Biomedical informatics publications: a global perspective: part I: conferences

A Comparison of the Development of Medical Informatics in China and That in Western Countries from 2008 to 2018: A Bibliometric Analysis of Official Journal Publications

Objective

We focused on medical informatics journal publications rather than on conference proceedings by comparing and analyzing the data from journals and conferences from a broader perspective. The aim is to summarize the unique contributions of China to medical digitization and foster more multilevel international cooperation.

Method

In February 2019, publications from 2008 to 2018 in three major English-language medical informatics journals were retrieved through Scopus, including the journals, namely, International Journal of Medical Informatics (IJMI, international community), JAMIA (United States), and Methods of Information in Medicine (MIM, Europe). Three major Chinese-language journals, namely, China Digital Medicine (CDM), Chinese Journal of Health Informatics and Management (CJHIM), and Chinese Journal of Medical Library and Information Science (CJMLIS), were searched within the major three Chinese literature databases. The datasets were preprocessed using the NLP package on Python, and a smart local moving algorithm was used as a clustering method for identifying the aforementioned journals.

Result

Between 2008 and 2018, the total number of published papers and H-index of the three English-language journals was 1371 and 67 (IJMI), 1752 and 86 (JAMIA), and 637 and 35 (MIM), respectively. In the same period, the total number of published papers and H-index in the three Chinese-language journals was 6668 and 23 (CDM), 1668 and 22 (CJHIM), and 2557 and 25 (CJMLIS), respectively. IJMI, JAMIA, and MIM received submissions from 82, 59, and 62 countries/regions, respectively. By contrast, the three Chinese journals only received submissions from seven foreign countries. The proportions of authors from institutional affiliations were similar between the three English-language journals (IJMI, JAMIA, and MIM) and CJMLIS because the majority of the authors were from universities (81%, 74%, 73%, and 65.2%), followed by medical institutions (12%, 10%, 9%, and 23.4%) or research institutes (2%, 4%, 10%, and 4.3%). Furthermore, the proportions of the authors from enterprises were low (2%, 6%, 4%, and 0.3%) for all journals. However, the authors in CDM and CJHIM were mainly from medical institutions (50% and 40%), followed by universities (33% and 32%) and research institutes (3% and 4%). In addition, the proportions of enterprises were only 3% and 2%, respectively. Among the top five authors in three English-language journals (ranked in terms of the number of published papers), 100% had doctoral or master's degrees, compared with only 60% in the Chinese journals. Additionally, 28204 different keywords were extracted from the aforementioned papers, covering 275 specific high-frequency key terms. Based on these key terms, four clusters were found in the English literature-"Health and Clinical Information Systems," "Internet and Telemedicine," "Medical Data Statistical Analysis," and "EHRs and Information Management"-and three clusters were found in the Chinese literature: "Hospital Information Systems and EMR," "Library Science and Bibliometrics Analysis," and "Medical Reform Policy and Health Digitization." Only two clusters are similar, and Chinese-language journals focus more on health information in technology and industrial applications than in medical informatics basic research.

Conclusion

This study provides important insights into the development of medical informatics (MI) in China and Western countries showing that the medical informatics journals of China, the United States, and Europe have distinct characteristics. Specifically, first, compared with the Western journals, the number of papers published in the journals of professional associations in the field of MI in China is large and the application value is high, but the academic influence and academic value are relatively low; second, most of the authors of the Chinese papers are from hospitals, and most of the counterparts in the Western countries are from universities. The proportion of master's or doctoral degrees in the former is also lower than that of the latter; furthermore, regarding paper themes, on the one hand, China MI has no theoretical and basic research on medical data statistics and consumer health based on the Internet and telemedicine; on the other hand, after nearly 10 years of hospital digital development, China has fully used the latecomer and application advantages in hospitals and, through extensive international cooperation, has made significant advancements in and contributions to the development of medical information.

Analysing the Scientific Publications of Peter Reichertz: Reflections from the Perspective of Medical Informatics Knowledge Today

