medical research via mommsen

Medical Research

Via teodoro mommsen, 45 - roma, specializzazioni, medicina nucleare, endocrinologia e malattie del metabolismo, otorinolaringoiatria, ortopedia e traumatologia, cardiologia, dermatologia e venereologia, ginecologia ed ostetricia, informazioni.

IL CENTRO MEDICO MEDICAL RESEARCH SI DEDICA PRINCIPALMENTE ALL'EROGAZIONE DI SERVIZI RELATIVI ALLA DIAGNOSTICA PER IMMAGINI E SPECIALISTICA. LE VARIE SPECIAIZZAZIONI SI INTEGRANO E CONCORRONO SINERGICAMENTE ALLA SOLUZIONE DELLE VARIE PROBLEMATICHE. IL CENTRO è CONVENZIONATO CON IL S.S.N. PER LE SCINTIGRAFIE ( MEDICINA NUCLEARE E DIAGNOSTICA PER IMMAGINI) Macchinari: Ecografo

Indirizzo della clinica

Domande frequenti, come prenoto una visita o un esame con medical research .

Per prenotare visite ed esami in modo rapido e semplice, ti consigliamo di utilizzare Elty. Al momento non è possibile prenotare con Medical Research . Cerca sul sito elty.it gli orari disponibili per altre prestazioni, medici e cliniche nella tua città. Con Elty non ci sono costi aggiuntivi. Puoi scegliere di pagare online o direttamente in sede, e puoi cancellare la tua prenotazione gratuitamente con un solo click.

Dove si trova Medical Research ?

L'indirizzo di Medical Research è in Via Teodoro Mommsen, 45 - Roma.

Quali sono i prezzi ed esami offerti da Medical Research ?

Ecco la lista di prestazioni e relativi prezzi eseguite da Medical Research :

Ecocardiogramma

a partire da 90 €

Ecocolordoppler Arterioso Arti Inferiori

a partire da 120 €

Ecocolordoppler Tsa

Ecocolordoppler venoso arti inferiori, ecodoppler aorta addominale.

a partire da 80 €

prezzo non disponibile

Ecografia Addome Completo

a partire da 130 €

Ecografia Addome Superiore

a partire da 110 €

Ecografia Collo

a partire da 70 €

Ecografia Cute E Sottocute

Ecografia epatica.

a partire da 65 €

Ecografia Ghiandole Salivari

Ecografia linfonodi, ecografia mammaria, ecografia muscolotendinea, ecografia pelvica, ecografia pelvica transvaginale, ecografia prostatica transrettale, ecografia renale, ecografia testicolare, ecografia tiroidea, elettrocardiogramma.

a partire da 40 €

Elettrocardiogramma Sotto Sforzo

a partire da 100 €

Esame Audiometrico

Infiltrazioni, mammografia, mammografia visita senologica ecografia mammaria.

a partire da 95 €

Moc - Mineralometria Ossea Computerizzata

a partire da 60 €

a partire da 20 €

Prima Visita Dermatologica

Scintigrafia cerebrale.

a partire da 1 €

Scintigrafia Delle Paratiroidi

a partire da 200 €

Scintigrafia Ghiandole Salivari

a partire da 150 €

Scintigrafia Miocardica Di Perfusione

a partire da 280 €

Scintigrafia Ossea

Scintigrafia renale, scintigrafia tiroidea, test da sforzo al cicloergometro, tomoscintigrafia miocardica, visita angiologica, visita angiologica + ecocolordoppler.

a partire da 140 €

Visita Cardiologica

Visita cardiologica + elettrocardiogramma (ecg), visita dermatologica + epiluminescenza, visita di controllo, visita diabetologica, visita diabetologica di controllo, visita endocrinologica, visita endocrinologica + ecografia tiroidea, visita endocrinologica di controllo, visita ginecologica, visita ginecologica + ecografia + pap test.

a partire da 15 €

Visita Ginecologica + Ecografia Transvaginale

Visita nutrizionistica, visita ortopedica, visita otorinolaringoiatrica, visita otorinolaringoiatrica + lavaggio auricolare, visita pediatrica, al momento non è possibile prenotare online.

• Medicina ed estetica
• Medici specialisti - varie patologie
• Condividi con gli amici
• Invia agli amici

Via Mommsen Teodoro, 45 00179 ROMA   (RM)

Medici specialisti - varie patologie, medical research s.r.l., via mommsen teodoro, 45 00179 roma   (rm) it mostra telefono 06 7825089.

• CONTATTI CONTATTI tel: 06 7825089 tel: 06 78345939

Attività simili a ROMA e nei dintorni

Tosoni Dott.ssa Fiorella Ginecologa

Viale Filarete, 179 00176 ROMA (RM)

Polimed Poliambulatorio Specialistico Ecografia Roma

Piazza Aruleno Celio Sabino, 32 00174 ROMA (RM)

SicurMedical Center

Via dei Castani, 183 00172 ROMA (RM)

Dott. Alessio Caggiati

Via della Fonte di Fauno, 29 00153 ROMA (RM)

Clinica Madonna della Fiducia

Via Alfredo Baccarini, 54 00179 ROMA (RM)

Prof. Luigi Uccioli

Categorie correlate.

• Ambulatori e consultori

Cerca nelle vicinanze

• Medici specialisti - varie patologie a Roma
• Medici specialisti - varie patologie a Ciampino
• Medici specialisti - varie patologie a Fonte Nuova
• Medici specialisti - varie patologie a Frascati
• Medici specialisti - varie patologie a Grottaferrata
• Medici specialisti - varie patologie a Mentana
• Medici specialisti - varie patologie a Marino
• Medici specialisti - varie patologie a Monte Porzio Catone
• Medici specialisti - varie patologie a Monterotondo
• Medici specialisti - varie patologie a Castel Gandolfo
• IN CITTÀ

© Italiaonline S.p.A. 2024 Direzione e coordinamento di Libero Acquisition S.á r.l.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• News Feature
• Published: 05 December 2019

Looking forward 25 years: the future of medicine

Nature Medicine volume  25 ,  pages 1804–1807 ( 2019 ) Cite this article

63k Accesses

6 Citations

320 Altmetric

Metrics details

A Publisher Correction to this article was published on 27 January 2020

This article has been updated

To celebrate the end of our 25th anniversary year, we asked thought leaders and experts in the field to answer one question: What will shape the next 25 years of medical research?

Core member and chair of the faculty, Broad Institute of MIT and Harvard; director, Klarman Cell Observatory, Broad Institute of MIT and Harvard; professor of biology, MIT; investigator, Howard Hughes Medical Institute; founding co-chair, Human Cell Atlas.

For many years, biology and disease appeared ‘too big’ to tackle on a broad level: with millions of genome variants, tens of thousands of disease-associated genes, thousands of cell types and an almost unimaginable number of ways they can combine, we had to approximate a best starting point—choose one target, guess the cell, simplify the experiment.

But we are now on the cusp of an inflection point, where the ‘bigness’ of biomedicine turns into an advantage. We are beginning to see advances towards these goals already, in polygenic risk scores, in understanding the cell and modules of action of genes through genome-wide association studies (GWAS), and in predicting the impact of combinations of interventions. Going forward, our success in harnessing bigness will rely on our ability to leverage structure, prediction and expanded data scale. Disease is highly structured at the molecular, genetic, gene program, cell and tissue levels; acknowledging and understanding this structure can help us reduce the overwhelming lists of genes and variants to a manageable number of meaningful gene modules . We cannot test every possible combination, so we need algorithms to make better computational predictions of experiments we have never performed in the lab or in clinical trials. But only when data are truly big, scaled massively and rich in content, will we have the most effective structuring and prediction power towards building a much-needed Roadmap of Disease for patients.

To achieve this, we need to invest in building the right initiatives—like the Human Cell Atlas and the International Common Disease Alliance—and in new experimental platforms: data platforms and algorithms. But we also need a broader ecosystem of partnerships in medicine that engages interaction between clinical experts and mathematicians, computer scientists and engineers who together will bring new approaches to drive experiments and algorithms to build this Roadmap.

PhD investigator, Howard Hughes Medical Institute; core member, Broad Institute of MIT and Harvard; James and Patricia Poitras Professor of Neuroscience, McGovern Institute for Brain Research, MIT.

Although it is difficult to pinpoint an exact value, it is safe to estimate that more than 250 patients have been treated with gene therapies for monogenic diseases for which there previously were no treatment options. Add in the patients who have received CAR-T therapy, and that number rises into the thousands. This is an enormous success, and it represents the beginning of a fundamental shift in medicine away from treating symptoms of disease and toward treating disease at its genetic roots.

