 The term "flagship" denotes a highly valued asset. Quite often the most impressive or revered holding of a brand or company/organization. Sounds nice to me but boring. I doubt they are looking to be too extreme or forward thinking with this precious "holding". Why fix it if it isn't broken? What we need in medicine are a few pirate ships scattered throughout the fleet. Risk takers willing to challenge the status quo for not only better questions--but more challenges of "established" answers. The behavior of ideas as they jump from person to person has the same pattern as the spread of the Plague. Both are described by the same mathematical model. Physicians tell me all the time--they are overwhelmed by the volume of medical literature within their specialties and across medicine in general. There is data to support this. Case in point. I went to PubMed (and their newly designed interface) and entered oncology 2020. It isn't even February yet and it yielded 12,181 results. Scimago Journal & Country Rank provides information on journal and country ranks and also provides a few visualization tools. The graphic below shows the % cited documents and cites per document. I tagged the oncology documents so we can get a general idea of where we are compared to other cited documents. Hovering around below 40% with less than 1.2 cites per document.  Now if we are looking for a measure of document volume look at our Medicine bubble below. Yowza. What is going on here? My first thoughts point to the lucrative journal and subscription markets in Medicine. According to 2015 data the value was more than 25 billion dollars. In 2019, Vox news reported that the UC Sytem in California dropped its $10 million-a-year subscription to Elsevier. Not to alarm you dear reader but me thinks perhaps all is not above board in medical publishing. As Vinay Prasad MD, MPH, says, its the flow of money through the system that is corrupt.  The h-index on the x-axis below is an author specific metric that reports productivity by creating an index of author's most cited papers combined with the number of citations they have received in other publications. Oncology continues to reign supreme when compared by influential authors ranked by their H-index.  What we actually need are more primary endpoints that measure overall survival, better statistical models, and less low hanging fruit. We need more pirates mateys...  Comments are closed.
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