Professor Peter L. Reichertz is one of the most significant pioneers in the field of medical informatics worldwide. In 1969, 50 years ago, he became Professor at the Hannover Medical School. On the occasion of this anniversary an attempt was made to report on the scientific work of Peter Reichertz and to reflect on this work in the light of medical informatics knowledge today. The aim of this study was to search publications listings in the Peter L. Reichertz Archive, in Pubmed/Medline, and in the Web of Science. As well as to analyse contents and communication approaches to help in classifying Peter Reichertz's scientific publications. Three comprehensive publication lists were identified: the Print Bibliography (384 publications), the Disc Bibliography (285 publications) and the Selected Publications Bibliography (111 publications). Based on the last bibliography, a classification was built along the semantic dimensions of (1) major topics, (2) fields of publication, and (3) publication languages. Major contents of Peter Reichertz's research in informatics were medical informatics as a field (including education), informatics applications in medicine and health care, and health information systems. Clear shifts over time were observed. To his research on informatics applications, in the 1970s health information systems was added as topic, which then became a major part of his research. While in the 1960s and earlier German was a major publication language, from the 1970s onwards this shifted to English as the major language. Peter Reichertz very early identified the potential of computers in medicine and health care. He did not just use information and communication technology and information processing methodology as if they were other technology, such as microscopes or ultrasonic devices, for improving diagnosis and therapy. He was visionary enough to very early see the revolutionary potential of informatics for biomedicine and health care, with consequential impact on research and education.

Trends and characteristics of global medical informatics conferences from 2007 to 2017: A bibliometric comparison of conference publications from Chinese, American, European and the Global Conferences

BACKGROUND

As the second-largest economy in the world, China has invested considerable financial and policy support into hospital informatization since health care reform in 2010. However, the results and experience of such investments have not been compared with relevant research and applications in the United States and Europe.

OBJECTIVES

From the perspective of professional conference proceedings, we comparatively analyzed the current situations, characteristics, hotspots, and trends of medical informatics (MI) development in China, the United States and Europe to help Chinese MI researchers and practitioners summarize their experiences and determine gaps compared to their American and European peers. We also aimed to educate foreign peers about the special contributions of the China MI circle and facilitate multilevel international cooperation.

METHODS

English conference proceedings of the American Medical Informatics Association (AMIA) Annual Symposium (USA), Medical Informatics Europe (MIE, Europe) and World Conference on Medical Informatics (MEDINFO, Global) from 2007 to 2017 were searched within Scopus and Pubmed. Proceedings of Chinese MI conferences (CMIAAS, CHINC, CHITEC, CPMI) (China) were searched within Chinese databases CQVIP, CNKI and WanFang during the same period. The datasets were preprocessed via a Natural Language Processing (NLP) package on Python and were qualitatively and quantitatively analyzed via bibliometric methods.

RESULTS

Overall, 2285, 1601, 1930 and 5431 papers were publicized from the AMIA Symposium (USA), MIE (Europe), MEDINFO (Global) and Chinese MI conferences (China) between 2007 and 2017, respectively, with an H-index of 32, 19, 19 and 3, respectively. The AMIA Symposium, MIE and MEDINFO received submissions from 43, 68 and 80 countries (or regions), respectively, but Chinese MI conferences (CMIAAS, CHINC, CHITEC, CPMI) only received submissions from 3 foreign countries. Author affiliations were quite similar among the AMIA Symposium, MIE and MEDINFO, as 67%, 75% and 70% of authors came from universities/colleges, respectively; 18%, 10% and 11% came from medical institutions, respectively; and 7%, 8% and 10% came from institutes, respectively. In contrast, the majority (54%) of authors in Chinese MI conferences came from medical institutions followed by universities/colleges (17%) and institutes (10%). Of the top 5 authors with the most publications in AMIA Symposium, MIE and MEDINFO, 14/15 of them had medical backgrounds, but only one author from the Chinese MI conferences majored in medicine. Electronic medical records (EMR) were included in the top 10 high-frequency keywords by all four conference groups, but the amount of time that this keyword appeared differed in 2009, 2011, 2012 and 2013, respectively.

CONCLUSIONS

The MI annual conferences are all different among China, the United States and Europe. China lags in the theoretical and discipline bases but has made considerable investments in the past 10 years. China should fully use its second-mover advantage and application advantages and utilize international experiences and cooperation to make stronger contributions to global MI development.

Development of medical informatics in China over the past 30 years from a conference perspective and a Sino-American comparison

Background

As the world’s second-largest economy, China has launched health reforms for the second time and invested significant funding in medical informatics (MI) since 2010; however, few studies have been conducted on the outcomes of this ambitious cause.

Objective

This study analyzed the features of major MI meetings held in China and compared them with similar MI conferences in the United States, aiming at informing researchers on the outcomes of MI in China and the US from the professional conference perspective and encouraging greater international cooperation for the advancement of the field of medical informatics in China and, ultimately, the promotion of China’s health reform.

Methods

Qualitative and quantitative analyses of four MI meetings in China (i.e., CMIAAS, CHINC, CHITEC, and CPMI) and two in the US (i.e., AMIA and HIMSS) were conducted. Furthermore, the size, constituent parts and regional allocation of participants, topics, and fields of research for each meeting were determined and compared.

