Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada.
Institute for the History and Philosophy of Science and Technology, University of Toronto, Toronto, Ontario, Canada.
J Eval Clin Pract. 2021 Jun;27(3):694-707. doi: 10.1111/jep.13550. Epub 2021 Feb 15.
RATIONALE, AIMS, AND OBJECTIVES: One of the sectors challenged by the COVID-19 pandemic is medical research. COVID-19 originates from a novel coronavirus (SARS-CoV-2) and the scientific community is faced with the daunting task of creating a novel model for this pandemic or, in other words, creating novel science. This paper is the first part of a series of two papers that explore the intricate relationship between the different challenges that have hindered biomedical research and the generation of scientific knowledge during the COVID-19 pandemic.
During the early stages of the pandemic, research conducted on hydroxychloroquine (HCQ) was chaotic and sparked several heated debates with respect to the scientific methods used and the quality of knowledge generated. Research on HCQ is used as a case study in both papers. The authors explored biomedical databases, peer-reviewed journals, pre-print servers, and media articles to identify relevant literature on HCQ and COVID-19, and examined philosophical perspectives on medical research in the context of this pandemic and previous global health challenges.
This paper demonstrates that a lack of prioritization among research questions and therapeutics was responsible for the duplication of clinical trials and the dispersion of precious resources. Study designs, aimed at minimising biases and increasing objectivity, were, instead, the subject of fruitless oppositions. The duplication of research works, combined with poor-quality research, has greatly contributed to slowing down the creation of novel scientific knowledge.
The COVID-19 pandemic presented challenges in terms of (1) finding and prioritising relevant research questions and (2) choosing study designs that are appropriate for a time of emergency.
背景、目的和目标:受 COVID-19 大流行挑战的领域之一是医学研究。COVID-19 源自一种新型冠状病毒(SARS-CoV-2),科学界面临着为这场大流行创建新型模型的艰巨任务,换句话说,就是要创造新的科学。本文是两篇论文系列的第一部分,探讨了在 COVID-19 大流行期间,阻碍生物医学研究和产生科学知识的不同挑战之间错综复杂的关系。
在大流行的早期阶段,对羟氯喹(HCQ)的研究是混乱的,引发了关于所使用的科学方法和产生的知识质量的激烈辩论。在这两篇论文中,HCQ 研究都被用作案例研究。作者在生物医学数据库、同行评议期刊、预印本服务器和媒体文章中搜索了有关 HCQ 和 COVID-19 的相关文献,并在这一大流行和以前的全球卫生挑战的背景下探讨了医学研究的哲学观点。
本文表明,研究问题和疗法之间缺乏优先级排序是导致临床试验重复和宝贵资源分散的原因。旨在减少偏倚和提高客观性的研究设计,反而成为毫无意义的对立的主题。研究工作的重复,加上低质量的研究,极大地阻碍了新科学知识的创造。
COVID-19 大流行在以下两个方面带来了挑战:(1)寻找和优先考虑相关研究问题;(2)选择适合紧急情况的研究设计。