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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "491" "paginaFinal" => "493" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Maite Solans-Domènech, Gaietà Permanyer-Miralda" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Maite" "apellidos" => "Solans-Domènech" "email" => array:1 [ 0 => "mtsolans@gencat.cat" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Gaietà" "apellidos" => "Permanyer-Miralda" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:1 [ "colaborador" => "on behalf of the ISOR Group (Impacte Social de la Recerca)" ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Doctor emeritus, Unidad de Epidemiología, Servicio de Cardiología, Hospital Universitario Vall d’Hebron, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación del impacto de la investigación biomédica: ¿para quién?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Biomedical research does not have a great tradition in our country, nonetheless, research managers, investigators and clinicians should be involved in assessing the impact of the same.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1–3</span></a> This activity (that of assessing its impact) has become increasingly important due to some features of the research process itself: the tremendous growth of current scientific production, which differs in quality and validity, its complex role in social dynamics, its huge consumption of financial and human resources, and its complicated journey until it can exert any effects, either positive or negative, on health and welfare.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4,5</span></a> For the purposes of this consideration, research impact relates to any effect, change or benefit generated by the same on the economy, society, politics or health services, health, environment or quality of life.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The heterogeneity of methods and conceptual models<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">7–9</span></a> is a basic feature of studies assessing the impact of research. This heterogeneity depends on the variety of possible impact types, sometimes vast; but largely, heterogeneity also reflects the wide range of assessment objectives and social groups that show an interest in it (their recipients or <span class="elsevierStyleItalic">target audiences</span>). The interest on impact assessment will differ based on whether they are politicians, sociologists, economists, managers, scientific societies, health professionals and citizens in general. The types of knowledge sought after will also differ depending on the group.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> This heterogeneity is obvious just by considering the questions that the research impact evaluator may want to respond. They are many, and no study can pretend to answer all. The questions that arise after each study and the type of knowledge generated will be consistent with the purpose of the study itself and the orientation of its potential users,<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> for example: How should the various types of economic and social impact related to research be analyzed?; how can estimating the potential impact of a particular research project help in promoting or prioritizing the same?; how can knowing the mechanisms involved in generating the social impact of research facilitate and encourage these?; how are research results transferred to health practice?</p><p id="par0015" class="elsevierStylePara elsevierViewall">Who are interested in evaluating the impact of research? who are their target audiences?, these questions need answers.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a> The influences of 2 social orders converge in the investigator: on the one hand, the various managers, planners, politicians and economists, and big industries; groups or individuals who are “upstream” in the research process. Also their economic beneficiaries could be placed “upstream”, at least partially. In summary, individuals or groups that promote or regulate the process. “Downstream” are health professionals, patients and people in general; that is, most receptors of the research product, their so-called end users. All of them may be interested in the study of its impact. The nature of the various studies will reflect the interests and objectives of any of these groups, and we can speculate that the nature of the same will be related to the historical circumstances, values and beliefs of their time and place. The type of recipient of an impact assessment study and the nature of the said study will be closely associated. This can be illustrated by three important studies evaluating the impact of research and seeing how their target audiences influence the nature and methodology of these.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The first study can be interpreted as directed to large investors and is based on estimating the <span class="elsevierStyleItalic">economic benefits</span> (or “returns”) <span class="elsevierStyleItalic">of cancer research conducted in the UK</span> in terms of net value of clinical results, conducted by <span class="elsevierStyleItalic">RAND Europe</span> and the <span class="elsevierStyleItalic">King's College</span> of London.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">13</span></a> The same estimated the economic benefits generated by the investment in public and philanthropic research between 1970 and 2009. The investment in research was identified and its net monetary benefits were calculated from the application rates of its results, estimating the potential years of life gained adjusted by quality. It was concluded that the internal rate of return on investment was around 10%. It is noteworthy that, by far, the largest share of that benefit was attributable to research on abstaining from smoking, well above what was observed in research with more complex objectives, of a basic or therapeutic nature. The main message was that, assessed as a whole, investment in cancer research generated a significant economic benefit. This ensured the overall profitability of their operations to large investors (both, the state and philanthropic research organizations). The benefit of specific projects or other types of impact other than the economic were not analyzed. A time in history during which the economic sustainability of certain public initiatives it can be questioned, a study like this provides data in favour of its feasibility and can help justify its continuation.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The managers of funding organizations can be considered the primary target audience of the second study, which was also conducted in the UK and also by members of <span class="elsevierStyleItalic">RAND Europe</span> and <span class="elsevierStyleItalic">Brunel University</span>. It analyzed the various types of social impact related to <span class="elsevierStyleItalic">joint disease research</span> carried out thanks to the grants given by the <span class="elsevierStyleItalic">Arthritis Research Campaign</span>(ARC), an important charity in the UK, who wanted to know the types of social benefits that had resulted from the money invested in research grants.