AWMF: Undesirable developments in the science system threaten the quality and freedom of medical research
15.11.2018 17:58
Good, evidence-based treatment of patients is based on serious medical research. The Working Group of Scientific Medical Societies e. V. (AWMF), however, sees the penetration of knowledge from serious science into practice increasingly at risk. Symptoms of this undesirable development are the increasing spread of worthless research and pseudo-knowledge through so-called predatory journals and fake conferences as well as the influence of lobby groups. At their delegate conference on November 10, 2018, the AWMF member companies analyzed the underlying causes of this undesirable development and discussed countermeasures.
“The integrity of medical research is an essential basis for the introduction of effective diagnostic and treatment procedures,” says Professor Dr. med. Rolf Kreienberg, President of the AWMF. Serious research is reflected, among other things, in systematic reviews by the Cochrane Collaboration and in medical guidelines that are developed and disseminated by the 180 specialist societies that make up the AWMF. “In contrast, dubious information is spreading uninhibitedly - as a result, we see patients in danger,” explains the AWMF President and adds: “The rapid increase in the emergence of pseudo-scientific journals and specialist conferences that can be observed in this context, as well as the increasing influence of lobby groups on systematic ones However, reviews and guidelines are only symptoms of an undesirable development – the causes for this lie deeper.”
The main reasons for this undesirable development are incorrect reward systems, which are fueled not only by external influences, but also by the erosion of medical science's own demands. Professor Dr. rer. nat. Gerd Antes, former director of Cochrane Germany, who has been critically observing this undesirable development for years, identifies the core problem: “Quantity counts instead of class.” Symptoms of this are increasing multiple publications of studies. Professor Antes sees false incentive mechanisms at universities as partly responsible for the increase in publication volumes. Instead of long lists of publications that are crucial for the career development of scientists, for example in the context of habilitation and appointment procedures, the publications that are really relevant to improving patient care should be taken into account. In this context, Professor Antes also criticizes the performance-oriented allocation of funds at university institutions and calls for a rethink. In particular, the use of the Journal Impact Factor, i.e. the calculated number that provides information about how often articles from a particular journal have been cited in other publications, which has been widely criticized by the AWMF for years, has ensured that it is the quantity that counts.
Another reason for the increase in the volume of publications is the economic interests of publishers and magazines. Add to this Professor Dr. med. Christoph Herrmann-Lingen, head of the permanent AWMF commission for performance evaluation in research and teaching, states: “Unfortunately, the open access process supported by the AWMF to promote academic freedom, which is intended to ensure the free availability of scientific publications through payment by the authors, is increasingly being used in this way so-called predatory journals, which finance themselves through publications paid for by authors, but do not guarantee the necessary quality assurance - peer review procedures." As a countermeasure, authors should follow positive lists of reputable open access journals, such as those provided by Directory of Open Access Journals and are maintained by the AWMF, or which are listed in selected Web of Science databases.*
Professor Dr. med. Ina Kopp, head of the AWMF Institute for Medical Knowledge Management, shows another facet of the problem of mismanagement: “50 percent of all randomized clinical trials are never published. In particular, unwanted study results are not made public.” The AWMF therefore supports international initiatives to improve clinical studies and their complete publication. “The official registration of all studies and the publication of all study results must be mandatory,” demands Professor Kopp. This is the only way quality assurance is possible. In Germany, the legislature is required to enforce this requirement. Reliable study registers such as the German Register of Clinical Studies (DRKS) in Freiburg are essential for this.
* 1. Directory of open access journals. https://doaj.org/ 2. AWMF Commission for Performance Evaluation in Research and Teaching. https://www.awmf.org/forschung-lehre/komm-evaluation-von-fl/leistungsevaluation-forschung/bibliometrie/fachzeitschriften.html 3. Science Citation Index Expanded (SCIE). http://mjl.clarivate.com/cgi-bin/jrnlst/jloptions.cgi?PC=D; Social Sciences Citation Index (SSCI). http://mjl.clarivate.com/cgi-bin/jrnlst/jlresults.cgi?PC=ss