benefits from medical research

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Clinical Research: Benefits, Risks, and Safety

On this page:

What are the potential benefits of participating in clinical research?

What are the potential risks of participating in clinical research, will i always get the experimental treatment in a clinical trial, how is the safety of clinical research participants protected.

If you’re interested in volunteering for clinical research, you may wonder: What makes a study a good fit for me? How do I know it’s safe? Clinical research involves studying health and illness in people through observational studies or clinical trials . Participating in a trial or study has many potential benefits and also some possible risks. Learn about the benefits and risks of participating in clinical research and how your safety is protected.

There are many possible benefits of being part of clinical research, including:

• You may have the chance to help scientists better understand your disease or condition and to advance treatments and ways to prevent it in the future.
• You may feel like you’re playing a more active role in your health.
• You may learn more about your disease or condition.
• You may be able to get information about support groups and resources.

In addition, some people participate in clinical trials because they hope to gain access to a potential new treatment for a disease before it is widely available.

Clinical trials and studies do come with some possible risks, including:

• The research may involve tests that pose a risk to participants. For example, certain physical tests may increase the chance of falling, and X-rays may cause a small increase in the risk of developing cancer.
• Participating in a study could also be inconvenient for you. For example, you may be required to have additional or longer medical appointments, more procedures, complex medication instructions, or hospital stays.

Additional risks of participating in clinical trials may include:

• For those who receive the experimental treatment, it may be uncomfortable or cause side effects (which can range from mild to serious).
• The experimental treatment might not work, or it may not be better than the standard treatment.
• For trials testing a new treatment, such as a new medication or device, you may end up not being part of the group that gets the experimental treatment. Instead, you may be assigned to the control (or comparison) group. In some studies, the control group receives a placebo, which is given in the same way as the treatment but has no effect.

Participant confidentiality is a concern in any kind of research. People other than the researchers, such as the study sponsors or experts who monitor safety, may be able to access medical information related to the study. Safeguards are in place to ensure that researchers tell potential participants what information could be shared and how their privacy will be protected before they consent to participate in research.

The study coordinators will provide detailed information and answer questions about the risks and benefits of participating in a particular study. Having this information can help you make an informed decision about whether to participate.

Clinical trial volunteers do not always get the treatment being tested. The gold standard for testing interventions in people is called a randomized controlled trial. Randomized means that volunteers are randomly assigned — chosen by chance — to receive either the experimental intervention (the test group) or a placebo or the current standard care (the control or comparison group). Then, researchers compare the effects in each group to determine whether the new treatment works.

When you enroll in a clinical trial, you may be assigned to the test group or to the control group. While participants in the control group do not receive the experimental treatment, these volunteers are just as important as those in the test group. Without the control group, scientists cannot be sure whether an experimental treatment is better than the standard or no treatment.

In many cases, you won’t know until the end of the trial whether you are in the test group or the control group. That’s because knowing the group assignment might influence the results of the trial. Studies are often “blinded” (or “masked”) to prevent this accidental bias. In a single-blind study, you are not told whether you are in the test group or the control group, but the research team knows. In a double-blind study, neither you nor the research team knows what group you are in until the trial is over. If medically necessary, however, it is always possible to find out which group you are in.

What is a placebo?

Whenever possible, clinical trials compare a new treatment for a specific condition to the standard treatment for that condition. When there is no standard treatment available, scientists may compare the new treatment to a placebo, which looks like the drug or treatment being tested but isn’t meant to actually change anything in your body. A pill that doesn’t contain any medicine is one example.

A trial that uses a placebo is described as a “placebo-controlled trial.” In this type of study, the test group receives the experimental treatment, and the control group receives the placebo.

Placebos are not used if an effective treatment is already available or if you would be put at risk by not having effective therapy. You will be told if placebos are used in the study before entering a trial as part of the process of informed consent.

What happens if a clinical trial ends early?

Most clinical trials run as planned from beginning to end. However, sometimes researchers end trials early. Clinical trials may be paused or stopped for a number of reasons:

• There is clear evidence that one intervention is more effective than another. When this happens, the trial may be stopped so that the new treatment can be made available to other people as soon as possible.
• The trial shows that the treatment doesn’t work or causes unexpected and serious side effects.
• The researchers can’t enroll enough people in the trial to provide meaningful results.

Even when a clinical trial ends early, it can still provide researchers with valuable information. For example, scientists may gain insights about how to best design and conduct clinical trials in a specific research area. In some cases, health information collected during a trial can lead to new potential therapies that researchers can test in the future.

Based on many years of experience and learning from past mistakes, strict rules are in place to keep participants safe . Today, every clinical investigator in the United States is required to monitor and make sure that every participant is safe. These safeguards are an essential part of the research.

Each clinical study follows a careful study plan, called a protocol, which describes what the researchers will do. The principal investigator, or head researcher, is responsible for ensuring the protocol is followed.

Safeguards to protect clinical research volunteers include Institutional Review Boards, informed consent, Data and Safety Monitoring Boards, and Observational Study Monitoring Boards.

• Most clinical studies in the U.S. must be approved by an Institutional Review Board (IRB) . The IRB is made up of doctors, scientists, and members of the general public who ensure that the study participants are not exposed to unnecessary risks. The people on the IRB regularly review the study and its results. They make sure that risks (or potential harm) to participants do not outweigh the potential benefits of the study.
• Informed consent also helps protect participants. Informed consent is the process by which you learn the key facts about a study before deciding whether to participate. Members of the research team explain the research before you start and throughout the study. They provide an informed consent document, which includes details about the study, such as its purpose, how long it will last, required procedures, and who to contact. The informed consent document also explains risks and potential benefits. You are free to ask questions, request more information, or withdraw from the study at any time.

Clinical trials and studies also have committees that monitor the safety of the research as it occurs.

• Clinical trials that test an intervention are closely supervised by a Data and Safety Monitoring Board . The board is made up of experts who review the results of the study as it progresses. If they determine that the experimental treatment is not working or is harming participants, they can stop the trial early.
• Observational Study Monitoring Boards monitor the safety of observational studies with large or vulnerable populations, or risks associated with tests or standard of care.

Several historical incidents have caused mistrust in clinical research. These events also led to the creation of laws that provide clinical research participants with multiple levels of protection.

One example is the U.S. Public Health Service Syphilis Study at Tuskegee , which was conducted between 1932 and 1972. In this study, researchers wanted to determine the effects of untreated syphilis. They did not explain the study’s risks or obtain informed consent from the participants, all of whom were Black men. They also did not offer the study participants penicillin when it became widely available in the mid-1940s, causing preventable illness and suffering. After news of the study leaked in 1972, it led to sweeping changes in standard research practices and guidelines to protect human research participants. Today, IRBs are responsible for reviewing all studies involving humans to ensure they meet these guidelines and for reporting any study plan that breaks the rules.

After obtaining all the information, you can make an informed decision about whether or not to participate in a clinical trial or study. If you decide to volunteer for clinical research, you will be given an informed consent form to sign. By signing the form, you show that you understand the details and want to be part of the research. However, the informed consent form is not a contract. You may leave the study at any time and for any reason.

Where can I find a clinical trial or study?

Looking for clinical research related to aging and age-related health conditions? There are many ways to find a trial or study. Talk to your health care provider and use online resources to:

• Search for a clinical trial or study .
• Look for clinical trials on Alzheimer’s disease, other dementias, and caregiving .
• Find a registry for a particular diagnosis or condition .
• Explore clinical trials and studies funded by NIA .

To learn more about a particular trial or study, you or your doctor can contact the research staff and ask questions. You can usually find contact information in the study description.

You may also be interested in

• Getting more information about clinical trials and studies
• Downloading and sharing an infographic with the benefits of participating in clinical research
• Learning about participating in Alzheimer's disease research

For more information about clinical research

Clinical Research Trials and You National Institutes of Health www.nih.gov/health-information/nih-clinical-research-trials-you

ClinicalTrials.gov www.clinicaltrials.gov 

U.S. Food and Drug Administration 888-463-6332 [email protected] www.fda.gov

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 18, 2023

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Why Is Medical Research Important?

Medical research has become an important part of the health care industry, and advances in technology have made it possible for much of it to be done on an outpatient basis, meaning that investigators sometimes don’t need to do extensive studies in a research facility. The field of medical research is one of the most interesting fields in all of science because of its focus on science and medicine in conjunction with a great deal of research.

Medical research covers a wide variety of studies, stretching from ‘baseline’ investigation, through systematic reviews and to the cutting-edge of medical science. It involves the study of all human diseases or may have only disease-specific research. For example, AIDS research includes both studying patients who have AIDS and those who do not, as well as studying children with AIDS and children without AIDS. Similarly, researchers may be investigating the causes of Parkinson’s disease in old age and Parkinson’s disease in young adulthood.

4 Phases of Medical Research Studies

The four phases of Medical Research Studies are experimental, comparative/expository, understudy, and last, analysis and validation/regression.

• Comparative/expository medical research compares experimental and comparative samples from which the study population is developed; compare post hoc comparisons with the initial data; evaluates associations among variables measured.  
• Understudy studies consist of data from observational studies and random chance sampling.
• Experimental refers to clinical trials that are done specifically to test a new medical product, device, or technique.  
• Finally, validation/ regression Research studies compare new designs or drugs to earlier designs and evaluate their effect on any association found.

There are many reasons why medical research is so valuable. Whether you aim to start a career in this field or to gain more knowledge about health conditions and their treatments, it’s important to understand the benefits that medical research provides. You can learn about medical research at http://hrmdresearch.com/ .

The Importance Of Medical Research

The breakthroughs that people enjoy today are virtually unimaginable without the knowledge gained through medical research. Here are some of the most important reasons medical research is important:

• Generate Valuable Insights

Medical research helps people learn more about themselves and their health. The knowledge gained by medical research is constantly improving.

• With new scientific information coming from medical studies, people will be able to take care of their health and well-being more effectively.
• It also seeks to understand the reasons for diseases, to discover new methods of preventing or controlling diseases, and to develop treatments for these diseases and their effects.

2. Development Of New Drugs

Medical research must be done to find a cure for diseases and illnesses. Without medical research, medicine and other medical innovations as we know it could not exist. Sometimes called pharmaceutical research, medical research encompasses a broad spectrum of scientific studies. It starts with the research and development of drugs, followed by treatments and procedures used in clinical practice.  

The process of new drug development may involve the following steps:

• It can be done in several different ways, including doing laboratory experiments in bioresources such as blood and cells, or cell culture, to studying the effects of chronic exposure to toxins, drugs, hormones, and other compounds in the environment.  
• Other research is directed toward understanding disease mechanisms, to find better ways of treating or preventing disease, and how disease progression is influenced by environmental factors.  

3. Improve The Quality Of Life

Medical researchers don’t just look for ways to manage the symptoms of diseases, they try their best to find a cure for a specific illness or a group of diseases. There are several ways drug research and testing improve the quality of life:

• Medical studies that aid in the development and administration of vaccines allow people to live without worrying about deadly diseases. An example will be the ongoing development and clinical trials for the COVID-19 vaccine which may help the world go back to normal.
• Some people can live with their conditions for years by understanding how to manage them properly. As time goes by, everyone is also learning how to prevent certain illnesses from occurring and even eliminate them.

Why is medical research so important? Medical research saves lives every day. Scientists and researchers work day and night to develop new treatments, drugs, and procedures. Without the help of dedicated scientists, doctors, and other medical professionals, the advances made would be slow and limited.  

When a patient participates in a trial, they must undergo several physical tests and provide some information about their lifestyle and diet. The findings and insights derived from these studies and trials are invaluable in coming up with treatments and cures for various health conditions.

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• Open access
• Published: 03 March 2015

Health research improves healthcare: now we have the evidence and the chance to help the WHO spread such benefits globally

• Stephen R Hanney 1 &
• Miguel A González-Block 2  

Health Research Policy and Systems volume  13 , Article number:  12 ( 2015 ) Cite this article

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There has been a dramatic increase in the body of evidence demonstrating the benefits that come from health research. In 2014, the funding bodies for higher education in the UK conducted an assessment of research using an approach termed the Research Excellence Framework (REF). As one element of the REF, universities and medical schools in the UK submitted 1,621 case studies claiming to show the impact of their health and other life sciences research conducted over the last 20 years. The recently published results show many case studies were judged positively as providing examples of the wide range and extensive nature of the benefits from such research, including the development of new treatments and screening programmes that resulted in considerable reductions in mortality and morbidity.

Analysis of specific case studies yet again illustrates the international dimension of progress in health research; however, as has also long been argued, not all populations fully share the benefits. In recognition of this, in May 2013 the World Health Assembly requested the World Health Organization (WHO) to establish a Global Observatory on Health Research and Development (R&D) as part of a strategic work-plan to promote innovation, build capacity, improve access, and mobilise resources to address diseases that disproportionately affect the world’s poorest countries.

