There are many different types of health research going on at any one time. Some of it may look at the effects of standard treatments, other research may be investigating whether new treatments offer any benefit or how the NHS can best organise and provide services.
The main types of health research (explained on this page) are:
Most research in the NHS involves people, often patients, and is usually referred to as clinical research or medical research.
One particular type of research, the clinical trial, compares the effects, both wanted and unwanted, of two or more treatments. This is described in detail in the next section.
Observational research means using data collected during routine clinical care to analyse:
- the health of the population,
- the natural history of disease, and
- the safety and cost-effectiveness of healthcare interventions (treatments and therapies) used in daily clinical practice.
Laboratory or test tube research
Before new medicines are tested in clinical trials, they are tested in laboratories. Only when laboratory research has shown that they are promising and unlikely to cause serious side effects will they go on to be tested in a clinical trial.
The medicines will often be tested on cell cultures, which are cells taken from living tissue that are grown and kept alive artificially. These cells cannot survive on their own and once the supply of nutrients, warmth and oxygen is removed, they die.
Research using cell cultures is often called test tube or ‘in vitro’ (meaning ‘in glass’) research, even though much laboratory equipment is now made of plastic.
Cell cultures may, for example, be used to assess the effects of possible drug treatments on cancer cells. Chemicals that are shown to be toxic to cancer cells in the laboratory may be tested in further research as possible cancer drugs.
Epidemiology is a special branch of research that looks at patterns of illness and disease in groups of people. It tries to identify what the causes of disease are.
Some epidemiology studies compare people who have a disease (cases) with people without the disease (controls).
Other studies look at a group of people (a cohort) over time to see what happens. Those who develop a condition and those who do not may then be compared.
A third type of epidemiology study looks at patterns in populations and may find associations between environmental factors, such as diet and disease.
The main drawback of epidemiology is that while studies can identify strong links they do not prove that one thing has caused the other.
Epidemiology has made some of the most important medical discoveries, including:
- that smoking tobacco is the main cause of lung cancer, and
- the health risks of high-fat diets and a lack of physical activity.
It may seem obvious that a good diet, not smoking and being active are healthy, but now there is research to clearly show this.
Research on animals is a subject of public debate and controversy, and many people have strong feelings about it.
By law, all medicines must be tested on animals before being given to humans in clinical trials.
There are regulations to ensure that animal research is only carried out when there is no alternative, that it is carried out humanely, and that it is likely to bring real benefits.