The problem of bias in medical research and its relationship with medical education
Biases in medical research are becoming acknowledged as a serious and increasing problem for medicine all over the world. They compromise the evaluation of the real effects of drugs, and jeopardise the possibility of evidence-based decisions and knowledge in medical practice. The current measures adopted to attempt to reduce them, although important and necessary, seem to have had only a limited effect. The fundamental aim of this study is to be a piece of exploratory research on the possible factors involved in medical education that can be related to the existence of bias in medical research. The randomised controlled trial, the main research method in much of medical research, is analysed concerning its strengths and weaknesses as a scientific instrument and the most common biases that may occur in this research method are evaluated. Questionnaires and interviews with students and teachers of five medical schools in Parana State (Brazil) were used to appraise aspects of a potential connection between medical education and the aforementioned problems in medical research. Qualitative and quantitative analyses of the data obtained were performed. The level of awareness about bias in research, in these schools, was evaluated as insufficient and fragmentary. Some critical obstacles, related to the transmission of knowledge about bias to the students, were identified. There is evidence that, at least in the schools involved in this research, the problem of bias is considered as a minor issue, when compared with other structural and educational problems. Possible solutions to the problem of low level of awareness about bias in research were collected by the research instruments employed, and are discussed in regard to their potential efficacy and feasibility.