Gene therapy has been under development for more than 30 years, but several recent major advances have tipped the scales toward clinical feasibility, including improved delivery methods and the development of robust molecular technologies for gene editing in human cells. In parallel, affordable genome sequencing has accelerated our ability to identify the genetic causes of disease. With these advances, the stage is set for the widespread use of gene therapy. Already, nearly 1,000 clinical trials testing gene therapies are ongoing, and the pace of clinical development is likely to accelerate.

To fulfil the potential of gene therapy and ensure that all patients have access to this revolutionary treatment, we will need to continue developing delivery approaches that are practical and widely usable, to refine molecular technologies for gene editing, to push our understanding of gene function in health and disease forward, and to engage with all members of society to openly discuss the risks and benefits of gene therapy.

Elizabeth Jaffee

Dana and Albert “Cubby” Broccoli Professor of Oncology, Johns Hopkins School of Medicine; deputy director, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins.

“An ounce of prevention is worth a pound of cure.” Benjamin Franklin said this in reference to fire safety, but it can easily be applied to health too. The twentieth century saw amazing advances aimed at preventing the onset of disease—including vaccines and risk-factor interventions—nearly doubling life expectancy worldwide. Only two decades into the twenty-first century, healthcare has already entered its next phase of rapid advancements. By using precision medicine technologies, genetic vulnerabilities to chronic and deadly diseases at the individual level can now be identified, potentially pre-empting disease decades later.

My hope for the next 25 years is that someday a single blood test could inform individuals of the diseases they are at risk of (diabetes, cancer, heart disease, etc.) and that safe interventions will be available. I am particularly excited about the possibility of developing cancer vaccines. Vaccines targeting the causative agents of cervical and hepatocellular cancers have already proven to be effective. With these technologies and the wealth of data that will become available as precision medicine becomes more routine, new discoveries identifying the earliest genetic and inflammatory changes occurring within a cell as it transitions into a pre-cancer can be expected. With these discoveries, the opportunities to develop vaccine approaches preventing cancers development will grow.

But, as is the case today, prevention technologies can only be fully successful if they are widely available, to reduce unnecessary morbidity and mortality and healthcare costs and further raise life expectancy. Global accessibility is key to reduce global disparities. For these strategies to work, funding agencies should consider prioritizing prevention strategies.

Jeremy Farrar

Director, Wellcome Trust.

Politics, demographics, economics, climate—how the world changes and interacts fundamentally affects all of us. Research is part of that and can help provide solutions to the great challenges we face, but only if the three pillars of science, innovation and society come together in an environment where people and teams can thrive. We must therefore take the opportunity today to shape how the culture of research will develop over the next 25 years.

Building a career in research can be incredibly rewarding, yet it often comes at a cost. The drive for research excellence—to which Wellcome has certainly contributed—has created a culture that cares more about what is achieved than how it is achieved. We can do better, and building a creative, inclusive and open research culture will unleash greater discoveries with greater impact.

Changing culture requires us to acknowledge the issue and then make a long-term commitment. As an independent foundation, Wellcome is able to acknowledge the issue and make that commitment. This is a permanent shift in our thinking. Working openly with, and as part of, the wider research community, we aim to make research inclusive, more inspiring, more fun, more rewarding. As a result, it will contribute even more to making the world a healthier place to live.

John Nkengasong

Director, Africa Centres for Disease Control and Prevention.

Population wise, Africa is the continent of the future. By 2050, it is estimated that its population will be 2.5 billion people. This means that one in every four persons in the world might be an African, with rapidly growing economies and a rising middle class. These demographic changes have important implications for both communicable and noncommunicable disease patterns, including emerging and re-emerging infectious diseases; resistance to antibiotics; and rising rates of cancers, diabetes, cardiovascular diseases and maternal and child deaths. To meet its health challenges by 2050, the continent will have to be innovative in order to leapfrog toward solutions in public health.

Precision medicine will need to take center stage in a new public health order—whereby a more precise and targeted approach to screening, diagnosis, treatment and, potentially, cure is based on each patient’s unique genetic and biologic make-up. For example, universal newborn screening and a more accurate analysis of causes of death in this age group could be established to curb under-five mortality; genetic screening programs could help avoid progression towards aggressive cancers; and medicine side effects could be reduced if tests could predict negative reactions and enable caregivers to proactively prescribe alternative treatments.

In Africa, precision medicine should not be seen from the lens of sequencing whole genomes, diagnosing DNA abnormalities and developing medications targeted to very small populations. Rather, African countries should begin pursuing policy approaches and partnerships to advance precision medicine to meet the African Union’s Agenda 2063 goals. This includes the integration of precision medicine approaches into national strategies to improve healthcare—including genomic data policy—and increase diagnostic capacity, and the creation of biobanks, such as H3Africa, that encompass both physical and bioinformatics facilities.

Executive vice-president, Scripps Research Institute; founder and director, Scripps Research Translational Institute.

Twenty-five years ago, the World Wide Web was just getting off the ground. Therefore, when thinking of the medical research landscape in 25 years, it is reasonable to think big and without limits.

In 2045, I hope we will have developed a planetary health infrastructure based on deep, longitudinal, multimodal human data, ideally collected from and accessible to as many as possible of the 9+ billion people projected to then inhabit the Earth.

This infrastructure, by using hybrid artificial intelligence (AI) models—including various deep neural networks, federated AI, nearest-neighbor analysis and systems yet to be developed—could provide individualized guidance for the prevention and optimal management of medical conditions, acting as a virtual medical coach for patients and a platform for clinicians to review a patient’s real-time, real-world, extensive and cumulative dataset.

Some have projected that, by this juncture, artificial general intelligence (AGI) will have been developed, giving machines enhanced capabilities to perform functions that are not feasible now. Notwithstanding that uncertainty, it is likely that machines’ ability to ingest and process biomedical text at scale—such as the corpus of the up-to-date medical literature—will be used routinely by physicians and patients. Accordingly, the concept of a learning health system will be redefined.

Linda Partridge

Professor, Max Planck Institute for Biology of Ageing.

Human life expectancy has increased over the past 170 years in many parts of the world. Unfortunately, the healthy lifespan has not, and the period of life when a person lives with disability and illness at the end of life is growing, especially in women.

But ageing is malleable, and mounting evidence suggests that late-life ill health can be combated. In laboratory animals, including mice and rhesus monkeys, genetic, lifestyle and pharmacological interventions can increase not only the lifespan, but also the healthspan. In humans, improvements in diet and the implementation of physical exercise regimes can effect major health improvements, but better lifestyle is not enough to prevent age-related diseases.

The big hope is that 25 years from now, medical sciences will have progressed enough to enable people to have healthier and more active lives almost up until their eventual death. Going forward, the direct targeting of mechanisms of ageing, including with existing drugs, presents an opportunity to reduce disability and illness in late life. Sirolimus, an mTORC1 inhibitor, extends the lifespan of laboratory animals and in clinical trials has proved to boost the immune response of older people to vaccination against influenza. Other drugs, such as the combination of desatinib and the BCL-2 inhibitor quercetin, which kill senescent cells, are farther from the clinic but show promise. Plasma from younger mice has been shown to have a beneficial effect on the stem cell function of several tissues in older mice; work to identify the natural metabolites responsible for this effect could open up avenues for translation to the clinic. Geroprotective drugs, which target the underlying molecular mechanisms of ageing, are coming over the scientific and clinical horizons, and may help to prevent the most intractable age-related disease, dementia.

Trevor Mundel

President of Global Health, Bill & Melinda Gates Foundation.

The most essential innovations in medical research over the next 25 years won’t just come from the explorations of bench scientists or the emergence of new technologies. They will come from what we do—as partners across the public and private sectors—to forge a new applied research ecosystem dedicated to the rapid discovery, development and delivery of life-changing tools that have been designed with the end user in mind.

This will mean finding new ways to share clinical data that are as open as possible and as closed as necessary. It will mean moving beyond drug donations toward a new era of corporate social responsibility that encourages biotechnology and pharmaceutical companies to offer their best minds and their most promising platforms. And it will mean working with governments and multilateral organizations much earlier in the product life cycle to finance the introduction of new interventions and to ensure the sustainable development of the health systems that will deliver them. If we focus on these goals, we can deliver on the promise of global health equity.

Josep Tabernero

Vall d’Hebron Institute of Oncology (VHIO); president, European Society for Medical Oncology (2018–2019).

Let’s briefly skip back 25 years. In oncology, who could have predicted that the stunning advances in genome sequencing would come to shape clinical decision-making? Who could have foreseen the increasing availability of genetic patient screenings or the promise of liquid biopsy policing of disease? Very few, which is why it is a fool’s errand to make sweeping predictions. But let’s try.

