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    "textoCompleto" => "<p class="elsevierStylePara">Dear Editor&#44;</p><p class="elsevierStylePara">I have read Dr&#46; Manual Praga<span class="elsevierStyleSup">1</span> Terente&#8217;s article about independent clinical research in Spain with great respect and admiration&#46; I share many of his ideas&#44; especially when he claims that quality research in hospitals will not be possible until there is real material recognition rather than mere moral support of the activity carried out&#46; Unfortunately&#44; the politically influenced persons who make the decisions regarding the management of personnel in the hospital environment systematically forget this premise&#44; making the development of any type of quality research in this area very difficult&#46;</p><p class="elsevierStylePara">Nonetheless&#44; in spite of my respect and admiration for Dr&#46; Praga&#44; I would like to put a different point of view&#44; not necessarily to the contrary of his about some of the topics that he covers&#46; In particular&#44; I would like to make a few brief references about the evaluation process&#44; the role of Official Agencies concerning Clinical Research and the systematically evoked dichotomy between clinical and basic research&#46;</p><p class="elsevierStylePara">The evaluation of a research project is a complex process&#46; In general&#44; it is based on a combined analysis of the scientific quality of the applicant group and of the project&#46; At the same time&#44; the research groups are usually evaluated with mixed criteria&#44; depending on their capacity to obtain competitive funding and on their level of scientific productivity&#46; It is true&#44; as Dr&#46; Praga notes&#44; that certain programmes&#44; or certain assessors&#44; attribute excessive relative importance to some of these areas&#44; creating a biased evaluation&#46; The examples given make reference to highly productive groups without competitive funding and to groups with great amounts of competitive funding and low productivity that can be evaluated as &#8220;bad&#8221; and &#8220;good&#8221; respectively in some of these evaluation processes&#46; Although it is true that this happens at times&#44; the managers of the evaluation process as well as the very assessors themselves are absolutely convinced that a quality research group is defined by a reasonable balance between planning capacity&#44; including obtaining resources&#44; and scientific productivity&#46; This is what normally happens bearing in mind that there are always exceptions&#46; Although in reality&#44; in the last few years&#44; groups with abundant funding and little scientific production are evaluated&#44; almost automatically&#44; in a negative manner&#44; while those with high scientific productivity&#44; although they have no funding&#44; are usually evaluated in a positive manner&#46;</p><p class="elsevierStylePara">I would like to note here that as pointed out in the last cited hypothetical figure&#58; it is the groups with high scientific productivity without funding in the hospital setting&#46; It is true that these groups exist&#44; as Dr&#46; Praga clearly is aware but it is also completely true that they are an exception&#46; Some of these groups have even been systematically funded by private companies with commercial interests leading to a scientific productivity that is not always based on their own ideas&#46;</p><p class="elsevierStylePara">While even considering this possibility&#44; there are still certain totally independent research groups of high quality&#44; without funding&#44; in the hospital setting&#46; These groups&#44; with an effort and dedication&#44; could have obtained economic support from the Public Research Agencies which would have helped their research efforts&#46;</p><p class="elsevierStylePara">The Public Agencies that evaluate and fund research have made huge efforts in the last few years to give proper attention to clinical research in the hospital setting&#46; Three examples are enough&#46; The ANEP&#44; the Spanish <span class="elsevierStyleItalic">Agencia Nacional de Evaluaci&#243;n y Prospectiva</span> has remodelled its evaluation areas&#44; creating a specific area of Clinical Medicine where not only the Coordinator but also the workers are hospital doctors&#46; The Carlos III Health Institute&#44; in its general project funding programme&#44; includes a specific area of Epidemiology and an area of the Evaluation of Health-related Technologies in order to foster specific hospital research of a strong clinical character&#46;</p><p class="elsevierStylePara">These areas&#44; which group together a large number of projects are as successful as others in obtaining funding&#44; are funded with success rates that are similar to others&#46;</p><p class="elsevierStylePara">Finally&#44; many research projects allow for the inclusion of atypical funding concepts which are very different from the classic &#8220;laboratory reagents&#8221; in order to meet the needs of groups that carry out clinical research&#46; There are many more examples of this concern for clinical research in the hospital setting but presenting an exhaustive list does not seem necessary&#46;</p><p class="elsevierStylePara">Abrief final reference to the dichotomy of clinical and basic investigation&#58; we have to forget about it&#46; We must stop systematically talking about this antagonism&#46; Those researchers who identify themselves as basic researchers should start interiorizing a profound and convinced feeling of respect for clinical research&#46; Clinical researchers should understand that some of their future activities are going to be conditioned by the work of basic researchers&#46;</p><p class="elsevierStylePara">They should speak amongst themselves in order to understand each other and&#44; despite the difficulty&#44; speak less and less about this antagonism thus making it disappear&#46;</p>"
