Psycho-Oncology Psycho-Oncology 23: 1439–1440 (2014) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3713
Letter to the Editor
‘Increasing value and reducing waste’ in psychosocial research demands more efforts in scrutinizing study designs
Dear Editor, The Lancet recently introduced a series of five papers where distinguished researchers with a critical mind looked into current biomedical research from different angles with the overarching purpose of suggesting improvements for ‘increasing value and reducing waste’ [1]. This call for increased self-reflection and criticism in the scientific community is important – it is a waste of money and it is fundamentally unethical to conduct research that, for different reasons, cannot contribute to the accumulation of knowledge. The Lancet series focuses on typical problems in biomedical research. Many problems raised in the series are also relevant to psychosocial oncology, which is a discipline on the border between the social sciences and biomedicine, but I do think this field also has some unique problems of a slightly different kind. A common research design we make use of in the field is to correlate different questionnaires as a means to identify relationships between variables and concepts. This design is not problematic given that the rationale for the study is meaningful and that the included instruments are not self-correlating. Unfortunately, these basic criteria are often not met. A recent example of this is a study in Psycho-Oncology by Pillay et al. who undertook a prospective study to determine the relationship between sense of coherence (SOC), depression, and well-being in patients who underwent stem cell transplantation [2]. To be more precise, 1. In accordance with previous studies, the study showed a positive correlation between a low level of SOC, a low level of mental well-being, and high level of depression. A short glimpse at the Orientation to Life Questionnaire (OLQ) that was used to measure SOC shows that answering affirmatively to the following statements supports a low level of SOC: I have a feeling that I don’t really care about what is happening to me. Life is completely routine. Until now my life has had no clear goals or purpose at all.
Copyright © 2014 John Wiley & Sons, Ltd.
I have a feeling that I’ve very often have been treated unfairly. Most of the things I will do in the future will probably be completely boring. When I think about my life I very often ask myself why I exist at all. Doing the things I do every day is a source of pain and boredom. I anticipate that my personal life in the future will be totally without meaning and purpose. I have very often felt like a sad sack (loser) in certain situations in the past. I often feel that there’s little meaning in the things I do in my daily life. All of these statements (10 of the 29 statements in the OLQ) can, however, hardly be considered as neutral in relation to depression and well-being. Taken together, the statements reflect a depressed state of mind. It cannot be the other way around. Low levels of SOC are thus by definition related to depression and decreased well-being. The relationship is based on grammatical reasons – there is no need for an empirical investigation and definitively not another study finding out what is already obvious. 2. The authors regarded it as an important finding that SOC predicted depression and level of well-being. They argue as if SOC is a purely neutral psychological entity within the human mind, but as I have shown above, SOC is also another measure of how people are doing psychologically, and, therefore, it is self-evident that SOC is related to other, and more concrete, measures of depression and well-being. In this letter, I have scrutinized a recently published paper with a rather common design as a contribution to the call in the Lancet. It is a waste of resources to conduct studies in a clinical context with the purpose of exploring the relationship between variables and concepts that are by definition correlated, because new and meaningful clinical knowledge cannot be obtained, and no useful recommendations can be made.
1440
Conflict of interest
Letter to the Editor
transplant patients over time. Psycho-Oncology 2014, Early view 23 july. DOI: 10.1002/pon.3633.
The authors have declared no conflicts of interest.
References 1. Kleinert S, Horton R. How should medical science change? Lancet 2014;383:197–198. 2. Pillay B, Lee SJ, Katona L, De Bono S, Burney S, Avery S. A prospective study of the relationship between sense of coherence, depression, anxiety, and quality of life of haematopoietic stem cell
Copyright © 2014 John Wiley & Sons, Ltd.