Over the next 25 years, genomic-driven analysis will continue to broaden the impact of personalized medicine in healthcare globally. Precision medicine will continue to deliver its new paradigm in cancer care and reach more patients. Immunotherapy will deliver on its promise to dismantle cancer’s armory across tumor types.

I also anticipate that AI will help guide the development of individually matched therapies, the harnessing and exchange of big data, and advances in telemedicine to bring crucial medical expertise to more patients everywhere. But the prospect is not all rosy. I worry about the exacerbating burden of comorbidities in cancer patients. We must collectively seek to strengthen and unify medical fields, with particular emphasis on oncology and cardiology. This is an emerging area for collaboration. Implementation research in the prevention and control of cancer will also be critical, as will be the shaping and strengthening of cancer policy-making at the global, national and regional levels.

With continued belief that scientific endeavors should be prioritized to respond to society’s and citizens’ needs, the scientific community must grasp future opportunities to uphold the very ethos of medicine as we continue to push boundaries in discovering new ways to extend and improve patients’ lives.

Pardis Sabeti

Professor, Harvard University & Harvard T.H. Chan School of Public Health and Broad Institute of MIT and Harvard; investigator, Howard Hughes Medical Institute.

A cataclysmic global pandemic is one of the greatest risks to humanity. Over the last 25 years, we have seen SARS, Ebola, Zika and other viruses spread undetected for months, leading to international emergencies and often devastating consequences. Even in the best US hospitals, most infectious diseases are not properly diagnosed or tracked.

But advances in two fields, genomics and information science, can transform our fight against viral threats. Ultrasensitive genome sequencing technologies are enabling the detection and characterization of viruses circulating under the radar. The advent of novel CRISPR, synthetic biology and microfluidic tools have allowed the development of rapid, ultrasensitive point-of-care diagnostics that can be deployed anywhere in the world. The resulting diagnostic and surveillance data can be integrated across healthcare nodes, from rural clinics to city hospitals, thanks to powerful new information systems. Together with advances from AI and other fields, these information systems can aid the rapid detection of infectious threats, to track their spread, and guide public health decision-making.

Over the next 25 years, the development and integration of these tools into an early-warning system embedded into healthcare systems around the world could revolutionize infectious disease detection and response. But this will only happen with a commitment from the global community.

Els Torreele

Executive director, Médecins Sans Frontières Access Campaign.

Of the many biomedical advances made by the scientific community, only those that can generate large financial profits are taken up for development by for-profit companies. This leaves many gaps—but also opportunities—in regard to developing new treatments to meet public health needs.

My hope is that the scientific community will step up and target efforts to develop innovative therapeutics and other health tools for populations across the world. This includes people affected by tuberculosis, hepatitis, Ebola, advanced HIV, neglected tropical diseases, vaccine-preventable diseases, antimicrobial resistance, snakebite—the list goes on. The creativity and brainpower of the global research community are required to find solutions addressing these grave human needs.

But to do this, we need a paradigm shift such that medicines are no longer lucrative market commodities but are global public health goods—available to all those who need them. This will require members of the scientific community to go beyond their role as researchers and actively engage in R&D policy reform mandating health research in the public interest and ensuring that the results of their work benefit many more people. The global research community can lead the way toward public-interest-driven health innovation, by undertaking collaborative open science and piloting not-for-profit R&D strategies that positively impact people’s lives globally.

Change history

27 january 2020.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article.

Looking forward 25 years: the future of medicine. Nat Med 25 , 1804–1807 (2019). https://doi.org/10.1038/s41591-019-0693-y

Download citation

Published : 05 December 2019

Issue Date : December 2019

DOI : https://doi.org/10.1038/s41591-019-0693-y

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Society Homepage About Public Health Policy Contact

About the journal.

About the journal

The Medical Research Archives is the official journal of the European Society of Medicine. The journal was founded in 2014 and has published over 2,500 peer-reviewed articles across 12 volumes. Originally published both in print and online, the journal has since become a fully online and open-access publication. Issues are published monthly on the society’s website and on a variety of digital platforms.

The journal publishes original research, reviews, and case reports addressing health issues of interest to a global community of medical professionals. While issues of the journal are often focused around topics of particular interest to the society, submissions from non- members are most welcome. In addition to the regular issues there are also several theme issues released each year which are dedicated to a single disease or topic.

About the society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries all around the world, yet are united by a common goal: to promote health and health equity, globally.

Public health has always been a core focus of both the society and the Medical Research Archives. The society’s scientific resources translate into compelling advocacy messages to inspire change in healthcare policy and medical innovation. Reducing the burden of disease is a difficult challenge which often demands a multidisciplinary approach. The multitude of backgrounds from which our members come allows us to be stronger, speaking with one voice, when advocating for change.

Further reading

Society homepage

Author Center

Latest issue

Editorial Board

Meet the ESMED Community

Most cited articles

Primary Central Nervous System Germ Cell Tumors: A Review and Update 98 citations

Pesticides used in Thailand and toxic effects to human health 96 citations

Keeping an Eye on Bardet-Biedl Syndrome: A Comprehensive Review of the Role of Bardet-Biedl Syndrome Genes in the Eye 93 citations

Health of mothers of children with intellectual disability or autism spectrum disorder: a review of the literature 55 citations

The Impact of the Role of Doctor of Nursing PracticeNurses on Healthcare and Leadership 53 citations

Most viewed articles

The Effects of Anabolic Androgenic Steroids on Performance and its Adverse Side Effects in Athletes 306,594 views

Regular sanitizing of cell phones during the Covid-19 pandemic 67,617 views

The Impact of the Role of Doctor of Nursing PracticeNurses on Healthcare and Leadership 59,214 views

Differential diagnosis of tonsillitis, tonsillar detritus accumulation, and tonsillar keratin cysts 52,724 views

The John F. Kennedy X-rays: The saga of the largest “Metallic fragment” 33,066 views

Free publication for society members

Members of the European Society of Medicine can benefit from free publication of their articles in the society's journal.

• Top Courses
• Online Degrees
• Find your New Career
• Join for Free

Understanding Medical Research: Your Facebook Friend is Wrong

Taught in English

Some content may not be translated

Financial aid available

91,145 already enrolled

Gain insight into a topic and learn the fundamentals

Instructor: F. Perry Wilson

Top Instructor

Included with Coursera Plus

(1,885 reviews)

Recommended experience

Beginner level

What you'll learn

How to efficiently read a medical research paper and how to differentiate between good and bad research

The different tests used in medical research and how to spot common errors in methodology and interoperation for each

Read and understand statistical figures, charts, and graphics

How best to verify claims made in news articles

Skills you'll gain

• Research Methods
• Medical Writing
• Medical Terminology
• Health Research

Details to know

Add to your LinkedIn profile

See how employees at top companies are mastering in-demand skills

Earn a career certificate

Add this credential to your LinkedIn profile, resume, or CV

Share it on social media and in your performance review

There are 7 modules in this course

How can you tell if the bold headlines seen on social media are truly touting the next big thing or if the article isn't worth the paper it's printed on?

Understanding Medical Studies, will provide you with the tools and skills you need to critically interpret medical studies, and determine for yourself the difference between good and bad science. The course covers study-design, research methods, and statistical interpretation. It also delves into the dark side of medical research by covering fraud, biases, and common misinterpretations of data. Each lesson will highlight case-studies from real-world journal articles. By the end of this course, you'll have the tools you need to determine the trustworthiness of the scientific information you're reading and, of course, whether or not your Facebook friend is wrong. This course was made possible in part by the George M. O'Brien Kidney Center at Yale.

Find out what you'll be learning and what powers you'll have by the end of the course!

What's included

1 video 3 readings

1 video • Total 10 minutes

• Course Introduction • 10 minutes • Preview module

3 readings • Total 25 minutes

• Lesson Guide • 10 minutes
• Critical Thinking Survey • 5 minutes
• Health Behavior Survey • 10 minutes

Gain some foundational knowledge!

4 videos 2 readings 1 quiz 1 discussion prompt

4 videos • Total 54 minutes

• How Research Works • 18 minutes • Preview module
• The Medical Manuscript • 14 minutes
• The Replication Crisis • 12 minutes
• The Question is - What is the Question? • 9 minutes

2 readings • Total 30 minutes

• Module Preview • 10 minutes
• Pre Quiz: The Basics • 20 minutes

1 quiz • Total 30 minutes

• The Basics • 30 minutes

1 discussion prompt • Total 10 minutes

• Post Module Impressions • 10 minutes

Medical Statistics Made Ridiculously Simple

It's (sort of) that easy!

