Exploring the clinical translation intensity of papers published by the world’s top scientists in basic medicine


The extent to which basic medical research is translated into clinical practice is a topic of interest to all stakeholders. In this study, we assessed the clinical translation intensity of papers published by scientists who have made outstanding contributions to the field of basic medicine (Lasker Prize winners for Basic Medical Research). Approximate Potential for Translation (APT), Translational science scores (TS), and Citations by clinical research (Cited by Clin.) were analyzed as dependent variables. A traditional citation indicator was used as a reference (relative citation ratio, RCR). In order to examine the correlation between these different indicators and the characteristics of the paper, the author, and the institution. we used nonparametric tests, Spearman correlations, ordinal least squares regressions (OLS), quantile regressions, and zero-inflated negative binomial regression methods. We found that among the basic medical research papers published by Lasker Basic Medicine Award winners, (1) 20% are cited by clinical research; 11.6% of the papers were more valuable for clinical research than basic research; 12.8% have a probability of more than 50% to be cited in future clinical studies; (2) Spearman correlations were conducted among APT, TS, Cited by Clin., RCR, and all of the other continuous variables. There is a significant, positive, low to moderate correlation between APT, TS, and Cited by Clin (APT and TS: r = 0.549, p < 0.01; APT and Cited by Clin: r = 0.530, p < 0.01; TS and Cited by Clin: r = 0.383, p < 0.01). However, the relationship between RCR and the three indicators of clinical translation intensity was not consistent. APT was positively correlated with RCR (r = 0.553, p < 0.01). Cited by Clin. is weakly positively correlated with RCR (r = 0.381, p < 0.01). There is almost no correlation between TS and RCR (r = 0.184, p < 0.01). (3) Publication age, primary research paper, multidisciplinary science, number of disciplines, authors, institutions, funded projects, references, length of the title, length of paper, physical age, gender, nationality, institutional type, Nobel Prize have a significant relationship with 1 to 3 types of clinical translation intensity measures. In a sample of basic medical research papers published by the world’s top scientists in basic medicine, we came to the following conclusions: the three indicators, APT, TS and Cited by Clin., measured the clinical translation intensity of the papers from different perspectives. They are both related to each other and have their own characteristics. In a sample of basic medical research papers published by the world’s top scientists in basic medicine, characteristics at the paper, winner, and institution level significantly correlated with the measures of clinical translation intensity. Gender effect on the clinical translation intensity of papers was confirmed. Traditional citation-based indicators and translational-focused indicators measure academic impact and clinical impact respectively. There is a certain degree of disconnect between them. Two types of indicators should be used in combination in future assessments of basic medical research.


Supplementary information:

The online version contains supplementary material available at 10.1007/s11192-023-04634-4.


Keywords:

Approximate potential to translate (APT); Basic medical research; Clinical translation intensity; Impact assessment; Lasker Prize; Translational science score (TS score).



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Defining Pediatric Chronic Critical Illness: A Scoping Review



Objectives:

Children with chronic critical illness (CCI) are hypothesized to be a high-risk patient population with persistent multiple organ dysfunction and functional morbidities resulting in recurrent or prolonged critical care; however, it is unclear how CCI should be defined. The aim of this scoping review was to evaluate the existing literature for case definitions of pediatric CCI and case definitions of prolonged PICU admission and to explore the methodologies used to derive these definitions.


Data sources:

Four electronic databases (Ovid Medline, Embase, CINAHL, and Web of Science) from inception to March 3, 2021.


Study selection:

We included studies that provided a specific case definition for CCI or prolonged PICU admission. Crowdsourcing was used to screen citations independently and in duplicate. A machine-learning algorithm was developed and validated using 6,284 citations assessed in duplicate by trained crowd reviewers. A hybrid of crowdsourcing and machine-learning methods was used to complete the remaining citation screening.


Data extraction:

We extracted details of case definitions, study demographics, participant characteristics, and outcomes assessed.


Data synthesis:

Sixty-seven studies were included. Twelve studies (18%) provided a definition for CCI that included concepts of PICU length of stay (n = 12), medical complexity or chronic conditions (n = 9), recurrent admissions (n = 9), technology dependence (n = 5), and uncertain prognosis (n = 1). Definitions were commonly referenced from another source (n = 6) or opinion-based (n = 5). The remaining 55 studies (82%) provided a definition for prolonged PICU admission, most frequently greater than or equal to 14 (n = 11) or greater than or equal to 28 days (n = 10). Most of these definitions were derived by investigator opinion (n = 24) or statistical method (n = 18).


Conclusions:

Pediatric CCI has been variably defined with regard to the concepts of patient complexity and chronicity of critical illness. A consensus definition is needed to advance this emerging and important area of pediatric critical care research.



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Associations between early sleep-disordered breathing following moderate-to-severe traumatic brain injury and long-term chronic pain status: a Traumatic Brain Injury Model Systems study



Study objectives:

To explore the relationship between polysomnography-derived respiratory indices and chronic pain status among individuals following traumatic brain injury (TBI).


Methods:

Participants (n = 66) with moderate to severe TBI underwent polysomnography during inpatient acute rehabilitation and their chronic pain status was assessed at 1- to 2-year follow-up as part of the TBI Model Systems Pain Collaborative Study. Pairwise comparisons across pain cohorts (ie, chronic pain, no history of pain) were made to explore differences on polysomnography indices.


Results:

Among our total sample, approximately three-quarters (74.2%) received sleep apnea diagnoses utilizing American Academy of Sleep Medicine criteria, with 61.9% of those endorsing a history of chronic pain. Of those endorsing chronic pain, the average pain score was 4.8 (standard deviation = 2.1), with a mean interference score of 5.3 (2.7). Pairwise comparisons revealed that those endorsing a chronic pain experience at follow-up experienced categorically worse indicators of sleep-related breathing disorders during acute rehabilitation relative to those who did not endorse chronic pain. Important differences were observed with elevations on central (chronic pain: 2.6; no pain: 0.8 per hour) and obstructive apnea (chronic pain: 15.7; no pain: 11.1 per hour) events, as well as oxygen desaturation indices (chronic pain: 19.6; no pain: 7.9 per hour).


Conclusions:

Sleep-disordered breathing appears worse among those who endorse chronic pain following moderate-to-severe TBI, but additional research is needed to understand its relation to postinjury pain. Prospective investigation is necessary to determine how clinical decisions (eg, opioid therapy) and intervention (eg, positive airway pressure) may mutually influence outcomes.


Clinical trial registration:

Registry: ClinicalTrials.gov; Name: Comparison of Sleep Apnea Assessment Strategies to Maximize TBI Rehabilitation Participation and Outcome (C-SAS); URL: https://clinicaltrials.gov/ct2/show/NCT03033901; Identifier: NCT03033901.


citation:

Martin AM, Pinto SM, Tang X, et al. Associations between early sleep-disordered breathing following moderate-to-severe traumatic brain injury and long-term chronic pain status: a Traumatic Brain Injury Model Systems study. J Clin Sleep Med. 2023;19(1):135-143.


Keywords:

TBI; chronic pain; polysomnography; sleep apnea.



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‘Optimal’ cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study



Objectives:

Optimal cutoff thresholds are selected to separate ‘positive’ from ‘negative’ screening results. We evaluated how depression screening tool studies select optimal cutoffs.


Methods:

We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation.


Results:

Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden’s J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies (76%) identified an optimal cutoff other than the standard; most did not make use recommendations (N = 56; 43%) or recommended using a non-standard cutoff (N = 53; 40%). Only 4 studies cited a reporting guideline, and 4 described a protocol with optimal cutoff selection methods, but none used the protocol method in the published study.


Conclusions:

Research is needed to guide how selection of cutoffs for depression screening tools can be standardized and reflect clinical considerations.


Keywords:

edinburgh postnatal depression scale; hospital anxiety and depression scale; major depression; optimal cutoff selection; patient health questionnaire-9; screening.



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The Relative Citation Ratio (RCR) as a Novel Bibliometric among 2,511 Academic Orthopaedic Surgeons



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doi: 10.1002/jor.25490.


Online ahead of print.

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Arjun Guptacitation-separator”> et al.

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Abstract

Objectively measuring research output is important for grant awards, promotion and tenure, or self-evaluation of productivity. However, certain shortcomings limit common bibliometric indicators. The time- and field-independent relative citation ratio (RCR) was proposed to overcome these limitations. The objective of this study was to determine whether the RCR correlates with academic rank, gender, and Ph.D. degree status among U.S. academic orthopaedic surgeons. Full-time faculty-surgeons at Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery residency programs were included in this study. Mean (mRCR) and weighted (wRCR) RCR scores were collected from the NIH iCite database to quantify scholarly “impact” and “production”, respectively, and were compared by academic rank, gender, and Ph.D. status. All information was collected from publicly available faculty listings on departmental websites. A total of 2,511 orthopaedic surgeons from 132 residency programs were assessed. Overall, the median (IQR) mRCR score was 1.56 (1.05-2.12) and the median wRCR score was 27.6 (6.97-88.44). Both metrics increased with each successive academic rank, except for department chairs. There was no difference in mRCR between male and female surgeons. Among assistant professors, males had higher wRCR scores. Both metrics were higher among surgeons with a Ph.D. degree. The RCR offers key advantages over other indices, which are reflected in differences in score distributions compared to the widely used h-index. Nevertheless, implementation of the RCR should be preceded with careful consideration of its own limitations. This article is protected by copyright. All rights reserved.


Keywords:

Bibliometrics; National Institutes of Health (NIH); Orthopaedic Surgery; Relative citation Ratio (RCR); Research Productivity.