As editors of Health Research Policy and Systems ( HARPS ), we are delighted that our journal has been invited to help inform the establishment of the WHO Global Observatory through a Call for Papers covering a range of topics relevant to the Observatory, including topics on which HARPS has published articles over the last few months, such as approaches to assessing research results, measuring expenditure data with a focus on R&D, and landscape analyses of platforms for implementing R&D. Topics related to research capacity building may also be considered. The task of establishing a Global Observatory on Health R&D to achieve the specified objectives will not be easy; nevertheless, this Call for Papers is well timed – it comes just at the point where the evidence of the benefits from health research has been considerably strengthened.

The start of 2015 sees a dramatic increase in the body of evidence demonstrating the benefits arising from health research. Throughout 2014, the higher education funding bodies in the UK conducted an assessment of research, termed the Research Excellence Framework (REF), in which, for the first time, account was taken of the impact on society of the research undertaken. As part of this, UK universities and medical schools produced 1,621 case studies that aimed to show the benefits, such as improved healthcare, arising from examples of their health and other life sciences research conducted over the last 20 years. Panels of experts, including leading academics from many countries, published their assessments of these case studies in December 2014 [ 1 ], with the full case studies and an analysis of the results being made public in January 2015 [ 2 , 3 ].

As we recently anticipated [ 4 ], the expert panels concluded that the case studies did indeed overwhelmingly illustrate the wide range and extensive nature of the benefits from health research. Main Panel A covered the range of life sciences and its overview report states: “ MPA [Main Panel A] believes that the collection of impact case studies provide a unique and powerful illustration of the outstanding contribution that research in the fields covered by this panel is making to health, wellbeing, wealth creation and society within and beyond the UK ” [ 3 ], p. 1. The section of the report covering public health and health services research also notes that: “ Outstanding examples included cases focused on national screening programmes for the selection and early diagnosis of conditions ” [ 3 ], p. 30. In their section of the report, the international experts say of the REF2014: “ It is the boldest, largest, and most comprehensive exercise of its kind of any country’s assessment of its science ” [ 3 ], p. 20.

The REF2014 is therefore attracting wide international attention. Indeed, some of the methods used are already informing studies in other countries, including, for example, an innovative assessment recently published in Health Research Policy and Systems ( HARPS ) identifying the beneficial effects made on healthcare policies and practice in Australia by intervention studies funded by the National Health and Medical Research Council [ 5 ].

The REF also illustrates that, even when focusing on the research from one country, there are examples of studies in which there has been international collaboration and which have built on research conducted elsewhere. For example, one REF case study on screening describes how a major UK randomised controlled trial of screening for abdominal aortic aneurysms (AAA) involving 67,800 men [ 6 , 7 ] was the most significant trial globally. The trial provided the main evidence for the policy to introduce national screening programmes for AAA for men reaching 65 throughout the UK [ 2 ]. The importance of this trial lay partly in its size, given that it accounted for over 50% of the men included in the meta-analyses performed in the 2007 Cochrane review [ 8 ] and the 2009 practice guideline from the US Society for Vascular Surgery [ 9 ]. Nevertheless, two of the three smaller studies that were also included in these two meta-analyses came from outside the UK, specifically from Denmark [ 10 ] and Australia [ 11 ].

Moreover, a recent paper published in HARPS also included descriptions of how the research contributing to new interventions often comes from more than one country. These accounts are included in a separate set of seven extensive case studies constructed to illustrate innovative ways to measure the time that can elapse between research being conducted and its translation into improved health [ 12 ]. While being a separate set of case studies, one of them does, nevertheless, explore the international timelines involved in research on screening for AAA, and, in addition to highlighting the key role of the UK research, it also highlights that the pioneering first screening study using ultrasound had been conducted in 1983 on 73 patients in a US Army medical base [ 13 ].

These case studies therefore further reinforce the well-established argument that health research progress often involves contributions from various countries. However, as has long been argued, not all populations fully share the benefits. In recognition of this, in May 2013, the World Health Assembly requested the World Health Organization (WHO), in its resolution 66.22, to establish a Global Observatory on Health Research and Development as part of a strategic work-plan to promote innovation, build capacity, improve access, and mobilise resources to address diseases that disproportionately affect the world’s poorest countries [ 14 ].

As editors of HARPS , we are delighted that our journal has been invited to help inform the establishment of the WHO Global Observatory by publishing a series of papers whose publication costs will be funded by the WHO. In support of this WHO initiative, Taghreed Adam, John-Arne Røttingen, and Marie-Paule Kieny recently published a Call for Papers for this series [ 15 ], which can be accessed through the HARPS webpage.

The aim of the series is “ to contribute state-of-the-art knowledge and innovative approaches to analyse, interpret, and report on health R&D information… [and] to serve as a key resource to inform the future WHO-convened coordination mechanism, which will be utilized to generate evidence-informed priorities for new R&D investments to be financed through a proposed new global financing and coordination mechanism for health R&D ” [ 15 ], p. 1. The Call for Papers covers a range of topics relevant to the aims of the Global Observatory. These include ones on which HARPS has published articles in the last few months, such as approaches to assessing research results, as seen in the Australian article described above [ 5 ]; papers measuring expenditure data with a focus on R&D, as described in a recent Commentary by Young et al. [ 16 ]; and landscape analyses of platforms for implementing R&D, as described in the article by Ongolo-Zogo et al. [ 17 ], analysing knowledge translation platforms in Cameroon and Uganda, and partially in the article by Yazdizadeh et al. [ 18 ], relaying lessons learnt from knowledge networks in Iran.

Adam et al. also make clear that the topics listed in the Call for Papers are examples and that the series editors are also willing to consider other areas [ 15 ]. Indeed, in the Introduction to the Call for Papers, the importance of capacity building is highlighted. This, too, is a topic described in recent papers in HARPS , such as those by Ager and Zarowsky [ 19 ], analysing the experiences of the Health Research Capacity Strengthening initiative’s Global Learning program of work across sub-Saharan Africa, and by Hunter et al. [ 20 ], describing needs assessment to strengthen capacity in water and sanitation research in Africa.

Finally, as we noted in our earlier editorial [ 4 ], the World Health Report 2013: Health Research for Universal Coverage showed how the demonstration of the benefits from health research could be a strong motivation for further funding of such research. As the Report states, “ adding impetus to do more research is a growing body of evidence on the returns on investments … there is mounting quantitative proof of the benefits of research to health, society and the economy ” [ 21 ]. We noted, too, that since the Report’s publication in 2013, there had been further examples from many countries of the benefits from medical research. The REF2014 in the UK signifies an additional major boost to the evidence that a wide range of health research does contribute to improved health and other social benefits. The results of such evaluations highlight the appropriateness of the WHO’s actions in attempting to ensure all populations share the benefits of health research endeavours by creating the Global Observatory on Health Research and Development. This will not be an easy task, but we welcome the opportunity afforded by the current Call for Papers for researchers and other stakeholders to engage with this process and influence it [ 15 ].

Abbreviations

Abdominal aortic aneurysms

Health Research Policy and Systems

Main Panel A

Research and development

Research Excellence Framework

• World Health Organization

Higher Education Funding Council for England. Research Excellence Framework 2014: The results. 2014. http://www.ref.ac.uk/pubs/201401/ . Accessed 20 Feb 2015.

Higher Education Funding Council for England. Research Excellence Framework 2014: Results and submissions. 2015. http://results.ref.ac.uk/ . Accessed 20 Feb 2015.

Higher Education Funding Council for England. REF 2014 Panel overview reports: Main Panel A and sub-panels 1–6. 2015. http://www.ref.ac.uk/media/ref/content/expanel/member/Main%20Panel%20A%20overview%20report.pdf . Accessed 20 Feb 2015.

Hanney SR, González-Block MA. Four centuries on from Bacon: progress in building health research systems to improve health systems? Health Res Policy Syst. 2014;12:56.

Article   PubMed   PubMed Central   Google Scholar  

Cohen G, Schroeder J, Newson R, King L, Rychetnik L, Milat AJ, et al. Does health intervention research have real world policy and practice impacts: testing a new impact assessment tool. Health Res Policy Syst. 2015;13:3.

Scott RAP, Ashton HA, Buxton M, Day NE, Kim LG, Marteau TM, et al. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002;360:1531–9.

Article   PubMed   Google Scholar  

Buxton M, Ashton H, Campbell H, Day NE, Kim LG, Marteau TM, et al. Multicentre aneurysm screening study (MASS): cost effectiveness analysis of screening for abdominal aortic aneurysms based on four year results from randomised controlled trial. BMJ. 2002;325:1135–8.

Article   Google Scholar  

Cosford PA, Leng GC, Thomas J: Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev 2007; (2)CD002945.

Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, et al. The care of patients with an abdominal aortic aneurysm: the Society for Vascular Surgery practice guidelines. J Vasc Surg. 2009;50(4 Suppl):S2–49.

Lindholt JS, Juul S, Fasting H, Henneberg EW. Hospital costs and benefits of screening for abdominal aortic aneurysms. Results from a randomised population screening trial. Eur J Vasc Endovasc Surg. 2002;23:55–60.

Article   CAS   PubMed   Google Scholar  

Norman PE, Jamrozik K, Lawrence-Brown MM, Le MT, Spencer CA, Tuohy RJ, et al. Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm. BMJ. 2004;329(7477):1259–64.

Hanney SR, Castle-Clarke S, Grant J, Guthrie S, Henshall C, Mestre-Ferrandiz J, et al. How long does biomedical research take? Studying the time taken between biomedical and health research and its translation into products, policy, and practice. Health Res Policy Syst. 2015;13:1.

Cabellon S, Moncrief CL, Pierre DR, Cavenaugh DG. Incidence of abdominal aortic aneurysms in patients with artheromatous arterial disease. Am J Surg. 1983;146:575–6.

World Health Organization. WHA resolution 66.22: Follow up of the report of the Consultative Expert Working Group on Research and Development: financing and coordination. Geneva: WHO; 2013. http://www.who.int/phi/resolution_WHA-66.22.pdf . Accessed 20 Feb 2015.

Google Scholar  

Adam T, Røttingen JA, Kieny MP. Informing the establishment of the WHO Global Observatory on Health Research and Development: a call for papers. Health Res Policy Syst. 2015;13:9.

Young AJ, Terry RF, Røttingen JA, Viergever RF. Global trends in health research and development expenditures – the challenge of making reliable estimates for international comparison. Health Res Policy Syst. 2015;13:7.

Ongolo-Zogo P, Lavis JN, Tomson G, Sewankambo NK. Climate for evidence informed health system policymaking in Cameroon and Uganda before and after the introduction of knowledge translation platforms: a structured review of governmental policy documents. Health Res Policy Syst. 2015;13:2.

Yazdizadeh B, Majdzadeh R, Alami A, Amrolalaei S. How can we establish more successful knowledge networks in developing countries? Lessons learnt from knowledge networks in Iran. Health Res Policy Syst. 2014;12:63.

Ager A, Zarowsky C. Balancing the personal, local, institutional, and global: multiple case study and multidimensional scaling analysis of African experiences in addressing complexity and political economy in health research capacity strengthening. Health Res Policy Syst. 2015;13:5.

Hunter PR, Abdelrahman SH, Antwi-Agyei P, Awuah E, Cairncross S, Chappell E, et al. Needs assessment to strengthen capacity in water and sanitation research in Africa: experiences of the African SNOWS consortium. Health Res Policy Syst. 2014;12:68.

The World Health Organization. The World Health Report 2013: Research for Universal Health Coverage. Geneva: WHO; 2013.

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The authors thank Bryony Soper for most helpful comments on an earlier draft.

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Hanney, S.R., González-Block, M.A. Health research improves healthcare: now we have the evidence and the chance to help the WHO spread such benefits globally. Health Res Policy Sys 13 , 12 (2015). https://doi.org/10.1186/s12961-015-0006-y

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Why is Research Important in Healthcare?

• January 9, 2023

Table of Contents

Research is critical to improving patient outcomes and the quality of healthcare. It helps us to understand what works, what doesn’t work, and why. In addition, research is essential for developing new treatments and therapies. Without research, we would not have many of the lifesaving vaccines and medications that we take for granted today.

What Is Healthcare Research?

Research in healthcare is scientific and academic innovation aimed at answering medical and social questions. It typically involves observing, comparing, and sometimes testing people with different conditions; analyzing samples of blood or other tissues; examining patient records; surveying data from health and lifestyle surveys; and exploring the benefits, costs, acceptability, and wider impact of treatments.

Research in healthcare can also focus on improving the lives of people who receive care from our social care sector by introducing new devices or technologies, such as lifting equipment for residents or changing policies for better practice.

1. Research helps determine the best treatments and practices for various conditions.

Research helps to identify new and better ways to prevent, diagnose, and treat diseases and conditions. It provides insights into the causes of illnesses as well as potential treatments that can be applied in clinical practice.