8 videos 2 readings 1 quiz 1 discussion prompt

8 videos • Total 107 minutes

• Types of Data • 11 minutes • Preview module
• Averages By Other Names • 11 minutes
• Sampling: The Secret Sauce of Statistics • 16 minutes
• Statistics is an Onion • 12 minutes
• The Biggest Secret in Medicine: Relative vs Absolute Risk • 10 minutes
• The Power and the Problem with the P-Value • 18 minutes
• Choosing a Statistical Test • 11 minutes
• The Interpretation of "Negative" Studies • 15 minutes

2 readings • Total 40 minutes

• Pre Quiz: Medical Statistics Made Ridiculously Simple • 30 minutes
• Medical Statistics Made Ridiculously Simple • 30 minutes

Types of Medical Studies

A test for every situation!

9 videos 2 readings 1 quiz 1 discussion prompt

9 videos • Total 111 minutes

• The Randomized, Controlled Trial • 14 minutes • Preview module
• Covid Content - How to Find Your Own Research • 17 minutes
• The Cohort Study • 9 minutes
• The Case-Control Study • 9 minutes
• Studies of Diagnostic Tests • 13 minutes
• Covid Content - Vaccine Efficacy Calculation • 3 minutes
• Meta-Analysis: Fondue or Clam Chowder? • 13 minutes
• Time to Event Analysis - Only the Strong Survive • 14 minutes
• The Cost-Effectiveness Study: How Much is Your Life Worth? • 14 minutes
• Pre Quiz: Types of Medical Studies • 30 minutes
• Types of Medical Studies • 30 minutes

How Wrong Conclusions Are Reached

Bad plan? Bad data? Bad actors?

8 videos • Total 108 minutes

• Causality • 15 minutes • Preview module
• Confounding • 15 minutes
• Effect Modification and Mediation • 14 minutes
• Covid Content - Smoking does not prevent Covid-19 death • 8 minutes
• Generalizability • 10 minutes
• Multiple Comparisons • 16 minutes
• Surrogate Endpoints • 14 minutes
• Fraud • 13 minutes
• Covid Content • 10 minutes
• Pre Quiz: How Wrong Conclusions are Reached • 30 minutes
• How Wrong Conclusions Are Reached • 30 minutes

Subtle and hard to correct, Bias is the silent killer of good research.

5 videos 2 readings 1 quiz 1 discussion prompt

5 videos • Total 66 minutes

• Selection Bias • 15 minutes • Preview module
• Information Bias • 12 minutes
• Time-Based Biases • 14 minutes
• Covid Content - Immortal Time Bias spotted in the wild! • 5 minutes
• Statistical Brain Teasers • 18 minutes
• Covid Content - Immortal Time Bias spotted in the wild! • 10 minutes
• Pre Quiz: Bias • 30 minutes
• Bias • 30 minutes

Fixing the Problems with Medical Studies

All hope is not lost!

4 videos 4 readings 1 quiz 1 discussion prompt

4 videos • Total 48 minutes

• Adjustment • 11 minutes • Preview module
• Matching • 11 minutes
• Propensity Scoring • 15 minutes
• Putting It All Together • 9 minutes

4 readings • Total 51 minutes

• Pre Quiz: Fixing the Problems with Medical Studies • 30 minutes
• Medical Study Interpretation - Don’t Forget: • 1 minute
• Post Course Surveys • 10 minutes
• Optional participation in survey, follow up from Week 1 • 10 minutes
• Fixing the Problems with Medical Studies • 30 minutes

Instructor ratings

We asked all learners to give feedback on our instructors based on the quality of their teaching style.

For more than 300 years, Yale University has inspired the minds that inspire the world. Based in New Haven, Connecticut, Yale brings people and ideas together for positive impact around the globe. A research university that focuses on students and encourages learning as an essential way of life, Yale is a place for connection, creativity, and innovation among cultures and across disciplines.

Recommended if you're interested in Research

University of Cape Town

Understanding Clinical Research: Behind the Statistics

Johns Hopkins University

Introduction to Systematic Review and Meta-Analysis

Design and Interpretation of Clinical Trials

Stanford University

Writing in the Sciences

Why people choose coursera for their career.

Learner reviews

Showing 3 of 1885

1,885 reviews

Reviewed on Aug 23, 2020

It is a pretty good course to begin sailing in the tricky sea of research :D but you will need more in-depth courses to fully understand and write in medical literature , specially on biostatistics .

Reviewed on Aug 11, 2020

Great Couse! The information is very useful and easy to understand. It is also presented in a way that is not boring and not too complicated. Everything was very informative and enjoyable!

Reviewed on Mar 16, 2022

Dear Professor and The Team Which Concern

It is an eminent presentations with useful and necessary informations about medical research. Thank you very much. With best regard Dr.Metin YALAZA

New to Research? Start here.

Open new doors with Coursera Plus

Unlimited access to 7,000+ world-class courses, hands-on projects, and job-ready certificate programs - all included in your subscription

Advance your career with an online degree

Earn a degree from world-class universities - 100% online

Join over 3,400 global companies that choose Coursera for Business

Upskill your employees to excel in the digital economy

Frequently asked questions

When will i have access to the lectures and assignments.

Access to lectures and assignments depends on your type of enrollment. If you take a course in audit mode, you will be able to see most course materials for free. To access graded assignments and to earn a Certificate, you will need to purchase the Certificate experience, during or after your audit. If you don't see the audit option:

The course may not offer an audit option. You can try a Free Trial instead, or apply for Financial Aid.

The course may offer 'Full Course, No Certificate' instead. This option lets you see all course materials, submit required assessments, and get a final grade. This also means that you will not be able to purchase a Certificate experience.

What will I get if I purchase the Certificate?

When you purchase a Certificate you get access to all course materials, including graded assignments. Upon completing the course, your electronic Certificate will be added to your Accomplishments page - from there, you can print your Certificate or add it to your LinkedIn profile. If you only want to read and view the course content, you can audit the course for free.

What is the refund policy?

You will be eligible for a full refund until two weeks after your payment date, or (for courses that have just launched) until two weeks after the first session of the course begins, whichever is later. You cannot receive a refund once you’ve earned a Course Certificate, even if you complete the course within the two-week refund period. See our full refund policy Opens in a new tab .

Is financial aid available?

Yes. In select learning programs, you can apply for financial aid or a scholarship if you can’t afford the enrollment fee. If fin aid or scholarship is available for your learning program selection, you’ll find a link to apply on the description page.

More questions

Le Nostre Prestazioni Mediche

La SCINTIGRAFIA è un'indagine che permette di studiare le caratteristiche morfologiche e funzionali di organi e apparati del corpo umano attraverso la creazione di immagini prodotte da una particolare apparecchiatura denominata Gamma Camera.

ESAMI SCINTIGRAFICI ACCREDITATI CON IL SSN:

• PET / TAC

• Scintigrafia linfodonale

• Scintigrafia miocardica

• Scintigrafia tiroidea

• Scintigrafia ossea

• Scintigrafia parotiroidea

• Scintigrafia renale

ALTRI ESAMI SCINTIGRAFICI:

• Scintigrafia ghiandole salivari

• Scintigrafia cerebrale datscan

• Scintigrafia con leucociti marcati

• RX Anca • RX Bacino • RX Caviglia • RX Clavicola • RX Colonna 1/s • RX Colonna Cervicale • RX Colonna Dorsale • RX Colonna in toto • RX Colonna in toto S.C. • RX Emitorace • RX Femore • RX Gamba • RX Ginocchia

• RX Gomito • RX Mano • RX Omero • RX Piedi • RX Polso • RX Seni Paranasali • RX Spalle • RX Tenue • RX Torace • RX Tutto sullo scheletro

PRESTAZIONI SPECIALISTICHE :

• Allergologia • Anestesia e Rianimazione • Angiologia • Bronco-pneumologia • Cardiologia • Chirurgia Generale • Chirurgia Vascolare • Dermatologia • Diabetologia • Ecografia-Diagnostica per immagini • Endocrinologia • Gastroenterologia • Ginecologia ed Ostetricia • Medicina dello Sport • Medicina Nucleare • Oculistica • Ortopedia • Otorinolaringoiatria

• Pediatria • Pneuomologia • Pet/Tc • Radiologia • Scienza della Nutrizione • Senologia - (Mammografia 3d con Fotosintesi) • TAC - (Con e Senza mezzo di contrasto) • Urologia

Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection

Collaborators.

