No place for incompetence in clinical research

I WOULD like to thank Dr Darren Ong Chung Lee ( The Star, Aug 7) and Dr Ramesh Rao (Aug 16) for their thoughtful responses to my letter “No mere academic activity” (Aug 5).

Firstly, allow me to reiterate that my comments and observations were strictly confined to clinical (medical) research as I am not familiar with research norms in the other branches of science or non-science fields. Clinical research is applied directly to treat future patients. Incompetent research has real world consequences for patients.

The purpose of giving local medical journals grants is to upgrade their facilities. Currently, it is difficult for doctors reading a research publication to highlight errors as it has to go through the editors who may choose to publish corrections or not. Some editors see corrections as an admission of editorial incompetence. Some journals (with the finances) have various forms of “Rapid Response” systems to allow timely calling out of errors. Less well-funded journals may rely on “sponsorships” by entities with conflict of interest situations such as pharmaceutical companies. This is obviously undesirable, so government grants are a help.

The dynamics and information flow system surrounding medical research are perhaps different to those in other branches of science.

We have international bodies such as the World Health Organisation who play a big role in disseminating information. Countries are connected as diseases can spread rapid- ly from one country to another. There is no real danger of any country being cut off from mainstream medical practice just because local research data is published in local journals.

In fact, the journal editorial and peer review process can be strengthened by putting it under the watchful eyes of medical councils, directors or ministers of health. Researchers will be guaranteed a fair and very public peer review of their work. Patients can rest assured that they are not being shortchanged by incompetent clinical researchers. Further, it is unlikely that those without the necessary qualifications will volunteer or be appointed to become editors and peer-reviewers.

I am not certain what Dr Lee means by “powerful senior scientists”. Clinical research is usually only conducted by registered medical practitioners. All aspects of medicine come under the regulatory authority of medical councils and governments. That is how high standards are maintained. Doctors can and do lose their medical council registrations to practise for research misconduct (fraud and fabrication). Research fraud and fabrication are perhaps easier to investigate. However, research misconduct (incompetence) is harder to investigate. We would need a permanent panel who are familiar with the technical aspects of medical research.