By studying various factors such as lifestyle choices, diet patterns, social networks, and family support systems, researchers can provide information about what works best for different conditions. This helps doctors make informed decisions about their patients’ healthcare plans and provides them with the knowledge they need to provide effective treatments.

2. Research can identify risk factors for certain diseases and conditions

Research can help identify risk factors associated with specific diseases and conditions. These include physical , social , genetic , environmental , and lifestyle factors.

By studying groups of people and their patterns of disease occurrence, researchers can identify potential risk factors for a given condition and explore ways to reduce them or prevent them from occurring in the first place. This includes exploring potential preventive measures such as vaccines or lifestyle changes that may help reduce the risk of developing a given condition.

3. Research can identify early warning signs of certain diseases and conditions

Research can help identify early warning signs of certain diseases and conditions by examining new detection methods, conducting clinical trials, and performing studies on patients. This enables researchers to gain a better understanding of the causes, symptoms, and progression of diseases so they can develop more accurate diagnostic tools and effective treatments.

Research also provides insights into how certain conditions may affect individuals differently depending on their age or genetic background. Ultimately this leads to better outcomes for people with diagnosed illnesses by allowing them to take proactive steps to manage their condition or live a healthier lifestyle.

4. Research can identify the most effective treatments for certain conditions

Research can help to identify new and better ways to prevent, diagnose, and treat diseases and conditions. This enables researchers to study the effectiveness of different treatments for specific ailments in order to provide patients with information about what works best for them.

5. Research can help identify the best ways to care for patients

Research can help to identify the best ways to care for patients by providing new and improved treatments, information about what works and what does not, and an overall better understanding of diseases. This knowledge can be used to prevent, diagnose, treat, and prevent disease; provide better quality care; and improve patient outcomes.

Additionally, research helps medical professionals stay up-to-date on the latest advances in medical science so they can provide their patients with the best care possible, including health digitalization .

6. Research can help find ways to prevent certain conditions from developing

Research can help identify risk factors and explore potential methods of prevention for certain conditions. This may include vaccines, lifestyle changes, or medicines.

By understanding the causes of certain conditions and exploring ways to prevent them, researchers can help prevent people from developing those conditions in the first place. This can have a positive impact on communities by improving care and helping more people around the world.

7. Research can help find ways to prevent complications from developing in certain conditions

Research can help to identify risk factors and explore potential methods of prevention for conditions such as diseases and illnesses. By understanding the causes of a condition and its associated risks, researchers can develop strategies to reduce the likelihood of complications occurring. This will help improve patient care by allowing doctors to provide more effective treatments while also reducing the number of adverse side effects associated with them.

8. Research can help find better ways to communicate information about specific conditions and treatments to the public

Research can help improve public communication about certain conditions and treatments by providing evidence-based information. By disseminating this research-based knowledge to the public through various channels such as websites and publications, people can make more informed decisions about their healthcare. They will also have access to up-to-date information about current research trends in their area of interest or concern.

9. Research can help identify the best ways to engage with healthcare stakeholders

Research can help to identify the key stakeholders involved in healthcare, such as patients, healthcare providers, payers, and insurers, and analyze existing theories, models, and frameworks that govern these relationships to better understand how they work together to influence health outcomes and research effectiveness.

It can also identify ways to improve communication between stakeholders through research in order to ensure that everyone has access to the best possible care while reducing costs associated with treatments or hospital stays.

10. Research can help find ways to improve the quality and effectiveness of healthcare by generating new evidence .

Research can help improve the quality and effectiveness of healthcare by generating new evidence that can be applied to make healthcare affordable, safe, effective, equitable, accessible, and patient-centered .

By applying this evidence in practice, healthcare systems can be improved to ensure that patients receive the best possible care. This may include making decisions that are better informed by research findings or organizing care processes to improve safety and efficacy. It may also provide an opportunity to design healthcare benefits or inform policy changes that benefit patients across the board.

Research is essential in healthcare in order to improve the quality and effectiveness of care while also making it more affordable and accessible. By applying evidence-based practices and real-world evidence , healthcare systems can be improved to better serve patients and digitalize the field.

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Participating in Health Research Studies

What is health research.

• Is Health Research Safe?
• Is Health Research Right for Me?
• Types of Health Research

The term "health research," sometimes also called "medical research" or "clinical research," refers to research that is done to learn more about human health. Health research also aims to find better ways to prevent and treat disease. Health research is an important way to help improve the care and treatment of people worldwide.

Have you ever wondered how certain drugs can cure or help treat illness? For instance, you might have wondered how aspirin helps reduce pain. Well, health research begins with questions that have not been answered yet such as:

"Does a certain drug improve health?"

To gain more knowledge about illness and how the human body and mind work, volunteers can help researchers answer questions about health in studies of an illness. Studies might involve testing new drugs, vaccines, surgical procedures, or medical devices in clinical trials . For this reason, health research can involve known and unknown risks. To answer questions correctly, safely, and according to the best methods, researchers have detailed plans for the research and procedures that are part of any study. These procedures are called "protocols."

An example of a research protocol includes the process for determining participation in a study. A person might meet certain conditions, called "inclusion criteria," if they have the required characteristics for a study. A study on menopause may require participants to be female. On the other hand, a person might not be able to enroll in a study if they do not meet these criteria based on "exclusion criteria." A male may not be able to enroll in a study on menopause. These criteria are part of all research protocols. Study requirements are listed in the description of the study.

A Brief History

While a few studies of disease were done using a scientific approach as far back as the 14th Century, the era of modern health research started after World War II with early studies of antibiotics. Since then, health research and clinical trials have been essential for the development of more than 1,000 Food and Drug Administration (FDA) approved drugs. These drugs help treat infections, manage long term or chronic illness, and prolong the life of patients with cancer and HIV.

Sound research demands a clear consent process. Public knowledge of the potential abuses of medical research arose after the severe misconduct of research in Germany during World War II. This resulted in rules to ensure that volunteers freely agree, or give "consent," to any study they are involved in. To give consent, one should have clear knowledge about the study process explained by study staff. Additional safeguards for volunteers were also written in the Nuremberg Code and the Declaration of Helsinki .

New rules and regulations to protect research volunteers and to eliminate ethical violations have also been put in to place after the Tuskegee trial . In this unfortunate study, African American patients with syphilis were denied known treatment so that researchers could study the history of the illness. With these added protections, health research has brought new drugs and treatments to patients worldwide. Thus, health research has found cures to many diseases and helped manage many others.

Why is Health Research Important?

The development of new medical treatments and cures would not happen without health research and the active role of research volunteers. Behind every discovery of a new medicine and treatment are thousands of people who were involved in health research. Thanks to the advances in medical care and public health, we now live on average 10 years longer than in the 1960's and 20 years longer than in the 1930's. Without research, many diseases that can now be treated would cripple people or result in early death. New drugs, new ways to treat old and new illnesses, and new ways to prevent diseases in people at risk of developing them, can only result from health research.

Before health research was a part of health care, doctors would choose medical treatments based on their best guesses, and they were often wrong. Now, health research takes the guesswork out. In fact, the Food and Drug Administration (FDA) requires that all new medicines are fully tested before doctors can prescribe them. Many things that we now take for granted are the result of medical studies that have been done in the past. For instance, blood pressure pills, vaccines to prevent infectious diseases, transplant surgery, and chemotherapy are all the result of research.

Medical research often seems much like standard medical care, but it has a distinct goal. Medical care is the way that your doctors treat your illness or injury. Its only purpose is to make you feel better and you receive direct benefits. On the other hand, medical research studies are done to learn about and to improve current treatments. We all benefit from the new knowledge that is gained in the form of new drugs, vaccines, medical devices (such as pacemakers) and surgeries. However, it is crucial to know that volunteers do not always receive any direct benefits from being in a study. It is not known if the treatment or drug being studied is better, the same, or even worse than what is now used. If this was known, there would be no need for any medical studies.

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• Last Updated: May 27, 2020 3:05 PM
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Why all doctors should be involved in research

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• Peer review
• Hannah Jacob , academic clinical fellow
• 1 UCL Institute of Child Health, London WC1N 1EH
• hcjacob{at}gmail.com

Neena Modi tells Hannah Jacob about her career in research and why this is a fundamental part of every doctor’s job

Neena Modi is president of the Royal College of Paediatrics and Child Health and professor of neonatal medicine at Imperial College, London. She is a practising clinician and academic lead of a neonatal research programme focusing on nutritional and other perinatal determinants of lifelong metabolic health. After a period as vice president for science and research at the college, she was elected president in April 2015.

How did you become interested in research?

I realised that what I was being taught during my training was wrong, and my very enlightened consultant challenged me to design a trial to back my contention. There were no training posts in neonatal medicine when I started my paediatric training, but there were lots of opportunities to learn and undertake research because the rate of change was so great. That was really exciting.

Which research projects are you most proud of? Which do you think has had the biggest impact?

We did a series of studies to develop methods for measuring body water compartments in extremely preterm babies and to describe the postnatal alterations in fluid balance. We also tested the hypothesis that immediate sodium supplementation in babies with respiratory distress syndrome was harmful. That was a big achievement.

Most recently we have identified possible biological mechanisms that underpin the epidemiological associations between early onset of features of the metabolic syndrome and being born extremely preterm. That is of real interest as we learn more about the long term effects of extremely preterm birth.

How have you coped with the inevitable setbacks of a career in clinical research?

Real life is about being refused things and carrying on anyway, so I have developed resilience. There was no academic training route when I started out, so I have had to forge my own way. People will always tell you that it cannot be done. You have to pursue the things you are passionate about.

Do you have any advice for junior doctors interested in doing research?

Work out what interests you, and then find the person who is going to help you do it. Being approached by an enthusiastic junior doctor is always well received, and once you have found the right senior person they can support you in achieving your goals. Do not lose heart if you don’t get an academic training post as they are not the only way into research. Some of the best research students I have worked with have not come through the standard path.

What would you say to doctors who have no interest in doing research?

I would argue that they may not be thinking broadly enough about what research actually is. Every clinician is responsible for evaluating their own practice, and to do that in a robust and meaningful way you need to use the tools of research. We all need to be able to critically review research done by others. For example, the guidelines used in everyday clinical practice are based on meta-analyses and systematic reviews. So I think all doctors need to be involved in research in some way, and that may be different for different people.

How can undertaking research help doctors in their careers?

It’s not just a help, it’s essential. There are few absolutes in science, and without inquiring minds medicine will stand still. Participation in research enables doctors to evaluate their practice objectively and to be involved in advancing their discipline. You can learn so many skills that make you a better clinician around appraising the evidence and thinking critically about a situation.

What are the benefits and downsides of doing research—both on a personal and professional level?

The benefits come from knowing you are contributing to the science of medicine as well as the art, and are able to question, evaluate, and test different approaches objectively. Everyone has a role in supporting research—many will contribute, and some will be research leaders.

As for downsides, life has ups and downs, and research is no different. You have to not be too disheartened when a grant application gets rejected. When you want to achieve something, you have to keep speaking to the powers that be until you find someone who can be an advocate.

How do you juggle the research, clinical, and leadership aspects of your working life?

It is a balance that is evolving all the time and that provides me with a huge stimulus. Every time I have been presented with an opportunity I have had to evaluate its potential effect on the other components of my work. I always say yes to the things that interest me and follow my muse. We are very privileged as doctors to have such a range of tremendous opportunities available to us.

Do you have a particular philosophy that has guided you in your career?

When life offers you an opportunity, do not turn it down. I believe you must do what grabs your interest, and if you are still doing it years later you know you made the right decision. When you lose the excitement, it is time for a change. The future lies with junior doctors, and you can be a part of shaping it in the way you think is right.

Is there anything you would do differently if you had your career again?

I would have much greater confidence to fight for something I believed in.

Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I am the academic officer for the Paediatric Educators Special Interest Group of the Royal College of Paediatrics and Child Health.

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Impact of nih research.

Serving Society

Societal Benefits from Research

NIH-supported research findings result in changes that benefit society and the economy.

Neighborhoods and Health

Societal-benefits-research--neighborhoods-health.jpg.

NIH-supported research shows that children who move from a high-poverty neighborhood to a low poverty neighborhood are more likely to attend college and earn over 30% more as young adults. This has prompted changes in policies at the U.S. Department of Housing and Urban Development and other U.S. agencies.

Image credit: Jonathan Bailey, NHGRI

• Individuals living in low-poverty neighborhoods have improved health and employment compared to individuals living in high-poverty neighborhoods.
• Moving from a high-poverty neighborhood to a low-poverty neighborhood resulted in improved well-being, mental health, and physical health, such as increased rates of employment, decreased substance use and exposure to neighborhood violence, and reduced prevalence of extreme obesity and diabetes. 
• This evidence led policymakers to begin reducing systemic barriers for families to live in areas with more opportunities and lower levels of poverty.