• Sechenov StopCOVID Research Team : Anna Berbenyuk ,  Polina Bobkova ,  Semyon Bordyugov ,  Aleksandra Borisenko ,  Ekaterina Bugaiskaya ,  Olesya Druzhkova ,  Dmitry Eliseev ,  Yasmin El-Taravi ,  Natalia Gorbova ,  Elizaveta Gribaleva ,  Rina Grigoryan ,  Shabnam Ibragimova ,  Khadizhat Kabieva ,  Alena Khrapkova ,  Natalia Kogut ,  Karina Kovygina ,  Margaret Kvaratskheliya ,  Maria Lobova ,  Anna Lunicheva ,  Anastasia Maystrenko ,  Daria Nikolaeva ,  Anna Pavlenko ,  Olga Perekosova ,  Olga Romanova ,  Olga Sokova ,  Veronika Solovieva ,  Olga Spasskaya ,  Ekaterina Spiridonova ,  Olga Sukhodolskaya ,  Shakir Suleimanov ,  Nailya Urmantaeva ,  Olga Usalka ,  Margarita Zaikina ,  Anastasia Zorina ,  Nadezhda Khitrina

Affiliations

• 1 Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 2 Inflammation, Repair, and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom.
• 3 Soloviev Research and Clinical Center for Neuropsychiatry, Moscow, Russia.
• 4 School of Physics, Astronomy, and Mathematics, University of Hertfordshire, Hatfield, United Kingdom.
• 5 Biobank, Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 6 Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 7 Chemistry Department, Lomonosov Moscow State University, Moscow, Russia.
• 8 Department of Polymers and Composites, N. N. Semenov Institute of Chemical Physics, Moscow, Russia.
• 9 Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
• 10 Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany.
• 11 Institute for Urology and Reproductive Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 12 Department of Intensive Care, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 13 Clinic of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 14 Department of Internal Medicine No. 1, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 15 Department of Forensic Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• 16 Department of Statistics, University of Oxford, Oxford, United Kingdom.
• 17 Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
• 18 Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
• 19 Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom.
• 20 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
• PMID: 33035307
• PMCID: PMC7665333
• DOI: 10.1093/cid/ciaa1535

Background: The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking.

Methods: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020.

Results: Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47).

Conclusions: Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.

Keywords: COVID-19; Russia; SARS-CoV-2; cohort; mortality risk factors.

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Publication types

• Observational Study
• Research Support, Non-U.S. Gov't
• Hospitalization
• Middle Aged

Grants and funding

• 20-04-60063/Russian Foundation for Basic Research

• Open access
• Published: 30 April 2024

Extent, transparency and impact of industry funding for pelvic mesh research: a review of the literature

• Angela Coderre-Ball 1 &
• Susan P. Phillips   ORCID: orcid.org/0000-0003-4798-1742 1 , 2  

Research Integrity and Peer Review volume  9 , Article number:  4 ( 2024 ) Cite this article

104 Accesses

2 Altmetric

Metrics details

Conflicts of interest inherent in industry funding can bias medical research methods, outcomes, reporting and clinical applications. This study explored the extent of funding provided to American physician researchers studying surgical mesh used to treat uterine prolapse or stress urinary incontinence, and whether that funding was declared by researchers or influenced the ethical integrity of resulting publications in peer reviewed journals.

Publications identified via a Pubmed search (2014–2021) of the terms mesh and pelvic organ prolapse or stress urinary incontinence and with at least one US physician author were reviewed. Using the CMS Open Payments database industry funding received by those MDs in the year before, of and after publication was recorded, as were each study’s declarations of funding and 14 quality measures.

Fifty-three of the 56 studies reviewed had at least one American MD author who received industry funding in the year of, or one year before or after publication. For 47 articles this funding was not declared. Of 247 physician authors, 60% received > $100 while 13% received $100,000-$1,000,000 of which approximately 60% was undeclared. While 57% of the studies reviewed explicitly concluded that mesh was safe, only 39% of outcomes supported this. Neither the quality indicator of follow-up duration nor overall statements as to mesh safety varied with declaration status.

Conclusions

Journal editors’ guidelines re declaring conflicts of interest are not being followed. Financial involvement of industry in mesh research is extensive, often undeclared, and may shape the quality of, and conclusions drawn, resulting in overstated benefit and overuse of pelvic mesh in clinical practice.

Peer Review reports

Introduction

When medical research and vested interest collide, objectivity, research integrity, and best clinical practices are sometimes the victims. Compromise to objectivity can arise via ghost management of research [ 1 ], that is by direct involvement of industry personnel, or indirectly through industry transfers of honoraria, gratuities, or speaker payments made to independent researchers [ 2 ]. Circumstances such as these, that “create a risk that judgments or actions regarding a primary interest will be unduly influenced by a secondary interest are defined as conflicts of interest (COI)” [ 3 ]. COI stemming from industry funding can, although do not always [ 4 ], bias design, recruitment, conduct, choice of outcome measures, or reporting, all of which have the potential to distort study findings and undermine medical practice [ 5 , 6 , 7 ]. The United States Centers for Medicare & Medicaid Services Open Payments [ 8 ] database documents any industry payment of at least $10 and annual payments of $100 or more made to American physician researchers since 2013. Its creation has facilitated identifying a portion of corporate support for medical research.

We wished to examine the extent, accuracy and implications of COI reporting among authors studying the effectiveness and safety of one particular medical device, pelvic mesh. The CMS Open Payments database described above enables this examination although only for authors who were or are US physicians. Surgical mesh was first used in hernia surgery in the 1950s [ 9 ] and has become the standard of care for hernia repairs, although controversy remains [ 10 ]. By the late 1990s, surgical mesh was routinely being inserted trans-vaginally to treat pelvic organ prolapse (POP) and stress urinary incontinence (SUI). This repurposing required no approval in the US because the Food and Drug Administration’s (FDA) 510k route grants automatic authorization for products deemed to be equivalent to predicate devices already in use [ 11 , 12 ]. Prior to 1976 the FDA did not require testing of any biomedical devices, meaning surgical mesh had never undergone pre-market testing [ 13 ]. Studies of success, failure and safety of both hernia and pelvic mesh are, therefore, generally retrospective reviews tracking outcomes of use in patients.

The FDA estimates that one in eight women (in the US) undergo surgery to repair uterine prolapse [ 14 ]. Post-market evidence from peer-reviewed journals has generally endorsed pelvic mesh to be a successful treatment for POP and SUI [ 15 ]. At the same time there are reports from an unknown proportion of female mesh recipients questioning that success [ 16 , 17 ]. Commentaries have noted the close links among industry, researchers, surgeons and professional organizations that examine or voice support for pelvic mesh use [ 18 ]. Two studies of mesh used for hernia repairs raise questions about the evidence supporting its success and safety in that setting. First, despite many accounts of the value of mesh for hernia repair, none has reported on women, specifically, or considered that women’s greater immune response to foreign materials might predispose to disproportionate harm from insertion of the product [ 12 , 19 ]. Second, Sekigami and colleagues [ 20 ] determined that the majority of studies of mesh used for hernia repairs did not accurately report COI.

Whether and how industry funding is entwined with published research on pelvic mesh is unknown. As noted above, what is known is that such funding compromises medical research in general [ 21 ]. Our objectives were, therefore, to: (1) examine the scope of industry funding provided to US physician-authors of pelvic mesh research; (2) determine the proportions of that funding that were declared or undeclared and; (3) explore whether the methodologic strength and conclusions of industry funded studies differed from those without industry support.

Study selection/data extraction

We undertook a cross-sectional review of publications identified in a PubMed search in October 2021. All studies related to surgical mesh used in POP and SUI repairs were initially identified. Included were clinical trials and observational studies with at least one American physician author, and that examined post-surgical outcomes for polypropylene mesh inserted for the treatment of POP or SUI. We excluded studies with no original data, no US physician authors, those whose main purpose was to compare surgical techniques (e.g., single incision mesh vs. sacrospinous ligament fixation), studies using only autologous material or non-polypropylene mesh, and studies that only examined peri-operative outcomes.

Search terms included (POP[title/abstract] OR SUI[title/abstract]) AND mesh[title/abstract]. Studies published between January 1, 2014, and September 30, 2021 were included. This time frame matched available entries in the CMS Open Payments database (see below). We chose the year of publication rather than year of acceptance as not all studies documented their acceptance date. Included were studies from any peer-reviewed journal. One author (ACB) screened studies for inclusion/exclusion criteria, and, if questions arose, discussion occurred between the two authors.

For each study, we extracted the authors’ and journal’s names, the date of acceptance where available and of publication, conflict-of-interest statements, funding declarations, the study’s inclusion and exclusion criteria, the outcome scales or measures, outcomes, and follow-up duration. We also determined the journal’s impact factor (April 2022). This information for 10 randomly selected studies was independently abstracted by both authors who then discussed and compared results to ensure accuracy and consistency. One author then extracted data for the remaining 48 studies. These data were then reviewed by both authors, together (see Outcomes, below).

