摘要：In public health, the generation, management, and transfer of knowledge all need major improvement. Problems in generating knowledge include an imbalance in research funding, publication bias, unnecessary studies, adherence to fashion, and undue interest in novel and immediate issues. Impaired generation of knowledge, combined with a dated and inadequate process for managing knowledge and an inefficient system for transferring knowledge, mean a distorted body of evidence available for decisionmaking in public health. This article hopes to stimulate discussion by proposing a Global Registry of Anticipated Public Health Studies. This prospective, comprehensive system for tracking research in public health could help enhance collaboration and improve efficiency. Practical problems must be discussed before such a vision can be further developed. IN 2004, THE INTERNATIONAL Committee of Medical Journal Editors announced that, from July 2005, researchers submitting articles to 11 medical journals would be asked to report the full results of clinical trials, both positive and negative, and that the journals would not publish studies unless they had been included in a public registry at their inception. 1 This policy should guard against selective reporting of trials and the distortion of the body of evidence available for clinical decisionmaking. 2 The International Committee of Medical Journal Editors has now specified the minimum registration data set. 3 , 4 We believe that similar considerations and standards are needed for nontrial public health studies. Public health studies are studies related to the efforts organized by society to protect, promote, and restore the people’s health, 5 many of which are observational and nonexperimental, or involve “natural experiments.” 6 We examined the current problems in generating, managing, and transferring knowledge in public health and have described a vision for a future Global Registry of Anticipated Public Health Studies (GRAPHS). Knowledge generation and use are a critical foundation of effective public health programs and policies, but many problems are evident in current practice. Because this article covers a broad scope, it can discuss neither all of the issues nor each issue in sufficient depth. Also, the proposed vision is not meant to address all of the numerous practical issues but to generate public discussion. We are describing a vision to encourage possible solutions to important problems; we are not making a concrete proposal. For the purpose of this article, the knowledge cycle is divided into 3 stages: (1) knowledge generation (also known as knowledge acquisition or creation) 7 ; (2) knowledge management (exploitation and development of the knowledge assets) 8 ; and (3) knowledge transfer (also known as knowledge exchange, dissemination, access, brokering, or translation). 7