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">14</span></a> A wide variety of social impacts were detected; among others, scientific publications, postgraduate education, research careers, influence on future studies, transfer of techniques, contribution to clinical practice guidelines, influence on medical practice, or any potential economic benefits. Health benefits were just one additional effect among all social effects. It is noteworthy that, in one of the analysis, and despite the wide range of types of impact, only 2.5% of the research prompted by the entity originated diagnostic, therapeutic or public health advances that would eventually reach the clinical practice. The mechanisms by which these advances were developed or how the research results were transferred into practice and what obstacles and facilities were associated to it, were not the subject of these studies. In connection with resource allocation, various types of impact would allow the organization's management to assess whether the investment was socially useful and also help them to prioritize the type of study that would generate greater social impact.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The third study, which had researchers and health managers as key target audience, was published in 2013 in New South Wales, Australia, regarding the <span class="elsevierStyleItalic">impact on clinical practice of health promotion research grants</span> awarded by a government institution between 2000 and 2006.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">15</span></a> In this study, 15 research grants on various subjects were evaluated (e.g. secondary cardiovascular prevention) and analyzed using qualitative methods. For example, what type of influence did the results have on those responsible for health policies, and what were the characteristics of the results which were finally applied to management and clinical practice. Different types of impact (such as setting priorities or providing new resources) were analyzed in the study, identifying the characteristics of research grants that facilitated that impact (such as the existence of dissemination strategies), and also those characteristics that hindered their adoption. The recipients of this type of study, much more local and alien to major economic, scientific or health policy powers, determined a methodology based, primarily, on studying the transfer of knowledge into practice, not assessing other types of impact. Again, the impact on the end user, patient or individual subjects was not the main objective.</p><p id="par0035" class="elsevierStylePara elsevierViewall">These three examples illustrate the wide range of types of study and knowledge that depend on the recipient for whom the impact of research is analyzed: large investors, research managers and health managers. Broadly speaking, the first 2 illustrate the approach to impact assessment according to the following question: What use has been given to the resources allocated to researchers or sites?; with the remote target of figuring out how those resources should be redistributed or reassigned (regulatory approach). The third example is directed, however, to answer the question: What are the ways through which research findings are transferred to society?; with the remote target of figuring out what can be done to enhance that transfer (analytical approach).<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">From the point of view and interests of the clinician and the patient, the end users of research, the degree of influence on clinical practice and subsequent health benefits and how to enhance this effect constitutes its most significant impact; in other words, the analytical approach.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">10,16</span></a> Many of the current studies and activities, however, are dictated by the regulatory approach, given the urgent need to properly manage research funds. Undoubtedly, the studies devoted to the transfer of knowledge, its determinants, modifiers and barriers are numerous.<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">17–19</span></a> Even some journals are exclusively dedicated to the implementation of research.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">20</span></a> But the methodology of these studies is somewhat less elaborate, homogeneous and widespread than those intended for health managers and funders, and their social projection is limited.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">21</span></a> For example, a recent work<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">22</span></a> analyzed data from a large project in the United Kingdom (2014 UK REF)<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a> intended for the state agency that finances all research carried out at university centres, which, like the ARC studies, exhaustively analyses the range of their social impacts. The aforementioned work, however, raises the risk that the 2014 UK REF study methodology is preferentially oriented to detect direct short-term impacts, primarily of interest to managers and more easily detectable from logic models and less compatible with indirect and long term impacts. This second type of impacts,<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">4,5,10,23,24</span></a> whose detection is more difficult and complex,<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">2,3,25</span></a> can include significant health impacts on patients and individuals, who are the theoretical end users of research.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Nevertheless, it would be appropriate to consider how the heterogeneity of goals and methods related to the impact of biomedical research could now be hidden under a picture of apparent homogeneity, given the dissemination and social scope of the studies related to resource management and allocation: the study of research impact involves much more than this, and the challenges that this complexity poses should not be neglected. Some questions were asked in a previous paragraph, but others may also be considered, closer to end users: What are the actual health benefits of biomedical research and how should they be analyzed?, how should those benefit determinants and their obstacles be analyzed?, how should or how can the impact of research in medical and health practice be measured?, how can that knowledge improve the quality of such practice? To a large extent, these questions remain waiting for rigorous and comprehensive answers.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In summary, assessing the impact of biomedical research is a complex and heterogeneous field. The type of target audience of the studies is associated with the subject, objectives and methodology of these. Those studies whose target audiences are managers and funders of research have a significant social relevance, given the magnitude of the issues raised by the need for an optimal allocation of resources. However, this fact should not relegate to the background of public, corporate and professional attention assessing the impact of research as a tool to improve health practice and global health. We should never forget who the real end users of research are.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Solans-Domènech M, Permanyer-Miralda G, en representación del Grupo ISOR (Impacte Social de la Recerca) Evaluación del impacto de la investigación biomédica: ¿para quién? 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