Open payments

For each physician author in each study, we searched the CMS Open Payments database to collect information on the types of payments (general, research, associated funding, and ownership and investment) made from all drug and device companies, the US dollar amount of each payment, and the companies making the payments. We included all payments authors received during the year before, the year of, and the year following publication to best ensure that all author payments that could be related to a study were captured. Payments totaling less than $100 over the three years, were entered as ‘no payment’. Small payments can influence physicians’ research and clinical behavior, however such amounts were not included to avoid modest sums or gratuities received that were likely unrelated to research.

Findings assessed

The key findings examined were the extent of industry funding of research and the dollar difference between declared and actual industry payment received. First we tallied the number of authors and papers with COI, whether declared or not. We then examined the declaration status of each author with a COI. This was recorded as no discrepancy if that COI was declared. We then counted how many authors made no declaration or declared that they did not have a COI and recorded each author’s total payment from all categories over the three years. We did not examine each journal’s declaration of COI requirements and authors’ compliance with these, nor could we determine whether aspects of authors’ declarations were redacted by specific journals.

To assess the strength of each study we examined the following. We determined the duration of patient follow-up post-surgery. This measure was chosen because complications from pelvic mesh continue to arise years after insertion. If studies did not explicitly state a mean or median follow-up in their results we accepted the follow-up duration as the timeframe indicated in the methods/design. If no measure or statement was present, this was left blank. The use of objective (e.g., POP-Q) and/or subjective (e.g., UDI-6, pain) scales and/or outcomes was tracked for each study. Critical appraisal of each included study was assessed using a purpose-built data extraction and appraisal tool (see Table  1 ) based on the Joanna Briggs Institute Checklist for Cohort Studies [ 22 ]. Fourteen questions appraised methodology including, for example, “ Are the authors conclusions supported by the findings ?” and “ Did the authors make a statement that mesh was safe to use ?” To ensure reliability both authors critically appraised each study independently and then reviewed and discussed all appraisals together to resolve differences and reach consensus. Evaluation of whether authors’ conclusions were supported by the findings (Table  1 , question ‘n’) was decided based on review of all the quality dimensions and discussion between both authors. For example, if a study made a positive conclusion about the effectiveness of mesh, but only followed patients for a short time (e.g., less than 12 months) and without a comparison group, it would be given a score of “no” or “unclear” for question ‘n’. Authors were blinded to information about funding when these quality indicators were recorded. Only after appraising and recording the strength of each study was this information merged with funding data.

Statistical analysis

Univariate analyses were used to determine the presence of study characteristics that aligned with discrepancy between declared and undeclared COI. Guided by previous research on COI of authors studying hernia mesh [ 20 ] we included impact factor (continuous), follow-up time (continuous), author’s role (e.g. first author, contributing author, senior author – categorical), and recommendations of mesh safety and effectiveness (categorical – yes/no). We report the difference in payments received between those that declared and did not declare COI. The relationship between categorical variables (e.g., author role) and the presence of undeclared COI was determined using Chi-Square testing. Logistic regression was used to determine the association of continuous variables (e.g., impact factor, follow-up time) with whether or not there was a discrepancy between reported and discovered COI (from CMS Open Payments).

Five hundred and sixty-two studies were retrieved from the PubMed search. After an initial review 56 of these were found to meet inclusion criteria (see Fig.  1 : Overview of retrieved articles, screening process, and final included studies). The majority of the excluded studies had no author whose data would appear in Open Payments (i.e. no American physician author).

Scope and declaration of industry funding: authors

There were a total of 299 authors of the 56 studies included in the full review. After excluding non-physicians and non-American physician authors as they would not be listed in the Open Payments database, 247 American MD authors remained and were included. For the remainder of the report, we only include these American MD authors in analyses.

Overview of retrieved articles, screening and final included studies

Of the 247 authors and across all 56 included studies one hundred forty-nine authors (60%) received payments totaling more than $100. Eighty-one authors’ (33%) explicit declarations that they did not have COI aligned with Open Payments documentation of payments of less than $100 over the relevant three-year timeframe examined. An additional 12 authors (5%) made no declaration and did not receive payments totaling more than $100. Twenty-eight authors (11%) explicitly declared COI and did receive more than $100 in payments. One hundred and one authors (40%) explicitly declared that they had no COI but received payments, 20 (8%) did not make any declaration and received payments, and five authors (2%) declared a conflict although no payments were recorded in Open Payments.

Examining the dollar value of payments received, we found that the largest group receiving payments (36%, n  = 54) was for amounts of between $100 and $1000 and was made to authors who did not declare any COI. The remaining undeclared payments were between $1,000-$10,000 (24%, n  = 36), between $10,000-$100,000 (13%, n  = 20) and >$100,000 (7%, n  = 11).

The majority of payments for each of the four dollar amounts were undeclared (see Fig.  2 : Proportions and amounts of declared and undeclared payments received by authors).

Proportions and amounts of declared and undeclared payments received by authors

Scope and declaration of industry funding: studies

Of the 56 studies reviewed, 53 (95%) had at least one American physician author with COI (declared or not). Thirty-nine (70%) included at least two American MD authors with COI, and 28 (54% of the 52 studies with 3 or more authors) had three or more American MD authors with COI.

Considering only non-declared COI, we found that 47 (84%) of studies included at least one American MD author with an undeclared COI, while 34 (61%) had at least two such authors, and 20 studies (38% of articles with more than 2 authors) had three or more authors with COI. Only three (5%) studies had no physician authors with any conflicts of interest (declared or not).

Study characteristics aligned with undeclared COI

We next examined alignment of the dollar amount of industry funding received and any of the following: declaring a COI; the duration of follow-up in a study; or the journal’s impact factor.

The median payment for US authors was $18,678 (IQR ~ $5000-$99,000) for those with declared COI and $158 (IQR ~ 0-$1,500) among authors, who did not declare COI, but had one (Cohen’s d effect size estimate = 0.39, 95% CI: 0.77 − 0.02).

Means and medians of the length of time patients were followed after mesh implant surgery were reported in 48/56 studies. Median follow-up was 1.0 year, with a mean of 1.9 years. Follow-up duration was not associated with whether or not a study had at least one author with undeclared COI ( OR  = 0.82 95% CI:0.54 1.17). The small number of studies without COI ( n  = 3) precluded comparing follow-up duration between them and the 53 with COI.

The impact factors of the journals publishing studies were also examined to see if there was any relationship with number of undeclared COI. A journal’s impact factor did not predict whether or not a study had at least one author with undeclared COI ( OR  = 0.98 95%CI [0.75 1.3]).

There was a trend although no statistical association between being the lead or senior author and the presence of COI ( p  = 0.18). 65% of first authors had COI (declared or not), as did 56% of middle authors, and 69% of senior authors.

Quality appraisal

We assessed the quality of each study using the 14 measures listed in Table  1 . Only 26% ( n  = 14) of articles included a comparison group, partially reflecting the different study designs included in the review, and of those, 40% had comparable patients (e.g., age) in the intervention and control groups. The majority of studies (80%) did identify at least one patient characteristic such as age or obesity that could affect the success of mesh as a treatment. Only 28% ( n  = 13) of these studies, however, utilized these data in their analyses. The majority of publications explicitly stated that mesh was safe and beneficial ( n  = 32, 57%) although only 39% ( n  = 22) of all articles’ methods and outcomes supported these conclusions (Table  1 ). The small number of studies with no COI (3 of 56) precluded comparisons of quality between groups defined by the presence or absence of COI.

95% of the 56 articles reviewed had at least one author among those who could be assessed using Open Payments who received industry funding. The majority of this funding (47/53 of articles) was undeclared. COI among American MD authors studying pelvic mesh are substantial (60%), and most (81%) are undeclared. This level of unacknowledged industry support aligns with findings of a meta-analysis of studies of undisclosed industry support to physicians in general [ 7 ] and of clinical practice guideline authors’ COI [ 23 ]. It may also explain why, despite patient reports and legal findings of harm, the scholarly literature tends to endorse pelvic mesh as effective and safe.

In 2009, the International Committee of Medical Journal Editors (ICMJE) introduced requirements for detailed disclosure of all relevant COI by any author [ 24 ]. All articles in this review were published well after this. Observed non-compliance could arise from journal laxity, researchers’ sense of impunity, conviction that they are not swayed by industry largess, or convincing themselves that funding received was not related to the reported research. 36% of all authors received undeclared industry support of less than $1000. Some might consider that smaller levels of funding which may not have been offered explicitly for research are unlikely to sway physicians and should, therefore, be exempt from required reporting. In reality, even small gifts and gratuities have repeatedly been found to ‘win over’ physicians’ research and practice [ 7 ]. In our study, industry-funding had an equivocal impact on research quality and reported outcomes. The majority of publications explicitly stated that mesh was safe and beneficial (57%, n  = 32) although only 10 of those 32 substantiated this with evidence. The median follow-up time of one-year post-op would have missed long-term complications. Such complications and failures of pelvic mesh are known to arise years after its insertion. For this reason, follow-up duration was chosen as a key indicator of study validity. As most studies were retrospective chart reviews longer follow-up duration could have been built into research designs. Indicators of poor research quality did not vary with authors’ declarations of industry support. The near ubiquitous presence of industry funding, however, precluded assessment of quality differences in articles with and without COI, and left us unable to really address aim 3 of this study.

