Bruijns Stevan, Lamanna Camillo
Faculty of Health Sciences University of Cape Town, Anzio Road, Cape Town, 7935, South Africa.
Ecancermedicalscience. 2018 Jan 29;12:ed78. doi: 10.3332/ecancer.2018.ed78. eCollection 2018.
Healthcare-related research is largely regional. Put simply, this is because disease burdens differ between world regions. Even global burdens, such as ischaemic heart disease and cancer, display distinctive characteristics in certain regions that are not seen in others. Regional differences in infrastructure, resources and human capital further compound the differences seen, as they affect the way in which the local scientific community can interact with the local disease burden. As such, it seems fair to assume that healthcare-related research ought to be regionally distributed. Although translation of research between regions can sometimes be done, the larger the gap in infrastructure, resources or human capital between regions, the less likely it is that it can be adequately bridged. A recent example of this pertains to accepted life-saving treatment for sepsis in high-income settings, which had the opposite effect when implemented and evaluated in low-income Zambia. This regionality of clinical medicine is, however, not reflected in academic publishing; the impact of a journal is measured and understood by metrics that use the world as their denominator. Therefore, top medical journals are perceived to be relevant equally to all contexts and regions. However, there is a strong case to be made that this lack of granularity is deleterious, and that the creation of a regional impact metric would place clinicians, researchers, and libraries in a better position to understand which journals are relevant to their context and practice.
与医疗保健相关的研究在很大程度上具有区域性。简而言之，这是因为世界不同地区的疾病负担存在差异。即使是全球性负担，如缺血性心脏病和癌症，在某些地区也呈现出其他地区未见的独特特征。基础设施、资源和人力资本的区域差异进一步加剧了这种差异，因为它们影响着当地科学界与当地疾病负担相互作用的方式。因此，可以合理地假设与医疗保健相关的研究应该按区域分布。虽然有时可以在不同地区之间进行研究翻译，但地区之间基础设施、资源或人力资本的差距越大，就越不可能充分弥合这一差距。最近的一个例子是，在高收入环境中被认可的败血症救命治疗方法，在低收入的赞比亚实施和评估时却产生了相反的效果。然而，临床医学的这种区域性在学术出版中并未得到体现；期刊的影响力是通过以全球为分母的指标来衡量和理解的。因此，顶级医学期刊被认为对所有背景和地区都同样相关。然而，有充分的理由认为，这种缺乏粒度的情况是有害的，创建一个区域影响力指标将使临床医生、研究人员和图书馆能够更好地了解哪些期刊与他们的背景和实践相关。