Pär Salander Department of Social Work, Umeå University, Umeå, Sweden Email: [email protected] DOI: 10.1002/pon.3713
Psycho-Oncology 23: 1439–1440 (2014) DOI: 10.1002/pon
Copyright of Psycho-Oncology is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Letter to the Editor
‘Increasing value and reducing waste’ in psychosocial research demands more efforts in scrutinizing study designs
Dear Editor, The Lancet recently introduced a series of five papers where distinguished researchers with a critical mind looked into current biomedical research from different angles with the overarching purpose of suggesting improvements for ‘increasing value and reducing waste’ [1]. This call for increased self-reflection and criticism in the scientific community is important – it is a waste of money and it is fundamentally unethical to conduct research that, for different reasons, cannot contribute to the accumulation of knowledge. The Lancet series focuses on typical problems in biomedical research. Many problems raised in the series are also relevant to psychosocial oncology, which is a discipline on the border between the social sciences and biomedicine, but I do think this field also has some unique problems of a slightly different kind. A common research design we make use of in the field is to correlate different questionnaires as a means to identify relationships between variables and concepts. This design is not problematic given that the rationale for the study is meaningful and that the included instruments are not self-correlating. Unfortunately, these basic criteria are often not met. A recent example of this is a study in Psycho-Oncology by Pillay et al. who undertook a prospective study to determine the relationship between sense of coherence (SOC), depression, and well-being in patients who underwent stem cell transplantation [2]. To be more precise, 1. In accordance with previous studies, the study showed a positive correlation between a low level of SOC, a low level of mental well-being, and high level of depression. A short glimpse at the Orientation to Life Questionnaire (OLQ) that was used to measure SOC shows that answering affirmatively to the following statements supports a low level of SOC: I have a feeling that I don’t really care about what is happening to me. Life is completely routine. Until now my life has had no clear goals or purpose at all.
Copyright © 2014 John Wiley & Sons, Ltd.
I have a feeling that I’ve very often have been treated unfairly. Most of the things I will do in the future will probably be completely boring. When I think about my life I very often ask myself why I exist at all. Doing the things I do every day is a source of pain and boredom. I anticipate that my personal life in the future will be totally without meaning and purpose. I have very often felt like a sad sack (loser) in certain situations in the past. I often feel that there’s little meaning in the things I do in my daily life. All of these statements (10 of the 29 statements in the OLQ) can, however, hardly be considered as neutral in relation to depression and well-being. Taken together, the statements reflect a depressed state of mind. It cannot be the other way around. Low levels of SOC are thus by definition related to depression and decreased well-being. The relationship is based on grammatical reasons – there is no need for an empirical investigation and definitively not another study finding out what is already obvious. 2. The authors regarded it as an important finding that SOC predicted depression and level of well-being. They argue as if SOC is a purely neutral psychological entity within the human mind, but as I have shown above, SOC is also another measure of how people are doing psychologically, and, therefore, it is self-evident that SOC is related to other, and more concrete, measures of depression and well-being. In this letter, I have scrutinized a recently published paper with a rather common design as a contribution to the call in the Lancet. It is a waste of resources to conduct studies in a clinical context with the purpose of exploring the relationship between variables and concepts that are by definition correlated, because new and meaningful clinical knowledge cannot be obtained, and no useful recommendations can be made.
1440
Conflict of interest
Letter to the Editor
transplant patients over time. Psycho-Oncology 2014, Early view 23 july. DOI: 10.1002/pon.3633.
The authors have declared no conflicts of interest.
References 1. Kleinert S, Horton R. How should medical science change? Lancet 2014;383:197–198. 2. Pillay B, Lee SJ, Katona L, De Bono S, Burney S, Avery S. A prospective study of the relationship between sense of coherence, depression, anxiety, and quality of life of haematopoietic stem cell
Copyright © 2014 John Wiley & Sons, Ltd.
Pär Salander Department of Social Work, Umeå University, Umeå, Sweden Email: [email protected] DOI: 10.1002/pon.3713
Psycho-Oncology 23: 1439–1440 (2014) DOI: 10.1002/pon
Copyright of Psycho-Oncology is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