Importance of Sleep

Societal-benefits-research--importance-sleep-cropped.jpg.

NIH-funded research shows the importance of sleep in boosting productivity at work and school. For example, a later school start time increases sleep duration and can lead to a 4.5% increase in grades. Because of this research, some states already enacted laws mandating later school start times.

Image credit: National Institute of Child Health and Human Development, NIH

• NIH-funded research shows that workplaces with health promotion programs have increased employee sleep duration and subsequent increased daytime performance. 
• Similarly, in school settings, later school start times can increase students’ median sleep time by 34 minutes and improve school attendance, resulting in a 4.5% rise in median grades. 
• A 60-minute delay in school start times also reduces car crash rates by 16.5%, as young drivers have a higher crash risk when sleep deprived.

Air Pollution and Health

Societal-benefits-research--air-pollution-health.jpg.

NIH-funded research found strong associations between exposure to air pollution and mortality. This research contributed to new Clean Air Act regulations in 1990, which resulted in air quality improvements that reached an economic value of $2 trillion by 2020 and prevented 230,000 early deaths in 2020 alone.

Image credit: Elisabeth De la Rosa, University of Texas Health Science Center, NCATS

• The net improvement in economic welfare due to new Clean Air Act regulations is projected to occur because cleaner air leads to better health and productivity for American workers, as well as savings on medical expenses for air pollution-related health problems. 
• The beneficial economic effects of better health and savings on medical costs alone are projected to more than offset the expenditures for pollution control.

Dietary Guidelines

Societal-benefits-research--dietary-guidelines.jpg.

Thanks to NIH-supported research, our understanding of how dietary intake contributes to health outcomes has expanded, and a more accurate way to measure metabolism in humans is now available. This has informed dietary guidelines for all Americans, including guidance on school lunches and labels for food and menus.

Image credit: Nancy Krebs University of Colorado Anschutz Medical Campus, Aurora, CO

• NIH-supported research has improved our understanding of the relationships between dietary intake, human development, and risk of chronic diet-related health conditions in the U.S. 
• The development of doubly labeled water (DLW)—a safe, non-invasive way to measure energy expenditure in humans—was funded by NIH and has revolutionized the measurement of metabolism in humans. 
• DLW is essential for the establishment of dietary reference intakes, which are the basis for updating dietary guidelines for all Americans.

Taxes for Public Health

Societal-benefits-research--taxes-public-health.jpg.

Several U.S. cities have imposed a tax on sugar-sweetened beverages, based on research funded by NIH. In Berkeley, CA, this tax resulted in more than $9 million of revenue from 2015-2019, for public health campaigns and promotion for the city.

Image credit: Dr. Ehsan Shokri Kojori, NIAAA

• Implemented in 2015, the Berkeley tax on sugar-sweetened beverages impacted consumer spending, leading to a 10% drop in purchases of unhealthy beverages within a year.
• It also supported a public health intervention that led to improved health outcomes.

Housing and COVID-19

Societal-benefits-research--housing-covid-19.jpg.

NIH-funded research supported federal policies that prevented evictions during the COVID-19 pandemic, reducing the spread of COVID-19 and preventing excess deaths.

Image credit: National Institute of Allergy and Infectious Diseases, NIH

• Lifting eviction moratoria in the spring and summer of 2020 was associated with 433,700 excess COVID-19 cases and 10,700 excess deaths. These findings were cited in decisions by other U.S. federal agencies to extend eviction moratoria.
• CDC cited NIH research when extending the federal eviction moratorium in January 2021, and in subsequent extensions, which may have had positive downstream impacts on productivity, employment, housing, and health costs.

Nurse Workload

Societal-benefits-research--nurse-workload.jpg.

NIH research demonstrated that when hospital nurses’ workloads are increased, there are higher rates of death for patients in that hospital. This research has informed proposed or passed legislation in almost 25 states that addresses nurse staffing levels, reduces workloads, and saves lives.

Image credit: National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH

• NIH-supported research found that each patient added to a nurse’s workload was associated with a 7% increase in patient mortality.
• This research has guided state-mandated nurse-to-patient ratios in California hospitals. After these guidelines went into effect, NIH researchers found that when compared to states without mandated nurse staffing levels, California nurse workloads were lower, which was associated with fewer patient deaths.

Nursing Education

Societal-benefits-research--nursing-education.jpg.

NIH-supported research showed that a more educated nurse workforce is associated with improvements in patient outcomes in hospitals. This informed recommendations from the National Academy of Medicine on nurse education, leading to an almost 10% increase in nurses with a bachelor’s degree or higher from 2011-2019.

Image credit: John Powell

• NIH-supported research showed that for every 10% increase in nurses with bachelor’s degrees, there is a related 5-7% decrease in the likelihood of death for patients in hospitals.
• This research contributed to the 2011 National Academy of Medicine (formerly the Institute of Medicine) recommendation that 80% of nurses hold a bachelor’s degree by 2020.
• Since these recommendations, the proportion of nurses in the U.S. with a bachelor’s degree or higher increased from 50% in 2011 to 59% in 2019.
• Ludwig J, et al.  N Engl J Med . 2011 Oct 20;365(16):1509-19. PMID:  22010917 . 
• Ludwig J, et al.  Science . 2012 Sep 21;337(6101):1505-10. PMID:  22997331 . 
• Fauth R, et al.  Soc Sci Med . 2004 Dec;59(11):2271-84. PMID:  15450703 . 
• Chetty R, et al.  Am Econ Rev . 2016;106(4):855-902. PMID:  29546974 .
• Thornton RLJ, et al.  Health Aff (Millwood) . 2016;35(8):1416-23. PMID:  27503966 . 
• Housing Choice Voucher Mobility Demonstration -- HUD invites comments to OMB on Phase 1 Evaluation (by 11/22):  https://www.aeaweb.org/forum/2181/housing-voucher-mobility-demonstration-comments-evaluation
• Center on Budget and Policy Priorities:  https://www.cbpp.org/research/housing/what-are-housing-mobility-programs-and-why-are-they-needed
• Robbins R, et al.  Am J Health Promot . 2019;33(7):1009-1019. PMID:  30957509 . 
• Watson NF, et al.  J Clin Sleep Med . 2017;13(4):623-625. PMID:  28416043 .
• Dockery DW, et al.  N Engl J Med . 1993;329(24):1753-9. PMID:  8179653 .
• Benefits and Costs of the Clean Air Act 1990-2020, the Second Prospective Study:  https://www.epa.gov/clean-air-act-overview/benefits-and-costs-clean-air-act-1990-2020-second-prospective-study
• Schoeller DA, et al.  J Appl Physiol Respir Environ Exerc Physiol . 1982;53(4):955-9. PMID:  6759491 .
• Pontzer H, et al.  Science . 2021;373(6556):808-812. PMID:  34385400 .
• Rhoads TW, et al.  Science . 2021;373(6556):738-739. PMID:  34385381 .
• Doubly Labelled Water Method:  https://doubly-labelled-water-database.iaea.org/about
• Scientific Report of the 2020 Dietary Guidelines Advisory Committee:  https://www.dietaryguidelines.gov/2020-advisory-committee-report
• Falbe J, et al.  Am J Public Health . 2020;110(9):1429-1437. PMID:  32673112 .
• Kansagra SM, et al.  Am J Public Health . 2015;105(4):e61-4. PMID:  25713971 .
• State and Local Backgrounders on Soda Taxes:  https://www.urban.org/policy-centers/cross-center-initiatives/state-and-local-finance-initiative/state-and-local-backgrounders/soda-taxes
• Leifheit KM, et al.  Am J Epidemiol . 2021;190(12):2503-2510. PMID:  34309643 . 
• Temporary Halt in Residential Evictions to Prevent the Further Spread of COVID-19. February 2021 https://www.federalregister.gov/documents/2021/02/03/2021-02243/temporary-halt-in-residential-evictions-to-prevent-the-further-spread-of-covid-19
• Temporary Halt in Residential Evictions to Prevent the Further Spread of COVID-19. March 2021.  https://www.federalregister.gov/documents/2021/03/31/2021-06718/temporary-halt-in-residential-evictions-to-prevent-the-further-spread-of-covid-19
• Supreme Court of the Unites States. No. 21A23. 2021.  https://www.supremecourt.gov/opinions/20pdf/21a23_ap6c.pdf
• Article: The Coming Wave of Evictions Is More Than a Housing Crisis.  https://www.theatlantic.com/family/archive/2021/09/cdc-eviction-ban-housing-crisis/619960/
• Article: Nurse staffing and education linked to reduced patient mortality:  https://www.nih.gov/news-events/news-releases/nurse-staffing-education-linked-reduced-patient-mortality    
• Article: Linda Aiken, Whose Research Revealed the Importance of Nursing in Patient Outcomes, Receives Institute of Medicine’s 2014 Lienhard Award:  https://www.nationalacademies.org/news/2014/10/linda-aiken-whose-research-revealed-the-importance-of-nursing-in-patient-outcomes-receives-institute-of-medicines-2014-lienhard-award    
• Article: Nurses, and patients, have this woman to thank:  https://www.uff.ufl.edu/gators/nurses-patients-woman-thank/   
• Aiken LH, et al.  JAMA . 2002;288(16):1987-93. PMID:  12387650 .  
• Aiken LH, et al.  Lancet . 2014;383(9931):1824-30. PMID:  24581683 .  
• Aiken LH, et al.  Health Serv Res . 2010;45(4):904-21. PMID:  20403061 .
• Learning From the California Experience:  https://www.nationalnursesunited.org/learning-california-experience
• Aiken LH, et al.  JAMA . 2003;290(12):1617-23. PMID:  14506121 .
• Friese CR, et al.  Health Serv Res . 2008;43(4):1145-63. PMID:  18248404 . 
• Institute of Medicine (US) Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine.  The Future of Nursing: Leading Change, Advancing Health . 2011.  https://www.ncbi.nlm.nih.gov/books/NBK209880/
• National Academies of Sciences, Engineering, and Medicine.  The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity . 2021. (page 200)  https://nap.nationalacademies.org/catalog/25982/the-future-of-nursing-2020-2030-charting-a-path-to

This page last reviewed on March 1, 2023

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Why all medical students need to experience research

• Post author By Website Publications Officer
• Post date June 4, 2016

Medical students are very busy. The demands of studying medicine are extraordinary. Why then is it so important, on top of all there is to learn, to bother engaging in health and medical research? It is particularly important to consider this question at a time when, nationally and internationally, medical schools are including a research project as either a requirement of their program or a highly encouraged option. In fact, the Australian government is now supporting research by medical students with a specific category of scholarship funding from the National Health and Medical Research Council (NHMRC) available to students undertaking in a combined MBBS/PhD or MD/PhD program. [1]

As a Dean of Medicine, and passionate advocate of health and medical research (HMR) in Australia, I support the inclusion of research in medical programs. Research training and experience are not just ‘nice to have’ but a ‘must’ for our doctors of the future. Increased research training in medical programs is beneficial for a student’s professional pathway, their evolving practice and, most importantly, for the health of the patients and communities they serve. [2,3]

Demonstrated research experience at medical school is increasingly important in obtaining positions in training programs post-graduation. [4] Recognition of the importance of HMR in developing and applying the skills and knowledge acquired in their medical studies has seen many of the specialist colleges including research training and productivity (for example publications) in their approach to selection of trainees. Competition for vocational and advanced training places is fierce, and a professional resume that includes research productivity and qualifications is and will continue to be important. Some colleges may even move to requiring a PhD for entry into advanced training.

A research experience may be the first time a student has had to write and record what they do, think, and find coherently, concisely and precisely. This can contribute to developing lasting habits of critical thinking. In a landmark and classic essay, C. Wright Mills commented that there was never a time he was not thinking, reflecting, analysing, and writing – he was always working on an idea. [5] This is the mindset that research can build up, and this is surely the mindset we want in clinical medicine and population health, where continuing critical appraisal of new evidence and engagement with new ideas is vital. In addition to stimulating ongoing interest in learning, this intellectually curious mindset contributes to a sense of personal satisfaction and eagerness to engage in discovery and learning as part of a team. [3,6] Research achievements are rarely made by individuals in isolation. Developing a mindset of critical inquiry in individuals and teams clearly encourages research productivity in grants and publications in the longer term, [3] which can ‘future-proof’ careers at a time when research performance is important in professional esteem and progression. Even more importantly, involvement in research appears to improve clinical practice. Research-active healthcare providers appear to provide better care and achieve better patient outcomes, [7] making the investment of time in research training for medical students potentially very important to building a healthier society in the long term. Given the potential benefits to early career clinicians and to patients, it is important to expose recent medical graduates to research as well, and successful postgraduate training programs are also taking steps to include research training. [3,8]

So, what is the best way for medical schools and postgraduate training programs to provide research training that maximises these benefits? It is clear from the literature that the most important thing is to have protected time to pursue research. Whether the research is a programmed experience as part of a course (as is increasingly the case), or something pursued independently by the individual student or trainee, giving as much time as possible is key to getting the best quality outcomes. For recent graduates, hospitals need to allow time to do research. [8] For students, time should be set aside within the program. [4] Students and trainees also need to be mentored by experienced researchers to get the best results. [3] Research experiences for students and trainees that combine mentorship and protected time can deliver the biggest benefits to our future clinical leaders and society as they are most likely to result in high quality outputs that are published and improve knowledge and practice. Where possible, trainees without research degrees should try to enrol in these at the same time as pursuing their research experiences, through a university that offers flexible research training and options to submit theses by publication, as earning a research degree such as a PhD is increasingly becoming a prerequisite for obtaining research funding that can support a clinical research career.

