Monday, 1 September 2014

Chinese prefer foreign brands - especially when it comes to medical journals

One of the more provocative articles in the China-themed Lancet this week is a brief letter from two orthopaedic surgeons in Xian. 

Dr Yang Junsong and Dr Hao Dingjun complain about the quality of medical journals in China and how Chinese clinicians invariably prefer to be published in foreign medical journals. This is because of the publish-for-promotion phenomenon which I touched on last week - to gain promotion in a Chinese hospital, a doctor needs to acquire a list of published research, and the greater the Impact Factor of the journal the better.

As Drs Yang and Hao remark, there has been a tidal wave of medical journal articles published by Chinese clinicians in recent years, and yet medical publishing is in crisis. Why? Because most of it is crap. Scholarly articles are not being published to to be read or to further scientific knowledge, but to be listed and to obtain the magic piece of paper that counts towards career advancement.

Well, you might say, this sort of things happens to all academics and clinicians  and you'd be right. But the scale of the problem in China - and the sheer numbers involved - means this is distorting medical publishing and also drowning out the genuine research and academic discussion that deserves to be published but which struggles to reach the most suitable audience.

Another problem noted by the doctors from the Medical College of Xi'an Jiaotong University is that most doctors in China don't read English language journals. They may only have access to Chinese language journals and these are poor in quality because they being neglected by Chinese researchers - and they are also often profit seeking rather than having any sense of collegiality. As the authors note, Chinese doctors deal with 4 billion patient consults a year and they depend on Chinese medical journals as their main source of medical information - if this is rubbish, where can they get good quality research,  evidence and discussion from to inform their practice?

"Rebuilding a scientific and reasonable assessment system for medical research would be an essential step for the Chinese government," the authors conclude.

This isn't the first complaint about medical publishing in China. The Economist touched on the  problem of poor quality - and sometimes fake - medical research publications last year. Other bloggers have also highlighted the bizarre practice of bonuses paid to researchers in China in proportion to the impact factor of journals they get published in: $300 for a low impact journal, and the jackpot of $30,000 for getting a paper in Science or Nature! This reminds me of Chiang Kai Shek's system or rewarding his air force pilots with dollar bonuses for every enemy aeroplane they shot down.

I can only agree with this article by a frustrated academic: "We must stop the avalanche of low quality research..."

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