Unnecessary research is a waste of time, effort, money, and other resources; it is also unethical and potentially harmful to patients
New research should only proceed if an up-to-date review of earlier research shows that it is necessary, and after it has been registered
Evidence from new research should be used to update the previous review of all the relevant evidence
Much research is of poor quality and done for questionable reasons
There are perverse influences on the research agenda, from both industry and academia
Questions that matter to patients are often not addressed
In earlier sections we emphasized why tests of treatments must be designed properly and addressed questions that matter to patients and the public. When they are, everyone can take pride and satisfaction in the results, even when hoped-for benefits do not materialize, because important insights will have been gained and uncertainty lessened.
Although much health research is good – and it is steadily improving as it conforms with design and reporting standards  – bad and unnecessary research continues to be done, and published, for various reasons. And as for the perpetual demand ‘more research is needed’, a better strategy would be to do less, but to focus the research on the needs of patients, and so help to ensure that it is done for the right reasons. We explore these issues in this section.