In summary, more than ever before, being a doctor in the 21st century is a career of lifelong learning. The combination of continued, rapid growth in knowledge and advancing technology bringing that information to your fingertips, have brought both a richness to the practice of medicine as well as a challenge. There is a growing appreciation that researchers make better clinicians. Research exposure increases understanding of clinical medicine; facilitates critical thinking and critical appraisal; improves prospects of successful application for post graduate training, grants, and high impact publications; develops teamwork skills; and increases exposure to the best clinical minds. The government is lifting its investment in health and medical researchers like never before. The establishment of the Medical Research Future Fund by the Australian Government, for example, offers the promise of continued durable investment in HMR and innovation, and the NHMRC’s substantial investment in research training scholarships for current students and recent graduates signals the Government’s commitment to developing clinician researchers for the future.

I encourage all students to make the most of research opportunities in medical school and beyond, not only for the personal and professional benefits, but in contributing to the health of their patients and to the Australian community.

[1] NHMRC Funding Rules 2015: Postgraduate Scholarships – 6 Categories of Award – 6.2. Clinical Postgraduate Scholarship. 2015. https://www.nhmrc.gov.au/book/6-categories-award-3 (accessed Nov 2015).

[2] Laidlaw A, Aiton L, Struthers J, Guild S. Developing research skills in medical students: AMEE guide no. 69. Med Teach. 2012;34:754–71.

[3] Lawson PJ, Smith S, Mason MJ, Zyzanski SJ, Stange KC, Werner JJ, Flocke SA. Creating a culture of inquiry in family medicine. Fam Med. 2014;46(7):515–521.

[4] Collier AC. Medical school hotline: importance of research in medical education. Hawai’i Journal Med Public Health. 2012;71(2):53-6.

[5] Mills, CW. On intellectual craftsmanship. In: Seale, C. Editor. Social research methods: A reader. London: Routledge, 2004.

[6] von Strumm S, Hell B, Chamorro-Premuzic T. The hungry mind: intellectual curiosity is the third pillar of academic performance of university. Perspect Psychol Sci. 2011;6(6):574-88.

[7] Selby P, Autier P. The impact of the process of clinical research on health service outcomes. Ann Oncol 2011;22(Suppl 7):vii5-vii9.

[8] Chen JX, Kozin ED, Sethi RKV, Remenschneider AK, Emerick KS, Gray ST. Increased resident research over an 18-year period – a single institution’s experience. Otolaryngol Head Neck Surg. 2015;153(3):350-6.

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When science meets mindfulness

Researchers study how it seems to change the brain in depressed patients

Alvin Powell

Harvard Staff Writer

First of two parts

In 2015, 16.1 million Americans reported experiencing major depression during the previous year, often struggling to function while grappling with crippling darkness and despair.

There’s an arsenal of treatments at hand, including talk therapy and antidepressant medications, but what’s depressing in itself is that they don’t work for every patient.

“Many people don’t respond to the frontline interventions,” said Benjamin Shapero, an instructor in psychiatry at Harvard Medical School (HMS) and a psychologist at Massachusetts General Hospital’s (MGH) Depression Clinical and Research Program . “Individual cognitive behavioral therapy is helpful for many people; antidepressant medications help many people. But it’s also the case that many people don’t benefit from them as well. There’s a great need for alternative approaches.”

Shapero is working with Gaëlle Desbordes , an instructor in radiology at HMS and a neuroscientist at MGH’s Martinos Center for Biomedical Imaging , to explore one alternative approach: mindfulness-based meditation.

In recent decades, public interest in mindfulness meditation has soared. Paralleling, and perhaps feeding, the growing popular acceptance has been rising scientific attention. The number of randomized controlled trials — the gold standard for clinical study — involving mindfulness has jumped from one in the period from 1995‒1997 to 11 from 2004‒2006, to a whopping 216 from 2013‒2015, according to a recent article summarizing scientific findings on the subject.

Studies have shown benefits against an array of conditions both physical and mental, including irritable bowel syndrome, fibromyalgia, psoriasis, anxiety, depression, and post-traumatic stress disorder. But some of those findings have been called into question because studies had small sample sizes or problematic experimental designs. Still, there are a handful of key areas — including depression, chronic pain, and anxiety — in which well-designed, well-run studies have shown benefits for patients engaging in a mindfulness meditation program, with effects similar to other existing treatments.

“There are a few applications where the evidence is believable. But the effects are by no means earth-shattering,” Desbordes said. “We’re talking about moderate effect size, on par with other treatments, not better. And then there’s a bunch of other things under study with preliminary evidence that is encouraging but by no means conclusive. I think that’s where it’s at. I’m not sure that is exactly how the public understands it at this point.”

Desbordes’ interest in the topic stems from personal experience. She began meditating as a graduate student in computational neuroscience at Boston University, seeking respite from the stress and frustration of academic life. Her experience convinced her that something real was happening to her and prompted her to study the subject more closely, in hopes of shedding enough light to underpin therapy that might help others.

“My own interest comes from having practiced those [meditation techniques] and found them beneficial, personally. Then, being a scientist, asking ‘How does this work? What is this doing to me?’ and wanting to understand the mechanisms to see if it can help others,” Desbordes said. “If we want that to become a therapy or something offered in the community, we need to demonstrate [its benefits] scientifically.”

Desbordes’ research uses functional magnetic resonance imaging (fMRI), which not only takes pictures of the brain, as a regular MRI does, but also records brain activity occurring during the scan. In 2012, she demonstrated that changes in brain activity in subjects who have learned to meditate hold steady even when they’re not meditating. Desbordes took before-and-after scans of subjects who learned to meditate over the course of two months. She scanned them not while they were meditating, but while they were performing everyday tasks. The scans still detected changes in the subjects’ brain activation patterns from the beginning to the end of the study, the first time such a change — in a part of the brain called the amygdala — had been detected.

Functional MRI (left) showing activation in the amygdala when participants were watching images with emotional content before learning meditation. After eight weeks of training in mindful attention meditation (right) note the amygdala is less activated after the meditation training.

Courtesy of Gaelle Desbordes

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In her current work, she is exploring meditation’s effects on the brains of clinically depressed patients, a group for whom studies have shown meditation to be effective. Working with patients selected and screened by Shapero, Desbordes is performing functional magnetic resonance imaging scans before and after an eight-week course in mindfulness-based cognitive therapy, or MBCT.

During the scans, participants complete two tests, one that encourages them to become more aware of their bodies by focusing on their heartbeats (an exercise related to mindfulness meditation), and the other asking them to reflect on phrases common in the self-chatter of depressed patients, such as “I am such a loser,” or “I can’t go on.” After a series of such comments, the participants are asked to stop ruminating on the phrases and the thoughts they trigger. Researchers will measure how quickly subjects can disengage from negative thoughts, typically a difficult task for the depressed.

The process will be repeated for a control group that undergoes muscle relaxation training and depression education instead of MBCT. While it’s possible that patients in the control part of the study also will have reduced depressive symptoms, Desbordes said it should occur via different mechanisms in the brain, a difference that may be revealed by the scans. The work, which received funding from the National Center for Complementary and Integrative Health , has been underway since 2014 and is expected to last into 2019.

Desbordes said she wants to test one prevalent hypothesis about how MBCT works in depressed patients: that the training boosts body awareness in the moment, called interoception, which, by focusing their attention on the here and now, arms participants to break the cycle of self-rumination.

“We know those brain systems involved with interoception, and we know those involved with rumination and depression. I want to test, after taking MBCT, whether we see changes in these networks, particularly in tasks specifically engaging them,” Desbordes said.

Desbordes is part of a community of researchers at Harvard and its affiliated institutions that in recent decades has been teasing out whether and how meditation works.

In the 1970s, when transcendental meditation surged in popularity, Herbert Benson, a professor at Harvard Medical School and what was then Beth Israel Hospital, explored what he called  “The Relaxation Response,” identifying it as the common, functional attribute of transcendental meditation, yoga, and other forms of meditation, including deep religious prayer. Benson described this response — which recent investigators say is not as common as he originally thought — as the opposite of the body’s adrenalin-charged “fight or flight” response, which was also identified at Harvard, by physiologist Walter Cannon Bradford in 1915.

Other MGH researchers also are studying the effects of meditation on the body, including Sara Lazar , who in 2012 used fMRI to show that the brains of subjects thickened after an eight-week meditation course. Work is ongoing at MGH’s Benson-Henry Institute ; at HMS and Brigham and Women’s Hospital’s Osher Center for Integrative Medicine ; at the Harvard-affiliated Cambridge Health Alliance, where Zev Schuman-Olivier directs the Center for Mindfulness and Compassion ; and among a group of nearly a dozen investigators at Harvard and other Northeastern institutions, including Desbordes and Lazar, who are collaborating through the Mindfulness Research Collaborative .

Among the challenges researchers face is defining mindfulness itself. The word has come to describe a meditation-based practice whose aim is to increase one’s sense of being in the present, but it has also been used to describe a nonmeditative state in which subjects set aside their mental distractions to pay greater attention to the here and now, as in the work of Harvard psychologist Ellen Langer .

Another challenge involves sorting through the many variations of meditative practice.

Recent scientific exploration has largely focused on the secular practice of mindful meditation, but meditation is also a component of several ancient religious traditions, with variations. Even within the community practicing secular mindful meditation, there are variations that may be scientifically meaningful, such as how often one meditates and how long the sessions are. Desbordes herself has an interest in a variation called compassion meditation, whose aim is to increase caring for those around us.

Amid this variation, an eight-week mindfulness-based stress reduction course developed in the 1970s by Jon Kabat-Zinn at the University of Massachusetts Medical Center has become something of a clinical and scientific standard. The course involves weekly two- or 2½-hour group training sessions, 45 minutes of daily work on one’s own, and a daylong retreat. The mindfulness-based cognitive therapy used in Desbordes’ current work is a variation on that program and incorporates elements of cognitive behavioral therapy, which involves talk therapy effective in treating depression.

Ultimately, Desbordes said she’s interested in teasing out just what in mindful meditation can work against depression. If researchers can identify what elements are effective, the therapy may be refined to be more successful. Shapero is also interested in using the study to refine treatment. Since some patients benefit from mindfulness meditation and some do not, he’d like to better understand how to differentiate between the two.

“Once we know which ingredients are successful, we can do more of that and less, maybe, of the parts that are less effective,” Desbordes said.

Research funding includes the National Center for Complementary and Integrative Health.

For more information about the Mindfulness & Meditation program at Harvard University, visit its website.

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The Latest Research About Paxlovid: Effectiveness, Access, and Possible Long COVID Benefits

• 1 Lead Senior Staff Writer, Medical News & Perspectives, JAMA
• Original Investigation Nirmatrelvir-Ritonavir and Symptoms of Postacute Sequelae of SARS-CoV-2 Infection Linda N. Geng, MD, PhD; Hector Bonilla, MD; Haley Hedlin, PhD; Karen B. Jacobson, MD; Lu Tian, DSc; Prasanna Jagannathan, MD; Phillip C. Yang, MD; Aruna K. Subramanian, MD; Jane W. Liang, PhD; Sa Shen, PhD; Yaowei Deng, MA; Blake J. Shaw, MS; Bren Botzheim, MS; Manisha Desai, PhD; Divya Pathak, MS; Yasmin Jazayeri, MPH; Daniel Thai, BS; Andrew O’Donnell, MA; Sukanya Mohaptra, BS; Zenita Leang, BS; Gabriella Z. M. Reynolds, BS; Erin F. Brooks, MS; Ami S. Bhatt, MD, PhD; Robert W. Shafer, MD; Mitchell G. Miglis, MD; Tom Quach; Anushri Tiwari; Anindita Banerjee, PhD; Rene N. Lopez, MPH; Magdia De Jesus, PhD; Lawrence R. Charnas, MD, PhD; Paul J. Utz, MD; Upinder Singh, MD JAMA Internal Medicine

As another COVID-19 summer surge hit the US this year, many infected people likely were prescribed the antivirals nirmatrelvir and ritonavir, better known as Paxlovid, for the first time. Or for the fourth time. Or somewhere in between.

