidence-based and is not based on the personal experiences of a doctor. When a clinician is involved in a medical trial, he or she can use this objective information to think critically about each patient’s plan of care and make better data-driven treatment choices.
➢ Industry contribution
Physicians who take part in a clinical trial can take pride in knowing they have contributed directly to medical advancement, and that their efforts have impacted the profession, in total.
Just as continuing medical education is part of a provider’s constant professional development, so too should be participating in clinical research. Clinical trials positively impact not only the doctor, but also the institution, and the patients, benefitting society at large.5
5. Historically Renowned Doctors, who changed the world, through their clinical Research.6
Physicians who have stood out for their medical research, and for what they have done to save and restore health and well-being for their patients, their communities, and society as a whole, are famous worldwide.
To this end, here are some famous physicians who—through thorough research, innovation, hard work, and dedication—have changed the face of medicine and how it is practiced today.
➢ Edward Jenner, MD, FRS, FRCPE: Discovered vaccinations
➢ Sir Alexander Fleming, MD: Discovered penicillin
➢ Georges Mathé, MD: Discovered treatment for leukemia
➢ Helene D. Gayle, MD: HIV/AIDS research, public health
6. What is the future of Clinical Research?
Advances in health information technology are enabling a metamorphosis, in health research that could facilitate studies that weren’t doable in the past, thus leading to new insights regarding health and disease.
The future lies in having clinically rich information that is readily available, in a more structured format, with electronic exchange through the health and healthcare continuum. As a result, the information can be better used for quality enhancement, public health, and research, and can significantly contribute to advancements in health and health care for individuals and populations. Information technologies can facilitate research in healthcare, by enabling broader sharing of health data while still guaranteeing regulatory compliance and guarding patient privacy.
Science today is also changing by leaps and bounds and is getting more complex. No single researcher or single research site can bring all the expertise to develop and validate medical innovations. Hence, effective sharing of information between institutions has become even more key than in the past, when there were fewer new therapies. The growth of treatment options, as well as the mounting expense of new therapies, requires greater scrutiny of the true effectiveness of these treatments. Studies on large populations, with registries of patient characteristics, outcomes, and adverse events, are required to facilitate the comparison, and to calculate risk and benefit estimates.
Information-grounded research, such as research using health information databases has a number of advantages (reviewed by Lowrance, 2002). It is often faster and less expensive than experimental studies. It can dissect veritably large sets of data and may detect unanticipated marvels, that might not be included in a controlled experimental study.1
“Research is to see what everybody else has seen, and to think what nobody else has thought.”
-Albert Szent-Gyorgyi
References:
1. Beyond the HIPAA Privacy Rule. Enhancing Privacy, Improving Health Through Research
Contributors. Institute of Medicine (US) Committee on Health Research and the Privacy of Health Information: The HIPAA Privacy Rule. Washington (DC): National Academies Press (US); 2009. ISBN-13: 978-0-309-12499-7. https://www.ncbi.nlm.nih.gov/books/NBK9571/
2. Clinical Trials Registry- India. ICMR. https://ctri.nic.in/Clinicaltrials/advancesearchmain.php
3. List of Clinical Research Organizations in India. Pharma Tutor. https://www.pharmatutor.org/articles/list-of-clinical-research-organizations-in-india
4. Clinical Trials Registry- India. ICMR. https://ctri.nic.in/Clinicaltrials/login.php
5. 9 Reasons Providers Should Take Part in Clinical Research. https://www.gebauer.com/blog/reasons-providers-should-take-part-in-clinical-research
6. 10 doctors who changed the world. MD Linx. https://www.mdlinx.com/article/10-doctors-who-changed-the-world/lfc-3582.