Results

From 1985 to 2016, approximately 45,000 individuals attended the CMIAAS and CPMI (academic), CHINC and CHITEC (industry), resulting in 5,085 documented articles. In contrast, in 2015, 38,000 and 3,700 individuals, respectively, attended the American HIMSS (industry) and AMIA (academic) conferences and published 1,926 papers in the latter. Compared to those of HIMSS in 2015, the meeting duration of Chinese industry CHITEC was 3 vs. 5 days, the number of vendors was 100 vs. 1,500+, the number of sub-forums was 10 vs. 250; while compared to those of AMIA, the meeting duration of Chinese CMIAAS was 2 vs. 8 days, the number of vendors was 5 vs. 65+, the number of sub-forums was 4 vs. 26. HIMSS and AMIA were more open, international, and comprehensive in comparison to the aforementioned Chinese conferences.

Conclusions

The current MI in China can be characterized as “hot in industry application, and cold in academic research.” Taking into consideration the economic scale together with the huge investment in MI, conference yield and attendee diversity are still low in China. This study demonstrates an urgent necessity to elevate the medical informatics discipline in China and to expand research fields in order to maintain pace with the development of medical informatics in the US and other countries.

Research Strategies for Biomedical and Health Informatics. Some Thought-provoking and Critical Proposals to Encourage Scientific Debate on the Nature of Good Research in Medical Informatics

BACKGROUND

Medical informatics, or biomedical and health informatics (BMHI), has become an established scientific discipline. In all such disciplines there is a certain inertia to persist in focusing on well-established research areas and to hold on to well-known research methodologies rather than adopting new ones, which may be more appropriate.

OBJECTIVES

To search for answers to the following questions: What are research fields in informatics, which are not being currently adequately addressed, and which methodological approaches might be insufficiently used? Do we know about reasons? What could be consequences of change for research and for education?

METHODS

Outstanding informatics scientists were invited to three panel sessions on this topic in leading international conferences (MIE 2015, Medinfo 2015, HEC 2016) in order to get their answers to these questions.

RESULTS

A variety of themes emerged in the set of answers provided by the panellists. Some panellists took the theoretical foundations of the field for granted, while several questioned whether the field was actually grounded in a strong theoretical foundation. Panellists proposed a range of suggestions for new or improved approaches, methodologies, and techniques to enhance the BMHI research agenda.

CONCLUSIONS

The field of BMHI is on the one hand maturing as an academic community and intellectual endeavour. On the other hand vendor-supplied solutions may be too readily and uncritically accepted in health care practice. There is a high chance that BMHI will continue to flourish as an important discipline; its innovative interventions might then reach the original objectives of advancing science and improving health care outcomes.

Information and communication technologies for promoting and sustaining quality of life, health and self-sufficiency in ageing societies--outcomes of the Lower Saxony Research Network Design of Environments for Ageing (GAL)

Many societies across the world are confronted with demographic changes, usually related to increased life expectancy and, often, relatively low birth rates. Information and communication technologies (ICT) may contribute to adequately support senior citizens in aging societies with respect to quality of life and quality and efficiency of health care processes. For investigating and for providing answers on whether new information and communication technologies can contribute to keeping, or even improving quality of life, health and self-sufficiency in ageing societies through new ways of living and new forms of care, the Lower Saxony Research Network Design of Environments for Ageing (GAL) had been established as a five years research project, running from 2008 to 2013. Ambient-assisted living (AAL) technologies in personal and home environments were especially important. In this article we report on the GAL project, and present some of its major outcomes after five years of research. We report on major challenges and lessons learned in running and organizing such a large, inter- and multidisciplinary project and discuss GAL in the context of related research projects. With respect to research outcomes, we have, for example, learned new knowledge about multimodal and speech-based human-machine-interaction mechanisms for persons with functional restrictions, and identified new methods and developed new algorithms for identifying activities of daily life and detecting acute events, particularly falls. A total of 79 apartments of senior citizens had been equipped with specific "GAL technology", providing new insights into the use of sensor data for smart homes. Major challenges we had to face were to deal constructively with GAL's highly inter- and multidisciplinary aspects, with respect to research into GAL's application scenarios, shifting from theory and lab experimentation to field tests, and the complexity of organizing and, in our view, successfully managing such a large project. Overall it can be stated that, from our point of view, the GAL research network has been run successfully and has achieved its major research objectives. Since we now know much more on how and where to use AAL technologies for new environments of living and new forms of care, a future focus for research can now be outlined for systematically planned studies, scientifically exploring the benefits of AAL technologies for senior citizens, in particular with respect to quality of life and the quality and efficiency of health care.

