The article by IAP President Naveen Thacker has focused on an important issue of Pediatric Research in Office Setting(1). We completely agree that, in general, there is a great need in our country to generate accurate pediatric epidemiological data and for carrying out research for finding indigenous solutions to the health issues affecting Indian children(1). Many dissertations submitted to the University are based on retrospective analysis or have a sample size or methodology too inadequate to draw meaningful inferences. It is not surprising that most of the dissertations remain unpublished and do not make any impact on scientific community or policy decisions. Private pediatricians cater to majority of children and therefore, they can help in making an enormous contribution to research activities. Their active participation once initiated can help generate data regarding various health parameters, evolve evidence-based practice guide-lines and probe for answers to our populations’ problems. However, we should also be aware of the ground realities as they exist.

Today’s pediatricians who are in the private practice, by and large, have not received adequate training in research methodology, research ethics, and biostatistics. This is a direct consequence of inadequate inclusion of these aspects in graduate and post-graduate curriculums. Even undertaking simplest form of research studies such as observational studies, would require the investigators to be aware of issues such as participants’ rights (especially those related to autonomy and confidentiality), documentation and basic biostatistics.

Ethics committees play an important role in safeguarding the interests of research participants. As the expertise available in the country in the field of research ethics is limited, even large private hospitals may not find it easy to constitute institutional ethics committees and establishing them would be beyond the capacity of smaller nursing homes. Once research activities are undertaken by several private clinics and institutions across the country, ethics committees might find it difficult to monitor these activities and ensure that the research is being carried out adhering to the mandatory ethical standards.

Most private pediatricians have an extremely busy practice and barely have enough time to communicate with their patients and parents. Finding time for research-related activities such as getting trained, interacting with research participants, documentation and training and supervising over the research team could be difficult. They will have to be committed to ensure that the quality of their research activities is adequate.

This does not mean that pediatric research in office setting cannot be implemented in our country. Private pediatricians desirous of undertaking research will have to spare time for getting trained and thereafter for conducting research activities without compromising on patient care. The IAP will have to take up the onerous responsibility of coordinating training activities for prospective researchers, identifying priority research areas, deciding on research sites (based on research question, availability of expertise, and patient population), monitoring data collection and ensuring quality research. IAP may be able to meet this challenge if it collaborates with Medical colleges and organizations such as the Indian Council of Medical Research (ICMR).

S B Bavdekar,
Sunil Karande,
Flat 24, Joothica, 5th Floor,
22A, Naushir Bharucha Road,
Mumbai 400 007, India.
E-mail: [email protected]