Limitations

The ability to track COI of all authors rather than only US physicians would help clarify the full extent and impact of industry funding on study design, findings, and interpretation of results. Open Payments data only include physicians licenced in the US. The database is verified and frequently updated but does not presume to include all payments made [ 25 ]. Accurate tracking of funding is further compromised because device manufacturers are known to violate reporting requirements [ 26 ]. Payments made to researchers’ family members, research or office staff, PhDs, institutions rather than individuals, etc., and any payments originating outside the US cannot, at present, be tracked. By extracting payment information for the year preceding, the year of and the year after publication we have attempted to identify all payments relevant to the articles studied, but may have missed some industry funding for included studies or captured funding for unrelated projects. It is also possible that funding received was not linked to the reviewed publication. Journal non-compliance with ICMJE requirements for declaring COI may have removed the reporting requirement for some authors and some funding. The overall impact of all these limitations may be an underestimation of the extent of undeclared industry funding to researchers.

Although we attempted to standardize our appraisal of articles, quality appraisal, as the name suggests, involves qualitative elements. The authors first rated each article separately then engaged in discussion to reach consensus, but acknowledge that the ‘objectivity’ of this process could be questioned.

Industry funding for medical research is, at present, substantial and can be a source of innovation, but needs to also be ethical and transparent. During the timeframe studied the extent of industry involvement in research explicitly justifying the merit of pelvic mesh was high, while findings were at odds with concurrent FDA warnings of risk [ 14 ]. Equally important, self-reporting of financial COI by researchers appears to be unreliable and often contravenes requirements agreed upon by international medical journal editors. Industry funding both declared and, to a greater extent, undeclared, permeates almost all research on pelvic mesh and almost certainly shapes the quality of and conclusions drawn from those studies. This biased evidence in turn skews the risk benefit picture and potentially drives overuse of pelvic mesh in clinical practice.

Availability of data and materials

All data used and generated can be made available by the corresponding author upon reasonable request.

Abbreviations

United States Centers for Medicare & Medicaid Services Open Payments

• Conflicts of interest

US Food and Drug Administration

International Committee of Medical Journal Editors

Interquartile range

Medical doctor

Pelvic organ prolapse

Stress urinary incontinence

Sismondo S, Doucet M. Publication Ethics and the Ghost Management of Medical Publication Bioethics. 2010;24(6):273–283. https://doi.org/10.1111/j.1467-8519.2008.01702.x .

Ioannidis JPA, Why Most Clinical Research Is Not Useful. PLoS Med. 2016;13(6):e1002049–1002049. https://doi.org/10.1371/journal.pmed.1002049 .

Article   Google Scholar  

Institute of Medicine Committee on Standards for Developing Trustworthy Clinical Practice G. Clinical practice guidelines we can trust. Washington (DC): National Academy of Sciences; 2011.

Google Scholar  

Via GG, Brueggeman DA, Lyons JG, Frommeyer TC, Froehle AW, Krishnamurthy AB. Funding has no effect on studies evaluating viscosupplementation for knee osteoarthritis: a systematic review of bibliometrics and conflicts of interest. J Orthop. 2023;39:18–29. https://doi.org/10.1016/j.jor.2023.03.015 .

Ahn R, Woodbridge A, Abraham A, et al. Financial ties of principal investigators and randomized controlled trial outcomes: cross sectional study. BMJ (Online). 2017;356:i6770–6770. https://doi.org/10.1136/bmj.i6770 .

Lundh A, Lexchin J, Mintzes B, Schroll JB, Bero L. Industry sponsorship and research outcome. Cochrane Database Syst Reviews. 2017;2017(2):MR000033–000033. https://doi.org/10.1002/14651858.MR000033.pub3 .

Taheri C, Kirubarajan A, Li X, Lam ACL, Taheri S, Olivieri NF. Discrepancies in self-reported financial conflicts of interest disclosures by physicians: a systematic review. BMJ Open. 2021;11(4):e045306. https://doi.org/10.1136/bmjopen-2020-045306 .

United States Centers for Medicare & Medicaid Services. Open Payments. ( https://www.cms.gov/openpayments ).

Sanders DL, Kingsnorth AN. From ancient to contemporary times: a concise history of incisional hernia repair. Hernia: J Hernias Abdom wall Surg. 2012;16(1):1–7. https://doi.org/10.1007/s10029-011-0870-5 .

Robinson TN, Clarke JH, Schoen J, Walsh MD. Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surg Endosc. 2005;19(12):1556–60. https://doi.org/10.1007/s00464-005-0120-y .

Heneghan C, Aronson JK, Goldacre B, Mahtani KR, Plüddemann A, Onakpoya I. Transvaginal mesh failure: lessons for regulation of implantable devices. BMJ (Online). 2017a;359:j5515–5515. https://doi.org/10.1136/bmj.j5515 .

Phillips SP, Gee K, Wells L, Medical, Devices. Invisible women, harmful consequences. Int J Environ Res Public Health. 2022;19(21):14524. https://www.mdpi.com/1660-4601/19/21/14524 .

Heneghan CJ, Goldacre B, Onakpoya I, et al. Trials of transvaginal mesh devices for pelvic organ prolapse: a systematic database review of the US FDA approval process. BMJ open. 2017;7(12):e017125–017125. https://doi.org/10.1136/bmjopen-2017-017125 .

Food US, Administration D. FDA takes action to protect women’s health, orders manufacturers of surgical mesh intended for transvaginal repair of pelvic organ prolapse to stop selling all devices. 2019.

Rubin R. Mesh implants for women: scandal or Standard of Care? JAMA: J Am Med Association. 2019;321(14):1338–40. https://doi.org/10.1001/jama.2019.0940 .

Motamedi M, Carter SM, Degeling C. Women’s experiences of and perspectives on transvaginal mesh surgery for stress urine incontinency and pelvic organ prolapse: a qualitative systematic review. The patient: patient-. Centered Outcomes Res. 2022;15(2):157–69. https://doi.org/10.1007/s40271-021-00547-7 .

Taylor D. The failure of polypropylene surgical mesh in vivo. J Mech Behav Biomed Mater. 2018;88:370–6. https://doi.org/10.1016/j.jmbbm.2018.08.041 .

Gornall J. Vaginal mesh implants: putting the relations between UK doctors and industry in plain sight. BMJ;363:k4164. https://doi.org/10.1136/bmj.k4164 .

Klein SL, Flanagan KL. Sex differences in immune responses. Nat Rev Immunol. 2016;16(10):626–38. https://doi.org/10.1038/nri.2016.90 .

Sekigami Y, Tian T, Char S, et al. Conflicts of interest in studies related to Mesh Use in ventral hernia repair and Abdominal Wall Reconstruction. Ann Surg. 2021;276(5):e571–6. https://doi.org/10.1097/SLA.0000000000004565 .

Chimonas S, Mamoor M, Zimbalist SA, Barrow B, Bach PB, Korenstein D. Mapping conflict of interests: scoping review. BMJ. 2021;375:e066576. https://doi.org/10.1136/bmj-2021-066576 .

Moola SMZ, Tufanaru C, Aromataris E et al. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E MZ, ed. JBI Manual for Evidence Synthesis 2020.

Mooghali M, Glick L, Ramachandran R, Ross JS. Financial conflicts of interest among US physician authors of 2020 clinical practice guidelines: a cross-sectional study. BMJ open. 2023;13(1):e069115–069115. https://doi.org/10.1136/bmjopen-2022-069115 .

Drazen JM, Van Der Weyden MB, Sahni P, et al. Uniform Format for Disclosure of competing interests in ICMJE journals. JAMA: J Am Med Association. 2010;303(1):75–6. https://doi.org/10.1001/jama.2009.1542 .

Department of Health and Human Services Office of Inspector General. Open Payments Data: Review of Accuracy, Precision, and Consistency in Reporting. 2018. ( https://oig.hhs.gov/oei/reports/oei-03-15-00220.pdf ).

Adashi EY, Cohen IG. Enforcement of the Physician payments Sunshine Act: Trust and verify. JAMA: J Am Med Association. 2021;326(9):807–8. https://doi.org/10.1001/jama.2021.13156 .