From bed to bench: bridging from informatics practice to theory: an exploratory analysis

BACKGROUND

In 2009, Applied Clinical Informatics (ACI)--focused on applications in clinical informatics--was launched as a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of the International Medical Informatics Association.

OBJECTIVES

To explore which congruencies and interdependencies exist in publications from theory to practice and from practice to theory and to determine existing gaps. Major topics discussed in ACI and MIM were analyzed. We explored if the intention of publishing companion journals to provide an information bridge from informatics theory to informatics practice and vice versa could be supported by this model. In this manuscript we will report on congruencies and interdependences from practice to theory and on major topics in MIM.

METHODS

Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 were indexed and analyzed.

RESULTS

Hundred and ninety-six publications were analyzed (ACI 87, MIM 109). In MIM publications, modelling aspects as well as methodological and evaluation approaches for the analysis of data, information, and knowledge in biomedicine and health care were frequently raised - and often discussed from an interdisciplinary point of view. Important themes were ambient-assisted living, anatomic spatial relations, biomedical informatics as scientific discipline, boosting, coding, computerized physician order entry, data analysis, grid and cloud computing, health care systems and services, health-enabling technologies, health information search, health information systems, imaging, knowledge-based decision support, patient records, signal analysis, and web science. Congruencies between journals could be found in themes, but with a different focus on content. Interdependencies from practice to theory, found in these publications, were only limited.

CONCLUSIONS

Bridging from informatics theory to practice and vice versa remains a major component of successful research and practice as well as a major challenge.

On determining factors for good research in biomedical and health informatics. Some lessons learned

OBJECTIVE

What are the determining factors for good research in medical informatics or, from a broader perspective, in biomedical and health informatics?

METHOD

From the many lessons learned during my professional career, I tried to identify a fair sampling of such factors. On the occasion of giving the IMIA Award of Excellence lecture during MedInfo 2013, they were presented for discussion.

RESULTS

Sixteen determining factors (df) have been identified: early identification and promotion (df1), appropriate education (df2), stimulating persons and environments (df3), sufficient time and backtracking opportunities (df4), breadth of medical informatics competencies (df5), considering the necessary preconditions for good medical informatics research (df6), easy access to high-quality knowledge (df7), sufficient scientific career opportunities (df8), appropriate conditions for sustainable research (df9), ability to communicate and to solve problems (df10), as well as to convey research results (df11) in a highly inter- and multidisciplinary environment, ability to think for all and, when needed, taking the lead (df12), always staying unbiased (df13), always keeping doubt (df14), but also always trying to provide solutions (df15), and, finally, being aware that life is more (df16).

CONCLUSIONS

Medical Informatics is an inter- and multidisciplinary discipline "avant la lettre". Compared to monodisciplinary research, inter- and multidisciplinary research does not only provide significant opportunities for solving major problems in science and in society. It also faces considerable additional challenges for medical informatics as a scientific field. The determining factors, presented here, are in my opinion crucial for conducting successful research and for developing a research career. Since medical informatics as a field has today become an important driving force for research progress, especially in biomedicine and health care, but also in fields like computer science, it may be helpful to consider such factors in relation with research and education in our discipline.

Biomedical informatics publications: a global perspective. Part II: Journals

BACKGROUND

Biomedical Informatics (BMI) is a broad discipline, having evolved from both Medical Informatics (MI) and Bioinformatics (BI). An analysis of publications in the fieldshould provide an indication about the geographic distribution of BMI research contributions and possible lessons for the future, both for research and professional practice.

OBJECTIVES

In part I of our analysis of biomedical informatics publications we presented results from BMI conferences. In this second part, we analyse BMI journals, which provide a broader perspective and comparison between data from conferences and journals that ought to confirm or suggest alternatives to the original distributional findings from the conferences.

METHODS

We manually collected data about authors and their geographical origin from various MI journals: the International Journal of Medical Informatics (IJMI), the Journal of Biomedical Informatics (JBI), Methods of In formation in Medicine (MIM) and The Journal of the American Medical Informatics Association (JAMIA). Focusing on first authors, we also compared these findings with data from the journal Bioinformatics.

RESULTS

Our results confirm those obtained in our analysis of BMI conferences - that local and regional authors favor their corresponding MI journals just as they do their conferences. Consideration of other factors, such as the increasingly open source nature of data and software tools, is consistent with these findings.

CONCLUSIONS

Our analysis suggests various indicators that could lead to further, deeper analyses, and could provide additional insights for future BMI research and professional activities.