Nirmatrelvir-ritonavir, the only approved oral therapy for COVID-19, is recommended for treating mild to moderate SARS-CoV-2 infections among people who are at high risk of progression to severe disease. This includes people aged 50 years or older, especially those 65 years or older, as well as younger individuals who have any of a long list of comorbidities that increase the risk of severe COVID-19.

The clinical trials leading to the US Food and Drug Administration (FDA) authorizing emergency use of nirmatrelvir-ritonavir in December 2021 and approving it in May 2023 were conducted with unvaccinated people who were infected with the now long-gone SARS-CoV-2 Delta variant. This has led to questions about its effectiveness for people who have been vaccinated or have been infected with subvariants of Delta’s successor Omicron, which have been circulating for nearly 3 years.

But recent observational studies suggest nirmatrelvir-ritonavir still protects people at high risk against hospitalization and death from COVID-19. That is if they’re able to get a prescription for it—research has uncovered racial and ethnic disparities in which eligible patients get a prescription for the treatment.

And as the number of people with postacute sequelae of SARS-CoV-2 infection (PASC), or long COVID, grows, scientists have been investigating whether nirmatrelvir-ritonavir might be useful in protecting against or treating the condition.

Does It Still Prevent Severe COVID-19?

Because the nirmatrelvir-ritonavir phase 2 and 3 trial involved unvaccinated adults without prior COVID-19 infection when the Delta variant dominated, questions have remained about its relevance today.

Scientists from Pfizer, which markets nirmatrelvir-ritonavir, and coauthors recently published a systematic literature review examining that question. They searched for real-world studies reported from December 2021 through March 2023 and identified 18 that met their final selection criteria.

The evidence showed that nirmatrelvir-ritonavir was effective regardless of age, underlying high-risk conditions, or vaccination status. The treatment significantly reduced the postinfection risk of all-cause and COVID-19–related mortality both within the first 30 days and in the long-term. Treatment started within 5 days of symptom onset, as recommended on the label, was associated with the greatest reduction in postinfection risk.

“We remain very confident in Paxlovid’s clinical effectiveness at preventing severe outcomes, including hospitalization and death, from COVID-19 in patients at high risk of severe disease,” Pfizer spokesperson Kit Longley said in an early August email.

Another recently published study reached a somewhat different conclusion. That study, conducted by University of Manitoba researchers, analyzed results from 4 randomized trials and 16 real-world studies, some of which had not yet been peer-reviewed, with a total of nearly 2 million adults aged 18 years or older.

The evidence suggested nirmatrelvir-ritonavir has a small but significant efficacy in reducing COVID-19 hospitalization and all-cause mortality among people with laboratory-confirmed mild to moderate infections, but the evidence is weak, so more studies are needed, the authors concluded.

At Risk but No Script

COVID-19 laid bare health disparities in the US, and nirmatrelvir-ritonavir has been no exception, according to a study published in August.

Using National COVID Cohort Collaborative (N3C) data, researchers studied individuals 18 years of age or older who were diagnosed with COVID-19 between January 2022 and December 2023; up until the end of that period, the US government covered the cost of nirmatrelvir-ritonavir for everyone who needed it.

About 1.26 million people in the N3C cohort were at high risk of progressing to severe disease, making them eligible for nirmatrelvir-ritonavir treatment. But overall, nearly two-thirds of those who were eligible weren’t prescribed the treatment, the authors observed. After accounting for age, sex, and clinical characteristics, the researchers found that non-Hispanic Black and Latino individuals were nearly a third less likely to have used nirmatrelvir-ritonavir than non-Hispanic White individuals.

Patients may not seek care or may not seek it out early enough for the treatment to be effective, coauthor Hemalkumar Mehta, PhD, a core member of the N3C, speculated in an interview with JAMA Medical News.

Another reason could be that patients don’t have a regular source of primary care whom they could ask for a prescription, noted Mehta, a pharmacist and epidemiologist at the Johns Hopkins Bloomberg School of Public Health. They likely don’t know that the FDA has authorized state-licensed pharmacists to prescribe nirmatrelvir-ritonavir, he said.

Mehta acknowledged that until he conducted his study, even he didn’t realize that pharmacists could prescribe the COVID-19 treatment. Publicizing that fact by simply hanging a sign in pharmacies would help, he pointed out.

However, the FDA created an obstacle to quick prescribing of nirmatrelvir-ritonavir by pharmacists, a 2023 article noted. Prior to prescribing, pharmacists must assess patients’ liver and kidney function through health records from the previous 12 months or consultation with their clinician. Other prescribers can simply ask patients about their liver and kidney function and take their word for it, the authors explained. In addition, there is no standardized pathway for pharmacists to bill payors for assessing patients to see if they’re eligible for nirmatrelvir-ritonavir, which typically takes 15 to 30 minutes, according to the American Pharmacists Association.

When people do get a prescription for nirmatrelvir-ritonavir, most get it filled, a recently published study of Walgreens pharmacies nationwide data found. The retrospective study included people 12 years of age or older for whom a nirmatrelvir-ritonavir prescription was ordered from Walgreens pharmacies between December 2021 and August 2023.

A total of about 2.1 million nirmatrelvir-ritonavir prescriptions were ordered for about 2 million individuals. Among the 95% of people who were prescribed only 1 course of the treatment, 88% filled their prescription. Improving uptake of nirmatrelvir-ritonavir requires increasing patient and prescriber awareness, reducing prescribing disparities, and ensuring treatment initiation within 5 days of symptom onset, the authors concluded.

Treat Acute Infection, Prevent Long COVID?

Taking nirmatrelvir-ritonavir for acute COVID-19 might protect against long COVID, although research into that topic has had mixed results.

For example, 2 recent studies, neither of which had yet been peer-reviewed, reached different conclusions.

A preprint posted in June reported observational study results from the Researching COVID to Enhance Recovery ( RECOVER ) initiative funded by the US National Institutes of Health (NIH). The study population included nearly 500 000 people who tested positive for SARS-CoV-2 between March 2022 and February 2023. Of those, about 165 000 were treated with nirmatrelvir-ritonavir within 5 days after becoming infected.

Compared with no treatment, nirmatrelvir-ritonavir therapy was associated with a 12% lower risk of developing long COVID within 180 days of infection, or an absolute risk reduction of about 3 cases per 100 people. However, no such risk reduction was seen in people at low risk of severe COVID-19 infection who received nirmatrelvir-ritonavir.

“There are quite a few patients who are not at risk but who received a Paxlovid prescription,” first author Fei Wang, PhD, explained in an interview with JAMA Medical News. “This provides us an opportunity to evaluate a low-risk population that got COVID.”

Another preprint , posted this summer, used N3C electronic health records. It found that nirmatrelvir-ritonavir treatment of acute COVID-19 was not significantly associated with reducing long COVID overall, although it was linked to fewer cognitive and fatigue symptoms.

The mixed findings between the 2 studies aren’t surprising, said Wang, an assistant professor of health care policy and research at Weill Cornell Medicine.

Some information, such as COVID-19 vaccination history and nirmatrelvir-ritonavir use, isn’t always encoded in electronic health records, Wang pointed out. Although he and his colleagues “spend a lot of effort” to make sure they have complete patient information, Wang explained, “there’s no way we can evaluate how complete that is.”

He added that not having a consensus definition of long COVID is another critical issue. The N3C’s definition isn’t the same as RECOVER’s, and the 2 cohorts have different patient populations. “All these can lead to different results,” he said.

For Wang, it makes sense that taking nirmatrelvir-ritonavir, an antiviral, for acute COVID-19 would protect against long COVID. The severity of acute SARS-CoV-2 infections is correlated with the risk of long COVID, he said, and one theory about the cause of PASC is the persistence of SARS-CoV-2 in the body.

However, Yale cardiologist Harlan Krumholz, MD, SM, pointed out that unidentified confounders, not nirmatrelvir-ritonavir itself, might be at play in the relationship between treating acute SARS-CoV-2 infection and long COVID risk. “People who take Paxlovid might be different in many other ways,” he noted.

A Long COVID Treatment?

Many individuals with long COVID didn’t have the opportunity to take nirmatrelvir-ritonavir when they first became ill with acute COVID-19. They might have been infected before the treatment became available, or they weren’t considered to be at high risk for severe disease, so they weren’t eligible for it.

Some case reports have suggested that it might not be too late for people who’ve had long COVID for months to benefit from nirmatrelvir-ritonavir. For example, in early 2023 internist Linda Geng, MD, PhD, codirector of Stanford’s PASC clinic, and coauthors reported the case of a patient who’d had long COVID for 7 months, around which time the symptoms of acute COVID-19 returned. Although rapid antigen test results were negative, the patient had been exposed to multiple people with COVID-19, so a primary care physician prescribed nirmatrelvir-ritonavir. Not only did the acute flu-like symptoms resolve, but so did the long COVID symptoms, which included severe fatigue and cognitive difficulties.

That patient spurred Geng and her colleagues to conduct what they say is the first published randomized trial of nirmatrelvir-ritonavir to treat PASC , which appeared in June in JAMA Internal Medicine . The trial enrolled 155 participants with long COVID, all but 2 of whom had received the primary COVID-19 vaccination series. On average, the time between their initial SARS-CoV-2 infection and randomization into the trial was about a year and a half.

The trial found that the longer 15-day course of nirmatrelvir-ritonavir it used was generally safe. However, the treatment didn’t significantly improve long COVID symptoms compared with the control group.

It’s far from the final answer about nirmatrelvir-ritonavir’s effectiveness against long COVID, though, Geng noted. “This is just the first step in many investigations that need to be done.”

The NIH is funding several clinical trials targeting long COVID under the RECOVER initiative umbrella. One, the Platform Protocol to Measure the Effects of Antiviral Therapies on Long COVID Symptoms ( RECOVER-VITAL ), is testing an even longer course of nirmatrelvir-ritonavir among an estimated 900 participants at centers throughout the US.

And Krumholz and colleagues at Yale University are in the process of analyzing data from their placebo-controlled randomized trial of nirmatrelvir-ritonavir in 100 patients with long COVID. (The trial received funding and design input from Pfizer.)

“We’re not sure it works,” said Krumholz, founder and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation. “What I think we need are a lot more studies of 100 people or 200 people, trying a lot more things” to treat long COVID.

Participants in the Yale trial were all highly symptomatic and lived throughout the contiguous US. Instead of having them go to participating centers, the trial came to them. “Setting up centers is expensive,” Krumholz explained, noting that the trial’s decentralized design could help cut costs and could work for a variety of conditions and treatments.

Participants were shipped the medication. They gave blood and saliva samples at a local laboratory or at home and answered questions about their symptoms in a digital diary. Yale colleague Akiko Iwasaki, PhD, who studies antiviral immunity and viral disease pathogenesis, is looking at the blood and saliva samples for differences between people who appeared to respond to nirmatrelvir-ritonavir and those who didn’t.

Paxlovid 2.0?

Meanwhile, Pfizer is working to eliminate what one recent publication referred to as nirmatrelvir-ritonavir’s Achilles’ heel: the limited metabolic stability of nirmatrelvir, a protease inhibitor that requires ritonavir to boost it to the target therapeutic range.

The problem is that ritonavir boosts the plasma levels of a long list of other medications beyond the therapeutic range, so nirmatrelvir-ritonavir is contraindicated for people taking them, unless they can temporarily stop or reduce the dose of the concomitant drugs while taking the COVID-19 treatment. Ritonavir is also the source of the metallic taste many individuals who take Paxlovid experience.

Pfizer’s second-generation protease inhibitor for treating COVID-19 is called ibuzatrelvir. Although it’s structurally related to nirmatrelvir, ibuzatrelvir has greater bioavailability when taken orally, so it doesn’t require a ritonavir boost.

Pfizer has completed a phase 2B trial testing the safety and efficacy of a 5-day course of ibuzatrelvir treatment. Participants were nonhospitalized individuals aged 18 to 65 years with confirmed COVID-19 whose symptoms began within 5 days of randomization. Ibuzatrelvir showed robust antiviral activity in the trial, with statistically significant, dose-dependent decreases in viral load at days 3 and 5 compared with placebo, Pfizer researchers reported in April at the European Congress of Clinical Microbiology and Infectious Diseases.

“It is premature to speculate on potential timing of phase 3, but we are considering next steps and plan to share updates as they are available,” Pfizer spokesperson Longley said.

Meanwhile, SARS-CoV-2 continues to evolve along with attitudes toward COVID-19, Krumholz said. Many people “are treating it like a head cold,” he explained. “They’ve obviously made the determination that it’s not dangerous, but it is dangerous.”