Download references

Acknowledgements

Not applicable.

Funding was received from an internal Queen’s University grant (Wicked Ideas).

Author information

Authors and affiliations.

Centre for Studies in Primary Care, Queen’s University, Kingston, Canada

Angela Coderre-Ball & Susan P. Phillips

Family Medicine and Public Health Sciences, Queen’s University, Kingston, Canada

Susan P. Phillips

You can also search for this author in PubMed   Google Scholar

Contributions

Both authors contributed to all aspects of the study.

Corresponding author

Correspondence to Susan P. Phillips .

Ethics declarations

Ethics approval and consent to participate.

Neither ethics approval nor consent for publication were applicable given the study design.

Consent for publication

The authors consent to publication of this paper.

Competing interests

Authors have no financial or non-financial conflicts of interest to declare.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Coderre-Ball, A., Phillips, S.P. Extent, transparency and impact of industry funding for pelvic mesh research: a review of the literature. Res Integr Peer Rev 9 , 4 (2024). https://doi.org/10.1186/s41073-024-00145-9

Download citation

Received : 18 September 2023

Accepted : 09 April 2024

Published : 30 April 2024

DOI : https://doi.org/10.1186/s41073-024-00145-9

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Pelvic mesh
• Industry funding
• Research methods
• Uterine prolapse, stress urinary incontinence, women's health

Research Integrity and Peer Review

ISSN: 2058-8615

• Submission enquiries: [email protected]
• General enquiries: [email protected]

Morning Rundown: Israeli military urges 100,000 civilians to flee Rafah, Ole Miss opens conduct investigation over protest confrontation, Boeing set to fly to space

Biden administration plans to reclassify marijuana, easing restrictions nationwide

WASHINGTON — The Biden administration will take a historic step toward easing federal restrictions on cannabis, with plans to announce an interim rule soon reclassifying the drug for the first time since the Controlled Substances Act was enacted more than 50 years ago, four sources with knowledge of the decision said.

The Drug Enforcement Administration is expected to approve an opinion by the Department of Health and Human Services that marijuana should be reclassified from the strictest Schedule I to the less stringent Schedule III. It would be the first time that the U.S. government has acknowledged its potential medical benefits and begun studying them in earnest.

Attorney General Merrick Garland submitted the rescheduling proposal to the White House Office of Management and Budget on Tuesday afternoon, a source familiar with the situation confirmed.

Any reclassification is still months from going into effect. After the proposal is published in the Federal Register, there will be a 60-day public comment period. The proposal will then be reviewed by an administrative law judge, who could decide to hold a hearing before the rule is approved.

What rescheduling means

Since 1971, marijuana has been in the same category as heroin, methamphetamines and LSD. Each substance under the Schedule I classification is defined as a drug with no accepted medical use and a high potential for abuse. Schedule III substances include Tylenol with codeine, steroids and testosterone.

By rescheduling cannabis, the drug would be studied and researched to identify concrete medical benefits, opening the door for pharmaceutical companies to get involved with the sale and distribution of medical marijuana in states where it is legal.

For the $34 billion cannabis industry, the move would also eliminate significant tax burdens for businesses in states where the drug is legal, notably getting rid of the IRS' code Section 280E, which prohibits legal cannabis companies from deducting what would otherwise be ordinary business expenses.

The Justice Department’s rescheduling decision could also help shrink the black market, which has thrived despite legalization in states like New York and California and has undercut legal markets, which are fiercely regulated and highly taxed.

Years in the making

President Joe Biden directed the Department of Health and Human Services in October 2022 to review marijuana’s classification. Federal scientists concluded that there is credible evidence that cannabis provides medical benefits and that it poses lower health risks than other controlled substances.

Biden even made history in his State of the Union address this year, for the first time referring to marijuana from the dais in the House chamber and making note of the federal review process. “No one should be jailed for using or possessing marijuana,” he said.

When Biden was vice president in the Obama administration, the White House opposed any legalization of marijuana, saying it would “pose significant health and safety risks to all Americans.”

Jim Cole, who was deputy attorney general in the Obama administration, wrote the famous Cole Memo in 2013 , paving the way for the modern marijuana market. The memo scaled back federal intervention in states that had legalized marijuana as long as they implemented “strong and effective regulatory and enforcement systems to control the cultivation, distribution, sale and possession of marijuana.”

Cole, who is now a member of the National Cannabis Roundtable, said in an interview this week that reclassifying marijuana to Schedule III would “open up the ability to actually test it and put it in a laboratory without all of the restrictive measures” of a Schedule I drug.

Kevin Sabet, president and CEO of Smart Approaches to Marijuana and a former Obama administration adviser, said the decision to reclassify marijuana is "the result of a politicized process," arguing that it "will be devastating for America’s kids, who will be bombarded with attractive advertising and promotion of kid-friendly pot products."

"The only winner here is the marijuana industry, who will receive a new tax break and thus widen their profit margins," Sabet said. “Reclassifying marijuana as a Schedule III drug sends the message that marijuana is less addictive and dangerous now than ever before. In reality, today’s highly potent, super strength marijuana is more addictive and linked with psychosis and other mental illnesses, IQ loss and other problems.”

Researchers have raised concerns about high-potency marijuana and cannabis-induced psychiatric disorders, particularly among young men.

Some challenges ahead

Once the DEA formally makes its announcement, the marijuana industry would see an immediate benefit. But with the DEA’s proposed rule change comes a public review period that could lead to a challenge, and perhaps even a change, to the rescheduling proposal.

Once the public comment period has concluded and the Office of Management and Budget reviews the decision, Congress would also be able to overturn the rule under the Congressional Review Act, which gives it the power to weigh in on rules issued by federal agencies. Democrats control the Senate with a 51-seat majority, and for an overturn under the CRA to succeed, two-thirds of the House and the Senate would be needed to support it, meaning the marijuana rescheduling would most likely survive.

Though cannabis remains a divisive topic on Capitol Hill, there has been growing support on a bipartisan basis for marijuana reforms, largely driven by the electorate. Nearly 6 in 10 Americans say marijuana should be legal for medical and recreational purposes, according to a Pew Research poll last month. Cannabis is legal in 24 states for recreational use.

Congress is considering its own bills

Congress is considering its own measures that would make it easier for legal marijuana businesses to thrive and allow for more small and minority-owned shops to flood the marketplace.

The SAFER Banking Act , for example, which would grant legal marijuana businesses access to traditional banking and financial services, could pass both chambers by the end of the year.

Lawmakers are also considering the HOPE Act , another bipartisan bill that would provide states and local governments with resources to automatically expunge criminal records for petty, nonviolent cannabis offenses.

There is also a Democratic-only effort to remove cannabis entirely from the Controlled Substances Act, empowering states to create their own cannabis laws and prioritize restorative and economic justice for those affected by the “war on drugs.”

Senate Majority Leader Chuck Schumer, D-N.Y., praised the administration for its move, saying it amounts to "finally recognizing that restrictive and draconian cannabis laws need to change to catch up to what science and the majority of Americans have said loud and clear."

At the same time, he said he is "strongly committed" to moving forward with both the SAFER Banking Act and the Democratic bill to remove cannabis from the Controlled Substances Act entirely. “Congress must do everything we can to end the federal prohibition on cannabis and address longstanding harms caused by the War on Drugs," he said in a statement.

Sen. Cory Booker, D-N.J., also praised the administration’s move but cautioned that “we still have a long way to go.”

Booker called on Congress in a statement to "follow the lead of states around the country and legalize cannabis for adult-use and create a comprehensive taxation and regulatory scheme."

“Thousands of people remain in prisons around the country for marijuana-related crimes. Thousands of people continue to bear the devastating collateral consequences that come with a criminal record,” he said. “Legal marijuana businesses, especially those in communities hardest hit by the War on Drugs, still have to navigate a convoluted patchwork of state laws and regulatory schemes. I hope that my colleagues on both sides of the aisle, especially those who represent constituents benefitting from medical or adult-use programs, join me to pass federal legislation to fix these problems.”

But there is weariness among lawmakers who remember the last time Congress made law surrounding the drug.

The Republican-led Senate legalized hemp production in the 2018 farm bill, a decision that led to synthetic and exotic cannabinoids’ being sold over the counter, often without regulation, particularly in states where marijuana isn’t legal.

It’s a gray area that has drawn pushback from both sides of the aisle, most recently with the rise of Delta-8 , a synthetic tetrahydrocannabinol product that uses chemicals — some of them harmful — to convert hemp-derived CBD into Delta-8 THC.

Julie Tsirkin is a correspondent covering Capitol Hill.

Monica Alba is a White House correspondent for NBC News.