Science in transition, or not?

Something is happening in my university. My dean, prof. Frank Miedema (H-index >70), and friends discovered that the blibliometric way of evaluating quality of science (of a person or an institute) is wrong. (Especially) Young researchers are pursuing – for the wrong reasons – a high H-index (many papers cited frequently) and the publication pressure distracts them from doing the better things for patients and society. So, they decided to break free, and they tell their story this week in Nature (high impact factor, isn’t that what they call irony?).

I whole-heartedly agree with the philosophy of “Science in transition”. The impact system is sick, see. In Nature, also the story of Mark Ferguson, former dean of biology at the University of Manchester: as a predecessor of the Science Transitioners he decided 20 years ago that professor applicants should, instead of their impressive publication list, submit what they considered their 3 most important publications, with motivation.

That made me think. What would I submit? Here they are:

The recognition that the number of other patients with VRE in a ward is the best predictor for new acquisitions, see. Bob Weinstein named it colonization pressure, and the subsequent recognition that this number in the ward is influenced not only by acquisitions, but also by admitted and discharged patients got me on a plane to Oxford to learn about mathematical modelling and that the dynamics of AMR in a hospital are quite similar to malaria (healthcare workers being mosquitos). Today, I still enjoy working with mathematicians.

Two years later we had the first 2 outbreaks with VRE in the Netherlands. We studied these isolates, together with a bunch of isolates I took home from Chicago and other outbreaks across the globe. Rob Willems and Janetta Top discovered that all outbreak isolates contained the esp-gene (and others did not), see. Now we know that a subclade of E. faecium, containing esp and much more, is responsible fort he global pandemic of ampicillin-resistant and vancomycin-resistant E. faecium. Today, I still enjoy working with molecular biologists.

Six years ago we thought of ways to bypass the hurdles that killed clinically relevant research for treating community-acquired pneumonia (CAP); antibiotics before randomization to study antibiotics and enrolling only a fraction of those actually treated for CAP. Inspired by a previous study we used a cluster randomized approach and changed the hospital antibiotic policy every 4 months, see. The 3 options were – without preference – recommended by our national guideline. It took us 3 years  to get funding and IRB approval, but in the end we were among the first to integrate randomized comparative effectiveness research with patient care, see. I firmly believe that this type of research is the future for infection prevention.

Not sure if I would have been hired, since all 3 studies were published in respectable journals (and were cited). My point, science must transit, but it should not stop us from publishing our work in journals that are read by many colleagues, as I am convinced that these studies would not have received the same attention if published in non-peer-reviewed journals. I trust my dean & Science in Transition are with me on this.

I wrote this blog while listening to my playlist on Spotify, and at the end of writing Carly Simon sang “You’re so vain”.


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