Published Online: September 6, 2024. doi:10.1001/jama.2024.16432

Conflict of Interest Disclosures: Dr Geng reported grants from Pfizer during the conduct of her nirmatrelvir-ritonavir study; personal fees from UnitedHealth Group; and grants from the NIH and the Agency for Healthcare Research and Quality. Dr Krumholz reported receiving stock options for Element Science and Identifeye and payments from F-Prime for advisory roles; he is a cofounder of and holds equity in Hugo Health, Refactor Health, and ENSIGHT-AI; and, through Yale University, he is associated with research contracts from Janssen, Kenvue, Novartis, and Pfizer. No other disclosures were reported.

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Rubin R. The Latest Research About Paxlovid: Effectiveness, Access, and Possible Long COVID Benefits. JAMA. Published online September 06, 2024. doi:10.1001/jama.2024.16432

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What Are We Made For? Mobilizing Medical Education Research for Impact

Affiliations.

• 1 J. Sukhera is chair/chief of psychiatry, Institute of Living at Hartford Hospital, and associate clinical professor of psychiatry, Yale School of Medicine, Hartford, Connecticut; ORCID: https://orcid.org/0000-0001-8146-4947.
• 2 C.-C. Fung is professor of clinical medical education (educational scholar), vice chair of medical education, and assistant dean for assessment and scholarship, Department of Medical Education, Keck School of Medicine of USC, Los Angeles, California.
• 3 A. Teherani is professor of medicine, director of program evaluation and education continuous quality improvement, and founding codirector, University of California Center for Climate, Health and Equity, University of California San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0003-2936-9832.
• 4 T.R. Wyatt is associate professor and vice chair for research, Department of Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
• 5 D.J. Schumacher is professor of pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
• 6 A.N. Leep Hunderfund is associate professor of neurology and medical director, Office of Applied Scholarship and Education Science, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; ORCID: https://orcid.org/0000-0002-7784-504X.
• PMID: 39240893
• DOI: 10.1097/ACM.0000000000005850

During the past several decades, medical education research has advanced in many ways. However, the field has struggled somewhat with translating knowledge into practice. The field has tremendous potential to generate insights that may improve educational outcomes, enhance teaching experiences, reduce costs, promote equity, and inform policy. However, the gap between research and practice requires attention and reflection. In this commentary, the authors reflect on ways that medical education researchers can balance relevance and rigor, while discussing a potential path forward. First, medical education research can learn from implementation science, which focuses on adopting and sustaining best practices in real-world settings. Second, gaining a deeper understanding of the complex and dynamic ways that medical education contexts may influence the uptake of research findings into practice would facilitate the translation and mobilization of knowledge into practical settings. Third, moving from unilateral knowledge translation to participatory knowledge mobilization and engaging diverse stakeholders as active participants in the research process can also enhance impact and influence research findings. Overall, for medical education research to effect meaningful change, it must transition from producing generalizable findings to generating context-specific insights and embracing participatory knowledge mobilization. This shift will involve rethinking traditional research approaches and fostering collaboration with knowledge users to cocreate and implement innovative solutions tailored to their unique settings.

Copyright © 2024 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

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Errors in Deloitte-run Medicaid systems can cost millions and take years to fix

by Samantha Liss, Rachana Pradhan, KFF Health News

The computer systems run by the consulting giant Deloitte that millions of Americans rely on for Medicaid and other government benefits are prone to errors that can take years and hundreds of millions of dollars to update. While states wait for fixes from Deloitte, beneficiaries risk losing access to health care and food.

Changes needed to fix Deloitte-run eligibility systems often pile on costs to the government that are much higher than the original contracts, which can slow the process of fixing errors.

It has become a big problem across the country. Twenty-five states have awarded Deloitte contracts for eligibility systems, giving the company a stronghold in a lucrative segment of the government benefits business. The agreements, in which the company commits to design, develop, implement, or operate state-owned systems, are worth at least $6 billion, dwarfing any of its competitors, a KFF Health News investigation found.

Problems and delays can extend beyond Medicaid—which provides health coverage to roughly 75 million low-income people—because some state systems assess eligibility for other safety-net programs. Whether a person gets the benefits they are entitled to depends on what the computer says.

There is no automatic switch to stop errors in the system, said Elizabeth Edwards, a senior attorney with the National Health Law Program, a nonprofit that advocates for people with low incomes and medically underserved populations. The group in January filed a complaint urging the Federal Trade Commission to investigate Deloitte, alleging "ongoing and nationwide" errors and "unfair and deceptive trade practices."

"People will go without care," Edwards said, and until there's a fix or a workaround, "you will continue to have the harm over and over again."

Kenneth Smith, a Deloitte executive who leads its national human services division, previously told KFF Health News that Medicaid eligibility technology is state-owned and agencies "direct their operation" and "make decisions about the policies and processes that they implement." Smith has called the legal nonprofit's allegations "without merit."

States set aside millions of dollars to cover the cost of changes, but systems may require fixes beyond the agreed-upon work. The number of hours or updates is capped each year, so states are left to prioritize certain fixes over others. And even though Deloitte isn't reinventing the wheel for each eligibility system it builds or runs, the company addresses problems state by state rather than patching through fixes for systems across states, Smith said—a change request in one state "likely has absolutely nothing to do with another state."

"Because of the custom nature of these systems, it's never quite that simplistic as, 'Hey, a particular issue that's arisen in state of A is directly applicable to state of B,'" Smith said.

Speaking generally, Smith said, "I'm unaware of any circumstance in which a client has needed to get something done that we haven't found a way to get it done."

The work is lucrative for Deloitte, which reported global revenue of $65 billion in fiscal year 2023.

Deloitte's estimates show that 35 change requests for Georgia's eligibility system in 2023 would take more than 104,000 hours of work, according to a list of change requests that KFF Health News obtained in response to a public records request. That's the equivalent of 50 years of work, if someone worked 52 weeks a year at 40 hours a week.

"System changes were made to align with changing federal and state policies, as well as to meet evolving business needs," said Ellen Brown, a spokesperson for the Georgia Department of Human Services. Brown earlier said changes were also made to "improve functionality."

The federal government—that is, its taxpayers—covers 90% of states' costs to develop and implement state Medicaid eligibility systems and pays 75% of ongoing maintenance and operations expenses, according to federal regulations.

Eligibility systems for years have posed problems for states because of the dynamic between contractors and government officials, said Matt Salo, CEO of consulting firm Salo Health Strategies. The companies hold the expertise "and, quite frankly, they're kind of running circles around the state capacity," said Salo, a former executive director of the National Association of Medicaid Directors.

"For decades all I've heard from states in this arena is: We know that when we go out to contract it's going to cost us a lot of money and it is going to run over, it is going to deliver years late, it is going to deliver millions if not hundreds of millions of dollars over budget," Salo said, and "by the time it's delivered, our needs have changed and so it's just this constant process of change orders and going back and fixing."

Going to court in Florida

Two advocacy groups last August sued Florida in federal court, alleging tens of thousands of people were losing coverage without proper warning. And Florida's eligibility system was cutting off Medicaid coverage for some moms after giving birth, William Roberts, a state employee who reviews Medicaid eligibility decisions, testified when the case went to trial in July.

Florida previously gave moms two months of Medicaid coverage after giving birth. Federal regulators in 2022 approved Florida's proposal to grant Medicaid benefits for 12 months. But in April 2023, state officials discovered a "glitch," Roberts said, and "the system had reverted back to only giving mothers two months instead of giving them the 12 months that they were entitled to."

What became clear in the testimony is that the state and Deloitte take different views on what constitutes a "defect" in a Deloitte-run system. Deloitte said it would fix defects without billing any additional hours for the work. Although Deloitte is not a named defendant in the lawsuit, the company was called to testify about its role in operating Florida's eligibility system.

Harikumar Kallumkal, a Deloitte managing director who oversees the Florida system, initially testified that, in this case, there was no problem and "the computer system was providing 12 months" of postpartum coverage.

Then Kallumkal said, "Even in this case, I do not believe it was a defect." Even so, "we did fix that." And for the fix, he said, Deloitte "did not charge" the state.

Rather, a separate defect may have resulted in coverage losses for mothers after childbirth, Kallumkal testified.

Some historical data "required to determine postpartum coverage" was not loading into the system, Kallumkal said. "I don't know how many cases it impacted," he said, but Deloitte fixed the problem.

The courtroom revelation confirmed what Florida advocates already knew: an eligibility system issue prevented some of the state's most vulnerable from getting care. Florida denied allegations that it terminated Medicaid coverage without providing adequate notice. The case is ongoing.

When Michigan resumed regular Medicaid eligibility checks following the COVID-19 pandemic, advocates saw a concerning trend.

The computer system routinely fails to recognize when certain adults with disabilities should receive Medicaid benefits, said Dawn Calnen, executive director of The Arc of Oakland County, which provides support for those with intellectual and developmental disabilities.

Often, a person who qualifies for Medicaid initially for one reason could remain eligible even when life circumstances change. Calnen said there's no question that the people her group assisted are still eligible, just in a different way than during the pandemic.

The problem is frequent enough that Calnen's group felt compelled to notify others. "We kind of shout it from the rooftop for people: Know that this is going to happen."

When asked about the problem, Chelsea Wuth, a spokesperson for Michigan's Department of Health and Human Services, said there were "no issues" with the system. Deloitte operates Michigan's eligibility system. The company said it does not comment on state-specific issues.

Tennessee hired Deloitte in 2016 to build an eligibility system after the state canceled a contract with Northrop Grumman due to chronic delays. Deloitte didn't create the Tennessee system, known as TEDS, from scratch. It built on components from Georgia's system, according to a legal declaration and a deposition of Kimberly Hagan, Tennessee Medicaid's director of member services, that were part of a class-action lawsuit that Medicaid beneficiaries filed against the state in 2020.

The lawsuit, which is ongoing and does not name Deloitte as a defendant, seeks to order Tennessee to restore coverage under its Medicaid program, known as TennCare, for those who wrongly lost it. Hagan, in a court filing, said many problems "reflect some unforeseen flaws or gaps" with the Tennessee eligibility system and "some design errors."

A federal judge on Aug. 26 sided with the Medicaid beneficiaries, ruling that Tennessee violated federal law and the U.S. Constitution. "Poor, disabled, and otherwise disadvantaged Tennesseans should not require luck, perseverance, or zealous lawyering to receive health care benefits they are entitled to under the law," wrote U.S. District Court Judge Waverly D. Crenshaw Jr., adding, "TEDS is flawed, and TennCare knows that it is flawed."

Tennessee Medicaid spokesperson Amy Lawrence said the state is "determining what our next steps will be."

Tennessee's $823 million contract with Deloitte shows that the budget for changes outside the contract's original scope increased by hundreds of millions of dollars. Deloitte's maximum compensation for such change orders rose to $417 million under a 2023 contract amendment, up from $103.6 million four years earlier.

Lawrence said state officials "do not and would not pay to fix vendor errors." Lawrence attributed the cost increases to "system modernization" in "an effort to enhance our citizens' interactions with the state Medicaid program." Additional funding was also needed to comply with new federal requirements related to the COVID-19 pandemic, she said.

Waiting on fixes

States sometimes wait so long for Deloitte's fixes that the staffers who worked on the problems don't see the results. Jamie Perkins was responsible for making letters easier for Colorado Medicaid enrollees to understand. The letters are generated by Colorado's Deloitte-run eligibility system. State audits have found that the notices confuse enrollees and contain errors. Perkins said she left her job in 2021, frustrated that many of her fixes hadn't been implemented.

"It feels like a really perverse reward system, frankly, for Deloitte," Perkins said. "When Deloitte is themselves making a problem that did not originate with the department, the department is still paying them to fix those problems."

The state's contract with Deloitte now outlines "protocols to address issues that are the result of the contractor," said Trish Grodzicki, a spokesperson for Colorado's Medicaid agency. As of June 30, Colorado "has made substantial improvements" and a "majority of the letters have been rewritten" and updated in the system, she said.

Deloitte spokesperson Karen Walsh said "a change request can represent a number of different things," including when states make policy decisions that would warrant system updates. Smith said Deloitte views change requests and system issues, or defects, as different things.

"We have a responsibility when there's a system issue to fix that," Walsh said. "We don't get a change request to fix an issue."

Yet in Kentucky and other places, states have submitted change orders to resolve issues. Government officials and Deloitte sometimes negotiate fixes for months before they're implemented.

Kentucky resident Beverly Likens lost Medicaid coverage in June 2023 partly due to an error with the state's Deloitte-run system. State health officials told a legal aid group in September 2023 that a "change order has been submitted" to fix the glitch, which blocked her new coverage application from getting through online.

Likens, with the help of a lawyer, had her Medicaid benefits quickly reinstated, but that was far from the end of the saga. The problem that caused her benefits to lapse was resolved in April—10 months later—when Kentucky implemented the first phase of a change request, Kentucky's Cabinet for Health and Family Services told KFF Health News.

Agency spokesperson Brice Mitchell said the change request was designed to address a "limitation of the system rather than technical issues."