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A paper on independent clinical research in Spain
Carta sobre la Investigación Clínica Independiente en España
Diego Rodríguez Puyola
a Jefe de Sección de Nefrología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España,
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In particular&#44; I would like to make a few brief references about the evaluation process&#44; the role of Official Agencies concerning Clinical Research and the systematically evoked dichotomy between clinical and basic research&#46;</p><p class="elsevierStylePara">The evaluation of a research project is a complex process&#46; In general&#44; it is based on a combined analysis of the scientific quality of the applicant group and of the project&#46; At the same time&#44; the research groups are usually evaluated with mixed criteria&#44; depending on their capacity to obtain competitive funding and on their level of scientific productivity&#46; It is true&#44; as Dr&#46; Praga notes&#44; that certain programmes&#44; or certain assessors&#44; attribute excessive relative importance to some of these areas&#44; creating a biased evaluation&#46; The examples given make reference to highly productive groups without competitive funding and to groups with great amounts of competitive funding and low productivity that can be evaluated as &#8220;bad&#8221; and &#8220;good&#8221; respectively in some of these evaluation processes&#46; Although it is true that this happens at times&#44; the managers of the evaluation process as well as the very assessors themselves are absolutely convinced that a quality research group is defined by a reasonable balance between planning capacity&#44; including obtaining resources&#44; and scientific productivity&#46; This is what normally happens bearing in mind that there are always exceptions&#46; Although in reality&#44; in the last few years&#44; groups with abundant funding and little scientific production are evaluated&#44; almost automatically&#44; in a negative manner&#44; while those with high scientific productivity&#44; although they have no funding&#44; are usually evaluated in a positive manner&#46;</p><p class="elsevierStylePara">I would like to note here that as pointed out in the last cited hypothetical figure&#58; it is the groups with high scientific productivity without funding in the hospital setting&#46; It is true that these groups exist&#44; as Dr&#46; Praga clearly is aware but it is also completely true that they are an exception&#46; Some of these groups have even been systematically funded by private companies with commercial interests leading to a scientific productivity that is not always based on their own ideas&#46;</p><p class="elsevierStylePara">While even considering this possibility&#44; there are still certain totally independent research groups of high quality&#44; without funding&#44; in the hospital setting&#46; These groups&#44; with an effort and dedication&#44; could have obtained economic support from the Public Research Agencies which would have helped their research efforts&#46;</p><p class="elsevierStylePara">The Public Agencies that evaluate and fund research have made huge efforts in the last few years to give proper attention to clinical research in the hospital setting&#46; Three examples are enough&#46; The ANEP&#44; the Spanish <span class="elsevierStyleItalic">Agencia Nacional de Evaluaci&#243;n y Prospectiva</span> has remodelled its evaluation areas&#44; creating a specific area of Clinical Medicine where not only the Coordinator but also the workers are hospital doctors&#46; The Carlos III Health Institute&#44; in its general project funding programme&#44; includes a specific area of Epidemiology and an area of the Evaluation of Health-related Technologies in order to foster specific hospital research of a strong clinical character&#46;</p><p class="elsevierStylePara">These areas&#44; which group together a large number of projects are as successful as others in obtaining funding&#44; are funded with success rates that are similar to others&#46;</p><p class="elsevierStylePara">Finally&#44; many research projects allow for the inclusion of atypical funding concepts which are very different from the classic &#8220;laboratory reagents&#8221; in order to meet the needs of groups that carry out clinical research&#46; There are many more examples of this concern for clinical research in the hospital setting but presenting an exhaustive list does not seem necessary&#46;</p><p class="elsevierStylePara">Abrief final reference to the dichotomy of clinical and basic investigation&#58; we have to forget about it&#46; We must stop systematically talking about this antagonism&#46; Those researchers who identify themselves as basic researchers should start interiorizing a profound and convinced feeling of respect for clinical research&#46; Clinical researchers should understand that some of their future activities are going to be conditioned by the work of basic researchers&#46;</p><p class="elsevierStylePara">They should speak amongst themselves in order to understand each other and&#44; despite the difficulty&#44; speak less and less about this antagonism thus making it disappear&#46;</p>"
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