COMMENT ON CLINICAL RESEARCH IN GERMANY A S EXEMPLIFIED BY GYNECOLOGICAL ONCOLOGY - POINTERS ON HOW TO GET OUT OF A CUL-DE-SAC DILEMMA

Clinical research in Germany has serious deficiencies. In comparison t o basic research, clinical studies are generally considered to be of s econdary importance in terms of scientific qualification and career ma tters. All hospitals lack appropriate facilities and specialised teams for carrying out clinical studies. In addition, cooperation and commu nication between the university centers is also unsatisfactory, result ing in a myriad of small-scale studies without significant impact. A d ebate on this situation has recently been started in the media, but no t yet in our boards and journals. In the present paper we try to analy se the situation in gynaecology and obstetrics and propose solutions t o improve clinical research. The following proposals are made: immedia te start of a critical and thorough discussion of deficiencies, real i mprovement of cooperation between the centers, monitoring according to GCP and external referees for most/all studies, establishment of eval uation criteria for scientific qualification, more stringent evaluatio n standards for accepting papers in German OB/GYN journals. In the nea r future young clinicians could be motivated to do clinical research o nly if major changes in concept and infrastructure are achieved.