The request, for which a second phase was implemented in July, cost $522,455 and took more than 3,500 hours of work, according to Mitchell and documents obtained in response to a public records request. All such requests "are thoroughly vetted, negotiated and approved by several areas within the Cabinet," Mitchell said in an emailed statement.

"These are large, complex system implementations," Walsh, of Deloitte, said. "So in all of them, you're going to be able to find a point in time where there was an issue that needed to be fixed. And you can also find millions of people every day who are getting benefits through these systems."

In February, Georgia officials were discussing a high-priority change request to resolve an ongoing problem: A defect affected potentially tens of thousands of "cases/claims" for families in the Supplemental Nutrition Assistance Program, known as SNAP, and the Temporary Assistance for Needy Families program that, among other problems, led the state to recoup some residents' entire benefit, according to state documents KFF Health News obtained from a public records request.

The programs provide monthly cash assistance to low-income people for food and housing. Georgia in 2014 inked a contract with Deloitte to build and maintain its eligibility system, known as Georgia Gateway.

Federal regulations cap how much money the government can recoup if a SNAP recipient was overpaid at 20% or $20, whichever is higher, according to legal aid attorneys and SNAP experts.

"We have plenty of clients who, that is their entire grocery budget," said Adrianne Freeman, deputy director for litigation and advocacy at the Georgia Legal Services Program.

The defect—which Georgia DHS' Brown said was identified on April 29, 2022—created several problems, including incorrect calculations of how much to recoup and clawbacks not occurring on the correct start dates. "The Gateway system did not consistently adjust or apply the recoupment amount correctly," Brown said.

A fix was deployed the weekend of Feb. 17, the documents state, but a formal change request was needed to "allow the State Agency (SA) to correctly apply allotment reductions to all SNAP and TANF cases impacted by Defect 21068," the documents state. The change order would allow state officials to run an automated one-time mass update to fully resolve the problem.

The target date for doing so: March 1. That was nearly two years after officials were provided an "original report" noting that more than 25,000 cases may have been affected, the documents state.

Relying on workarounds

States often face constraints on how many changes can be made in a year. In Texas, there is a years-long waitlist for changes, according to advocates, state documents, and the state health agency. "The system isn't nimble enough to meet the needs and often relies really heavily on manual workarounds," said Stacey Pogue, a senior research fellow at Georgetown University's Center on Health Insurance Reforms with expertise on Medicaid in Texas.

Texas eligibility workers use workarounds to process applications while awaiting permanent fixes. Deloitte said in its $295 million Texas contract that "there is a real need" for workarounds, which allow operations to continue "without affecting client benefits."

Many of these "temporary" fixes were implemented years ago and were still in use in 2023, according to records obtained by KFF Health News that found 45 active workarounds in Texas last year. In one instance, a workaround was implemented nearly 14 years ago. Deloitte acknowledged in its Texas contract that reducing workarounds "is one of the top priorities."

Smith of Deloitte said it doesn't always take months to fix a problem: "We have changes that get implemented in a day and changes that get implemented in a month."

Further, Smith said, Deloitte "is one part of implementing a change," noting "we're often not necessarily the constraint."

The state considers several factors when assessing which fixes to tackle first, including how many beneficiaries are affected. The more complex the workaround, "the longer it may take for staff to process eligibility," said Jennifer Ruffcorn, a spokesperson for Texas Health and Human Services.

In Florida—in addition to the lapses in coverage for maternal care—the National Health Law Program and the Florida Health Justice Project alleged in their lawsuit in federal court that notices to Medicaid beneficiaries alerting them their benefits would be terminated did not explain the basis for the decision.

In October, about a month after the lawsuit was filed, the state asked Deloitte to provide an estimate to alter the notices, Kallumkal of Deloitte testified at trial in August.

Deloitte estimated it would need roughly 28,000 hours, he said. That's more than twice the 12,600 hours the state sets aside each year to pay Deloitte for revisions. The extra hours would require an amended contract in which the state would have to agree to pay more. Florida's Department of Children and Families did not respond to requests for comment.

For Deloitte, extra hours mean more revenue, Kallumkal acknowledged during his testimony while under cross-examination. Deloitte subsequently provided the state with a new estimate for a narrower scope of work that would take 12,000 hours, he said.

2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

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Involving medical students in research

Undergraduate research is not a new phenomenon in medicine. Charles Best was a medical student at the time that he and his supervisor, Frederick Banting, discovered insulin. Insulin arises from the pancreatic islets of Längerhans, themselves discovered in 1869 by medical student Paul Längerhans. In biomedical research, Alan Hodgkin, formerly professor of biophysics at the University of Cambridge, won the Nobel Prize in 1972 for work on nerve transmission that he began as an undergraduate.

Medical student research can be mandatory, elective or extracurricular. In Germany, medical school graduates practice medicine but cannot assume the title ‘Doctor’ until they have submitted a thesis. As a result, around 90% of practicing German physicians have undertaken a period of research. 1 Although research is usually voluntary for UK medical students, there is increasing undergraduate interest in research and publication. The 2007 MTAS form, for example, awards credit to medical graduates for a first author paper in a peer-reviewed journal.

The GMC document Tomorrow's Doctors states that medical school graduates must be able to ‘critically evaluate evidence’ and ‘use research skills to develop greater understanding and to influence their practice’. 2 It has been suggested that a period of research might help fulfill this requirement of new doctors. 3 , 4 Despite this possibility, medical students have only limited opportunities to pursue original research. However, a number of institutions offer intercalated degree courses in which students suspend their medical training to undertake a second degree, often with a strong research component. These attract around a third of UK medical students each year. 5 , 6

Reasons for medical students choosing to intercalate are varied and include improving their long-term career prospects as well as establishing a broad knowledge base. 6 The opportunity to conduct original research is, however, less frequently given as a reason for pursuing an intercalated degree. 5 , 6 In addition, two thirds of new doctors in the UK have not undertaken an intercalated degree 5 , 6 and may graduate without experiencing research. A number of barriers explain the reluctance of medical students to intercalate. One survey found the most common reasons were financial constraints, lack of interest, and reluctance to prolong medical training. 6

Nevertheless, there are many benefits of undergraduate participation in research. For example, student researchers can greatly increase the publication output of their medical school. Academic supervisors at one German institution have reported that students appear as co-authors on approximately 28% of papers published in Medline-indexed journals. 8

Research experience may also boost the career profile of graduating medical students. When a cohort of students at the Stanford University School of Medicine was encouraged to participate in research, 75% gained authorship of a paper and 52% presented data to a national conference. 3 In Germany, around 66% of medical students obtain a Medline-indexed publication before qualifying. This does not include data presented to meetings or published in peer-reviewed journals not indexed by Medline. 8

In addition to boosting graduate employability, publication as an undergraduate can have long-term career implications for doctors. For example, one survey of academic physicians found that career success is independently associated with having conducted research as a student. 9 In addition, physicians who undertook extracurricular research at medical school produced four times as many publications as their peers. 10

Undergraduate research may also provide a solution for countries in which academic medicine is experiencing a crisis in recruiting postgraduate clinical researchers. 11 For example, a survey of medical student researchers found that 75% were motivated to pursue further research and 60% aspired to a full-time academic career. 3

Those students not considering research careers may nevertheless develop skills transferable to clinical practice. In particular, medical student research may help instil a culture of evidence-based medicine (EBM) in clinical medicine. According to one author, ‘the practice of EBM is not a “behaviour”… it is an internalized spirit of enquiry born of a deep understanding… of the value and the limitations of biomedical research’. 5 Indeed, there is evidence to suggest that research experience as an undergraduate may foster this ‘deeper understanding’. 3–5 According to one survey, American medical students participating in research found that the experience ‘taught them to ask questions, review the literature critically, and analyse data’. 3 Students undertaking a mandatory literature review further developed ‘critical appraisal, information literacy, and critical thinking skills’ and the opportunity to make ‘contacts for postgraduate training’. 4

Despite these apparent benefits, there are objections to involving undergraduates in research. Intensive projects may, for example, disrupt the progress of students through the core medical curriculum. Similarly, supervision requirements may distract faculty members from their own clinical and research commitments. However, students do not have to run a clinical trial to learn about the research process. If there are not pre-existing clinical projects suitable for student participation, undergraduates might be involved in critically appraising literature for a review article, or preparing patient case reports for publication. Projects such as these require little supervision while still immersing students in the research culture of their profession.

In summary, research opportunities for medical students are often confined to intercalated degree courses; potentially increasing financial burden, prolonging the curriculum and delaying clinical experience. As a result, around two thirds of medical students eschew the opportunity to intercalate 5 , 6 and miss out on conducting original research. Nevertheless, the benefits of student participation in research are well-documented for graduates, institutions and the academic community as a whole. 3–5 , 7–10 As a result, senior doctors should strongly consider involving motivated students in elective or extracurricular research projects. Furthermore, medical educators should recognize the value of student research and incorporate opportunities into the curriculum wherever practicable. Only in these ways can we secure a future for academic medicine and foster a genuine respect for EBM in tomorrow's doctors.

DECLARATIONS —

Competing interests DM is an undergraduate medical student and Editor of Reinvention: A Journal of Undergraduate Research . He has received research funding from the Reinvention Centre for Undergraduate Research at the University of Warwick and Oxford Brookes University

Funding None

Ethical approval Not applicable

Guarantor DM

Contributorship DM is the sole contributor

Acknowledgements

The author would like to thank Mina Aletrari for reviewing earlier drafts of this paper

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1. Review the education and experience minimum qualifications (MQ’s) of the  Research Scientist IV . See the Minimum Requirements section above.

2. Complete the state application by clicking “Apply Now” above. See below for detailed application instructions.

3. Submit your application package with all required documents - see the "Required Application Package Documents" section below. 4. Once you have applied, take the  Research Scientist IV (all parentheticals) Exam . **Education: If you are meeting minimum qualifications with education, you must include a copy of your diploma/degree and/or unofficial/informal transcripts for verification. Official transcripts may be required upon appointment.**

Application Instructions

Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.

Who May Apply

How To Apply

Address for Mailing Application Packages

You may submit your application and any applicable or required documents to:

Address for Drop-Off Application Packages

You may drop off your application and any applicable or required documents at:

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

• Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at www.CalCareers.ca.gov. All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
• Resume is required and must be included.
• Supplemental Application - A completed Supplemental Application must be submitted with your STD. 678 in order to be considered for this position. Please see the Special Requirements Section above for additional information .

Desirable Qualifications

DHCS is dedicated to creating an innovative workplace for its team members that is inclusive, diverse, and interactive! Here are a few of the ways we stay engaged with our team:

• Continuous and ongoing training
• Diversity, Equity, and Inclusion program activities
• Employee Assistance Program (EAP)
• Medical, including health, dental, and vision insurance
• Paid Holidays and vacation/leave
• Defined retirement program
• Savings Plus Program (401(k), 457)
• Medical/Dependent Care Reimbursement Accounts

Comprehensive Benefit information may be obtained by visiting:  California State Civil Service Employee Benefits Summary - CalHR. 

DHCS 2023-2027 Strategic Plan  provides more information about our commitment to serving Californians and organizational excellence.

We need your help! Please let us know how you heard about our position by taking this brief optional survey:  SurveyMonkey link .

This survey is not required to be considered for this position.

Contact Information

The Hiring Unit Contact is available to answer questions regarding the position or application process.

Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.

Telework Information

The DHCS standard for hybrid work is a minimum of two days per week in-person and site-based and up to three teleworking days per week. The amount of telework is at the discretion of the Department’s operational business needs and subject to change consistent with DHCS’ Telework Program and Government Code sections 14200 – 14203. Telework is available to California residents, and proof of residency may be required. The DHCS office location for this position is: 1700 K Street, Sacamento, CA.

Additional Information

Using the online application system as specified in the announcement is the preferred method of applying for civil service job opportunities; however, applicants may instead apply by way of U.S. mail, parcel delivery or courier service, or in person, as set forth in this announcement. Paper applications must include a signature. Dates printed on envelopes by mobile barcodes or equivalent mobile print technology are not acceptable proof of the date the application and any other required documents or materials were filed. Applicants must state their basis of eligibility (List Eligibility, Lateral Transfer, Reinstatement, T&D, or Surplus/SROA), andthe Job Control (JC) number and/or position number in the “Examination(s) or Job Title(s), For Which You Are Applying” section on the STD. 678. Surplus/SROA candidates should submit a copy of their letter with their application. Please remove any confidential information (i.e., social security number, date of birth, etc.) as well as any information regarding your LEAP eligibility and/or exam scores from your documents prior to submission. If applying electronically, please note that CalCareers no longer allows applicants to withdraw their applications. If you need assistance to withdraw your application, please contact the Recruitment Section at [email protected]. For all other questions regarding your CalCareer account, please contact CalHR’s CalCareers Unit at (866) 844-8671 or [email protected] .

Equal Opportunity Employer

The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.

It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.

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