Einsteins' role in clinical research

Scientific research is a systematic process aimed to build knowledge through a set of structured evaluations, thus generating the development of both the individual that performs research and the society in which it is developed. The objective of research is to produce knowledge, possibly applicable inside and outside researchersénvironments, and perhaps generate practical actions. Research methodology should be reproducible and its results may be taken into real world scenarios, generating outcomes for the entire community. A good example of this process was the beginning of the past decade, when patients with ischemia that presented a short stenosis of the superficial femoral artery were treated with saphenous bypass surgery attaining very good results, but at the expense of high clinical complication rates. Several studies using angioplasty associated with stent placements demonstrated that the same lesions had appropriate long-term results, and lower complication rates. This new piece of information and cost-effectiveness-based concepts changed management, and patients were no longer submitted to major surgery, and began to be treated by the endovascular method. A well conducted study is considered the foundation for the development of a good health policy in any part of the world. Instead of only relying on what in theory could be effective or work, or use empirical or political methods, investigators perform studies that provide institutions and society with material data that will make their decisions easier, and generate effective institutional and even global health programs. Until a few years ago, patients with hyperhidrosis were treated as fast as possible with thoracic sympathectomy, but also had a constant side effect − compensatory hyperhidrosis, which frequently generated more suffering to patients than the initial condition. Today, patients with such a frequent condition regardless of age, are initially treated with a low cost drug, oxybutynin chlorhydrate, and those who improve remain on the medication with a record of major improvement in Quality of Life; only those who do not improve are submitted to surgery. This has led to a great decrease in the number of individuals operated on, with cost reduction for payment sources and decrease in the number of irreversible and unnecessary complications.