What is the ultimate scientific publication for the clinical scientist of the 21st century?
Over the last half of the 20th century, manuscripts published in peer-reviewed scientific journals became the gold standard for both knowledge dissemination and career promotion, being “impact factor” and “citations” two surrogate markers for success. Not surprisingly, the number of publications in high-impact journals within a field is key for a researcher who applies for a grant, whereas the grants are essential to fund the research that merits publication in high-impact journals. Weird, isn’t it?
The primary objective of knowledge generation should be neither citation nor impact factor. In the clinical setting, knowledge should be generated to answer questions, to solve problems, to address human needs. However, it has been extremely difficult, if not impossible, to find the right indicators to measure how much a “paper” improves individual patient care, the standard of care, and even worse, to quantify its impact on health-related outcomes, beyond systematic reviews and meta-analysis that defined the new paradigm of clinical practice in the past century: evidence-based medicine.
Almost simultaneously to the development of modern research, information and communication technology (ICT) have induced radical social and cultural changes. ICT has rapidly evolved from the undanymic access to the internet from a desktop computer in the 90’s, to applications (apps) designed to perform specific tasks in mobile phones.
Currently, clinical knowledge can be processed, packed and made immediately available for healthcare professionals and citizens through apps downloaded to the mobile healthcare center, the smartphone. Ubiquitous communication and data collection through apps (linked to information systems) used by healthcare professionals and patients may establish a two-way street between knowledge managers and knowledge users, skipping the traditional intermediate barriers.
We propose a radical change. Let’s abandon the “old manuscript” as the only “gold standard” and let’s focus on tools that allow clinical scientists to disseminate their knowledge and to quantify how much the final users benefit from it. Let’s consider healthcare IT tools (i.e apps) the new “gold standard” of the 21st century.
Several issues remain unsolved: the review process, validation, how to incorporate apps into clinical practice, data exploitation… We know it is not easy, but it doesn’t mean it’s not worthwhile.