Biostatistics Consortium Improving Quality Of Medical Research

Efficiency is the maximal output at least cost, where cost is not just financial but also manpower, expertise, and time. Realizing that variations exist in all processes including medical research, statistical thinking in terms adequate consideration of uncertainties has tremendous potential to streamline the process of medical research. Since this process can substantially differ from institution to institution, the BCI can be commissioned to study the research process in any particular institution and suggest measures to improve research efficiency after identifying the bottlenecks and irritants. For this, the institutions may have to give up the attitude that "We have always done it that way".

Improvement in efficiency primarily depends on the attitude of the management regarding maximizing output for fixed input. Whereas this is clearly visible for profit in private hospitals and for consultations in government hospitals, most medical organizations lack similar keenness for research. They may be encouraging research but the incentives are few, if at all.

BC can provide assistance to these hospitals in conducting seminars and workshops that can help in imparting skills for guiding DNB theses. Such activities can also help in conducting more efficient research without much investment of time and resources, and in developing an aptitude of research among the initiators. Efficiency in research in these hospitals can also be achieved by anonymous utilization of data of their patients, which can be easily done these days as most of such data are already digitized. The only requirement is proper organization of these databases so that the required information can be easily extracted for research purposes. BC would be happy to lend its services for these activities.

Most medical colleges and institutions, both private and public, have built-in mechanism to promote research but the emphasis mostly is on quantity rather than quality. Some colleges take pride in stating in their annual report that hundreds of papers were published and feel happy by improved ranking due to such numbers. Few, if any, particularly in India and other developing countries, can claim path-breaking research that has made impact on health management. When we talk of efficiency, we also include quality at lower cost (Figure). This requires repeated interaction with the researchers to reinforce the need to do quality research without wasting much of resources in producing quantity. Research methodology has defining role in this process. The management and the seniors have responsibility to provide environment that encourages creativity among students and faculty, and ignores status-quoists who resist change. Institutional authorities may like to identify faculty who are keenly interested in quality research, form a committee, and organize seminars and workshops on importance of quality research. BCI can help in developing a framework of such activities and in identifying external experts for this purpose, particularly for methodology part of research

Many private hospitals these days have realized the importance of research in building up their reputation, and in the positive attitude and confidence research endeavours develop among their consultants. In addition, many private hospitals run Diplomate of National Board (DNB) courses where thesis is an integral part. Despite strict regulation by the National Board of Examinations, most DNB theses turn out to be run-of-the-mill products containing replication of previous work and hardly any innovation. These hospitals may like to invest into their research efforts so that they reap real benefits in terms of better reputation as a quality hospital and well-informed consultants with latest developments. This can help them to reach to a better clientele.
The medical consultants in many private hospitals too have inclination for research. These consultants serve as guide and co-guide for the thesis of their DNB students but find themselves ill-equipped to provide adequate guidance. This happens mostly because they were not exposed to the modern research methodology. BCI can provide assistance to these hospitals in conducting seminars and workshops that can help in imparting skills for guiding DNB theses. Such activities can also help in conducting more efficient research without much investment of time and resources, and in developing an aptitude of research among the initiators. Efficiency in research in these hospitals can also be achieved by anonymous utilization of data of their patients, which can be easily done these days as most of such data are already digitized. The only requirement is proper organization of these databases so that the required information can be easily extracted for research purposes. BCI would be happy to lend its services for these activities.