Medical research influenced by training 'genealogy'

January 04, 2016

By analyzing peer-reviewed scientific papers that examined the effectiveness of a surgical procedure, researchers at University of California, San Diego School of Medicine provide evidence suggesting that the conclusions of these studies appear to be influenced by the authors' mentors and medical training. The study is published January 4 by the Annals of Neurology.

"Doctors are often faced with analyzing an expanding number of published articles to seek guidance in terms of evidence on how best to treat their patients," said senior author Clark C. Chen, MD, PhD, vice-chair of research and academic development in the Department of Neurosurgery at UC San Diego School of Medicine. "The challenge is magnified by the fact that many articles present contradictory results. Making sense of the aggregate of these articles requires a thorough understanding of medicine, as well as potential biases of the published article."

In their study, Chen and team analyzed 108 published articles that investigated whether or not surgical removal of a type of invasive brain tumor (high-grade gliomas) improved overall patient survival. Seventy-six of the 108 articles (70 percent) showed that the more tumor removed by the surgeon, the longer the patient lived. However, 32 (30 percent) of the articles concluded that surgical removal of this type of brain tumor did not necessarily affect patient survival.

"If you were a surgeon simply counting up the number of published articles in support of or against this surgery, you would be convinced that more complete removal of high-grade gliomas would likely benefit your patient," said the study's first author, Brian Hirshman, MD, staff research associate at Moores Cancer Center at UC San Diego Health. "But the reality is far more complicated."

Applying methods typically used to study social networks, the UC San Diego team found that many of the authors of the papers evaluated are related by medical training. That is, many researchers who published in this field share residency or fellowship training under the same mentor, or other physicians trained by the same mentor -- a phenomenon that Chen and Hirshman call "medical academic genealogy."

The team found that if an article was authored by someone from a genealogy whose founder is a neurosurgeon, its results were more likely to support maximal tumor removal for patient survival. In contrast, if an article was authored by someone from another genealogy, one founded by a radiation oncologist, for example, it was less likely to support maximal tumor removal for high-grade gliomas.

"The results are highly suggestive that the mentor and medical training of the researcher strongly influences the types of article that a researcher publishes throughout his or her career," said Chen. "The influence of mentorship and training on one's creative work is well understood in the fields of philosophy, music and the arts. In this study, we show the same effects are present in medical research."

"Understanding these potential biases will allow us to better interpret the medical literature, improve the quality of patient care and improve the training process for the next generation of physicians," said Bob S. Carter, MD, PhD, chairman of the Department of Neurosurgery at UC San Diego School of Medicine.

As a follow-up, Chen and his team developed statistical methods to evaluate peer-reviewed literature in a way that accounts for the medical academic genealogy of contributing authors. While the results are not yet published, they report that, after correcting for the genealogy effects, published literature robustly supports the notion that maximal surgical removal of high-grade gliomas is associated with improved patient survival.

With this in mind, Chen looks forward to the completion of the Jacobs Medical Center at UC San Diego Health, scheduled to open in 2016. The new hospital will include 14 operating rooms and four intraoperative imaging suites. "The ability to view MRIs throughout surgery will allow surgeons to achieve a more complete removal of high-grade gliomas, and raise the quality of care for our patients," Chen said.
-end-
Study co-authors include Jessica A. Tang, James A. Proudfoot, Lawrence Marshall, UC San Diego; Laurie A. Jones, and Kathleen M. Carley, Carnegie Mellon University.

This research was funded, in part, by the Czech Duck Research Fellowship in Neurosurgery at UC San Diego.

University of California - San Diego

Related Brain Tumor Articles from Brightsurf:

New function for potential tumor suppressor in brain development
New research from the group of Simon Hippenmeyer, professor at the Institute of Science and Technology Austria (IST Austria), has now uncovered a novel, opposite role for Cdkn1c.

Peering into the genome of brain tumor
Scientists at Osaka University have created a machine learning method for classifying the mutations of glioma brain tumors based on MR images alone.

Ultrasound blasts potent glioblastoma drug into brain tumor
A potent drug for glioblastoma can't be used in patients.

Improving drug delivery for brain tumor treatment
Despite improvements in drug delivery mechanisms, treating brain tumors has remained challenging.

Neurons promote growth of brain tumor cells
In a current paper published in the journal 'Nature', Heidelberg-based researchers and physicians describe how neurons in the brain establish contact with aggressive glioblastomas and thus promote tumor growth / New tumor activation mechanism provides starting points for clinical trials.

Discovered a factor that predicts long survival in brain tumor
Researchers of the Josep Carreras Leukaemia Research Institute have discovered an epigenetic lesion that allows identifying those patients affected by brain tumors that have a longer life expectancy.

Scientists track brain tumor turncoats with advanced imaging
To better understand the cells that brain tumors recruit, scientists developed advanced imaging techniques to visualize macrophages.

Understanding how people respond to symptoms of a brain tumor
A recent study from King's College London and Cambridge University highlighted that people may experience multiple subtle changes before being diagnosed with a brain tumor.

A breakthrough for brain tumor drug development
Glioblastoma is a devastating disease with poor survival stats due in part to a lack of preclinical models for new drug testing.

Improving operations for the brain's most malignant tumor
Important research by Barrow Neurological Institute neurosurgeons and University of Washington (UW) scientists on novel imaging technology for malignant brain tumors was published in the August issue of the Nature journal, Scientific Reports.

Read More: Brain Tumor News and Brain Tumor Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.