Thursday, March 19, 2009

Published I

One of the most challenging aspects of academic research is formulating a hypothesis, testing/replicating it, and if you are lucky, getting the work published in a peer-reviewed journal. This can become a long process and requires steadfast patience. Some journals will dissect your study and then make corrections or simply reject the paper. In particular cases, the editorial board might have questions regarding confounding factors and unless they are specifically addressed, the study won't be published. This is extremely important in peer reviewed journals-- there have been incidents where such process has not been undertaken with care and has resulted in flawed applied science. Take for instance the case of Dr Julio Cruz who had allegedly conducted a controlled study assessing the effects of using high dose Mannitol in severe head injuries. The rationale centered on the fact that severe head trauma can lead to increased intracranial pressure, and administering high dose Mannitol will systematically raise blood osmolality. The increase in osmolar gradient between the brain and blood would facilitate the flow of fluid out of the tissues and decrease the intracranial pressure.The aim of the study was to measure outcomes with such treatment. Three of his studies regarding Mannitol were published in the prestigious and influential peer-reviewed science journal of medicine, BMJ. The studies affected the clinical practice of physicians worldwide,and his name became recognizable among a highly selective group of thinkers. After being published, the studies were subsequently scrutinized by several expert clinicians, and naturally, the author’s were contacted. The intergrity of the data was questioned as it respectively should, but the author refused to provide adequate responses. The data was stained. The results of the studies were retracted after an expert investigation. Not long after the ordeal, the principal investigator, Dr. julio Cruz, commited suicide. The point I am trying to make is that validity and reliability of studies will be tested.

One may spend countless hours behind the lab bench doing assays, purifying DNA, running electrophoresis gels, etc. only to later discover a confounding variable was initially present. Ideally, a student should have a mentor/advisor who is experienced in the field that may provide assistance throughout the project and help avoid such flounders. With collaboration, the project can become fruitful. During undergrad, I worked as an NIH Scholar in a laboratory doing this line of work investigating the role of the glycolytic enzyme phosphofructose kinase-1 (PFK-1). It was tedious controlling every possible variable but it serves important purposes- validity.

So my bench work did not yield any publishable findings per se, but it was not a disappointment in any sense of the word. Ideally, one sharpens his/her skills with time and can later purse other similar projects. Personally, I find translational research or applied research somewhat 'cooler' but hey, for each their own. I opted for research projects in biomedical ethics instead. Some of my previous posts have dealt with criticism of the medical establishment involving medicalization, managed care, and health-inequalities. After digging into the literature, I found plenty of work. One of the paradigms used when analyzing the application of new technologies in medicine is the treatment-enhancement distinction, a subject topic I wrote about in a previous post. The paradigm has some flaws and has become a subject of criticism among various authors. Rather than simply carping it, I posed an alternative that might raise a few eyebrows.

The paper was accepted and will be published in the Ivy Journal of Ethics, entitled "An Alternative to the Treatment Enhancement Distinction". It's challenging and time consuming producing original papers, but it can be very rewarding, especially when it involves a subject you genuinely find interesting.
Garcia, M. (2009) "An Alternative to the Treatment-Enhancement Distinction." Ivy Journal of Ethics. 9(2): 48-52. 

No comments: