Health care research is untidy – what does it mean for postdocs?

by jano klimas

Why do we study health? Because we want to help patients. it’s no rocket science. And yet, most clinical trials do not measure outcomes that are important for patients. Besides, researchers don’t agree on what the core set of outcomes should be. “Health care research is untidy.” — Mike Clarke. In this post, I write about my experience of a conference about outcomes for clinical research and how it relates to postdoc training.

Systematic reviews are often required as part of a PhD or a postdoc training. Over 30,000 authors produce Cochrane systematic reviews of literature for the Cochrane library worldwide. The Canadian Cochrane Centre hosted about a hundred of them at a recent joint conference, together with the COMET initiative (Core Outcome Measures in Trials), in Calgary, Canada.

Many junior postdocs present at the conference struggled to publish papers. Yet, the number of publications is considered a core outcome of a postdoc training. Is it enough? What’s a core outcome set for a postdoc fellowship? “Not everything that can be counted counts, and not everything that counts can be counted.” — Albert Einstein.

 Ultimately, the fellowship should result in a faculty position. But we know that there aren’t enough positions for all PhD’s and postdocs. The truth is that we don’t need so many PhDs. “PhD ‘overproduction’ is not new and faculty retirements won’t solve it,” writes Melonie Fullick in her speculative diction at University Affairs (March 25, 2015): “Yet somehow no matter how many PhDs enroll and graduate, academic careers are the goal.”

What lessons can postdocs take from the Cochrane collaboration to improve their career prospects? All Cochrane reviews must have a protocol. Cochrane protocols get published in the Cochrane library. However, protocols for non-Cochrane systematic reviews are difficult to publish in journals. Nevertheless, postdocs  who decide to do a systematic review and can upload the review protocol on to their open-access universities’ depositories. They get picked up by the scholar.google and can be counted in the H-index. This way, junior postdocs can improve one of their core outcome measures – the track record. Although it’s probably not the best measure of a successful training, it’s the currency of science.