Research Is Hard - And That's A Good Thing

A physician in clinic recently commented on how difficult it is to do research in many areas of medicine as a very positive reflection on how far medicine has come. In a surprising number of circumstances, truly bad outcomes are rare enough that discerning the effect of any one intervention of those outcomes requires a massive sample size.

This brings me back to my pre-medicine days when I did some work on the negative effects of radiation from diagnostic imaging. It's incredibly difficult to do good research on harms caused by radiation in medicine because the main predicted harm (cancer) occurs so rarely at typical doses of radiation used, occurs way into the future making causality tough to demonstrate, and gets drowned out by the relatively high baseline risk of cancer from, well, being an alive human being long enough.

I've enjoyed my research experiences and in an ideal world, would like to continue with some research moving forward, despite going into a field not well-known for research productivity. It is a slog these days in medicine and not just because of systemic issues like funding or cumbersome ethics approval. However, a lot of these difficulties stem from prior successes. We've picked a lot of the low-hanging fruit. It's hard to discover something like penicillin with a virtually 100% cure rate for a common condition (well, until all that antibiotic resistance started popping up). Common conditions these days are often multi-factorial in etiology and while we can't cure many of them, we're not too bad at managing them to some degree of effectiveness.

Current efforts in medical research require complex and sophisticated approaches. That we can undertake that research - with at least some degree of success - shows how much research as a discipline itself has progress. That we need to undertake that research shows how much research in medicine has accomplished.