Better prioritization to increase research value and decrease waste

In a recent study published in BMC Medicine, Singh Ospina and colleagues outlined the important gaps between ongoing research and research needs in the field of endocrinology. Many recommendations from clinical practice guidelines are based on a low level of evidence, thereby resulting in research gaps. Despite the publication of around 25,000 randomized controlled trials each year, ongoing research does not cover most of these gaps. In contrast, trials are planned when sufficient data are already available for decision making, which results in redundant research and exposes patients to unnecessary risks. This lack of prioritization contributes to the enormous problem of waste in research. A systematic approach to accumulate the available body of evidence is necessary to determine when we have sufficient evidence and when we have knowledge gaps, defined as research questions with no or a low level of evidence available. Systematic registration of research gaps and their prioritization may help to organize future research. Some initiatives exist, but they need to be generalized.