Lies, damned lies and epidemiology: why global health needs good epidemiological practice guidelines

• Published in: BMJ global health Vol. 3; no. 5; p. e001019
• Main Authors: Alba, Sandra, Mergenthaler, Christina
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.10.2018; BMJ Publishing Group
• Subjects: Clinical practice guidelines; Collaboration; Data analysis; Data collection; Ebola virus; Epidemics; Epidemiology; Ethics; Gender; Global health; Interdisciplinary aspects; Medical research; Public policy; Qualitative research; Research methodology; Society; Transnationalism; Women; guidelines; questionable research practice; misconduct
• ISSN: 2059-7908; 2059-7908
• DOI: 10.1136/bmjgh-2018-001019

The most worrying data come from two recent Nigerian studies, which suggest staggering levels of scientific misconduct: nearly 70% of interviewed researchers admitted to some form of personal scientific misconduct,5 while 96% believed that one or more forms of scientific misconduct had occurred in their workplace.6 Scientific misconduct and questionable practices have no place in global health as they steer research in the wrong direction, misguide public policy and undermine society’s trust. [...]there are limits to their applicability to global health research: (1) international guidelines provide only general standards (which means their use as practical guidance is limited); (2) national guidelines lack international legitimacy; and (3) epidemiology encompasses a wide range of specialties (each with their own idiosyncrasies and corresponding implications for data collection, processing and use). Most ethical issues specifically pertaining to global health epidemiology have been addressed in the literature on the ethics of implementation research (eg, obtaining consent for cluster randomised trials, contextual equipoise, lack of study controls, unanticipated outcomes).14 In addition, global health epidemiologists face a number of dilemmas in the ethical review processes. [...]transnational research implies that at least dual (if not multiple) review is required, at the site of the organisation leading the study (‘sponsor’) as well as locally.7 Difficulties can arise when ethical review is not possible at one site (for lack of local capacity or willingness to review a study conducted in a foreign country) or if reviews conflict with each other.