Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research
Increasing disparities between resource inputs and outcomes, as measured by certain health deliverables, in biomedical research
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DOI：
10.1073/pnas.1504955112
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发表时间：
2015-09-08
影响因子：
11.1
通讯作者：
Casadevall, Arturo
中科院分区：
文献类型：
--
作者：
Bowen, Anthony;Casadevall, Arturo
社会对生物医学研究进行了大量投资，寻求改善人类健康的方法。这项研究的成果主要是发表在科学期刊上的信息。对科学的持续投资依赖于社会对研究结果的准确性、诚实性和实用性的信心。最近对生产力的关注主导了对科学家的竞争性评估，创造了激励措施，以最大限度地提高出版数量，引用计数和高影响力期刊的出版物。一些研究还表明，已发表文献的质量有所下降。社会对生物医学研究的投资在改善健康成果方面的效率尚未得到研究。我们发现，尽管资源投入和科学知识不断增加，但过去五十年来的生物医学研究成果（根据美国食品和药物管理局批准的预期寿命和新分子实体估计）仍然相对稳定。美国国立卫生研究院在这段时间的研究投资与出版物和作者数量相关，但与新疗法的数量发展无关。我们考虑了几种可能性的投入-产出差距不断扩大，包括事先消除更容易的研究问题，增加专业化，过度依赖还原论，不成比例地强调科学产出，以及其他对科学企业的负面压力。监测研究投资在产生积极社会成果方面的效率，可能是衡量科学企业改革成效的一个有用机制。了解生物医学研究中投入与成果差距日益扩大的原因可能会提高社会对科学的信心，并为未来不断增长的研究投资提供支持。
Society makes substantial investments in biomedical research, searching for ways to better human health. The product of this research is principally information published in scientific journals. Continued investment in science relies on society's confidence in the accuracy, honesty, and utility of research results. A recent focus on productivity has dominated the competitive evaluation of scientists, creating incentives to maximize publication numbers, citation counts, and publications in high-impact journals. Some studies have also suggested a decreasing quality in the published literature. The efficiency of society's investments in biomedical research, in terms of improved health outcomes, has not been studied. We show that biomedical research outcomes over the last five decades, as estimated by both life expectancy and New Molecular Entities approved by the Food and Drug Administration, have remained relatively constant despite rising resource inputs and scientific knowledge. Research investments by the National Institutes of Health over this time correlate with publication and author numbers but not with the numerical development of novel therapeutics. We consider several possibilities for the growing input-outcome disparity including the prior elimination of easier research questions, increasing specialization, overreliance on reductionism, a disproportionate emphasis on scientific outputs, and other negative pressures on the scientific enterprise. Monitoring the efficiency of research investments in producing positive societal outcomes may be a useful mechanism for weighing the efficacy of reforms to the scientific enterprise. Understanding the causes of the increasing input-outcome disparity in biomedical research may improve society's confidence in science and provide support for growing future research investments.