On Determining Factors for Good Research in Biomedical and Health Informatics

Summary

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.

Keywords

Medical informatics - biomedical informatics - health informatics - research - interdisciplinary research - multidisciplinary research.

^* This is an extended version of my ‘IMIA Award of Excellence’ lecture, given on August 23, 2013, at MedInfo 2013 in Copenhagen, Denmark. It is dedicated to Professor Jan Hendrik van Bemmel, University of Rotterdam, one of the most influential leaders in our field for me - and certainly for many other colleagues. I have benefited in my own development significantly from his work and from countless discussions with him during the past three decades.

• References

• 1 Haux R. „Wer waren Deine wichtigsten Lehrer?“ [“Who where your most important teachers?”]. Manuscript, 2013. GMS Med Inform Biom Epidemiol 2013; 9 (Suppl. 03) Doc15. doi: 10.3205/mibe000143, urn:nbn:de:0183-mibe0001434.
• 2 Grémy F. Hardware, software, peopleware, subjectivity. A philosophical promenade. Methods Inf Med 2005; 44: 52-8.
• 3 van Bemmel JH. Reflections on curiosity. Yearb Med Inform 2008; 183-8.
• 4 Blum B. editor. A framework for medical information science. Med Inform. 1984; 9: 167-313.
• 5 Shortliffe EH. The science of biomedical computing. Med Inform 1984; 9: 185-93.
• 6 German Research Associacion.. Proposals for Safeguarding Good Scientific Practice. Bonn, 1998 http://www.dfg.de/download/pdf/foerderung/rechtliche_rahmenbedingungen/gute_wissenschaftliche_praxis/self_regulation_98.pdf. Last access: August 22, 2013
• 7 Miller RA, Groth T, Hasman A, Safran C, Shortliffe EH, Haux R. et al. On exemplary scientific conduct regarding submission of manuscripts to biomedical informatics journals. Methods Inf Med 2006; 45: 1-3.
• 8 Haux R. Zur Wissenschaftlichkeit in Medizin und Informatik [On good scientific practice in the health and computer sciences]. Informatik-Spektrum 1999; 22: 276-83.
• 9 Haux R. Kriterien für gute medizinische Forschung [Criteria for good medical research]. In: Eich W, Bauer AW, Haux R, Herzog W, Rüegg JC. editors. Wissenschaftlichkeit in der Medizin, Teil IV [Good scientific practice, part IV]. 181-144 Frankfurt/M.: VAS; 2003
• 10 http://www.imia.org. Last access August 12, 2013
• 11 http://www.gmds.de. Last access August 12, 2013
• 12 http://www.plri.de. Last access August 12, 2013
• 13 Haux R, Hasman A, McCray AT, van der Lei J. Is Medical Informatics an Art or a Science?. Methods Inf Med 2006; 45: 651-6.
• 14 Hasman A, Bergemann D, McCray AT, Talmon JL, Zvárová J. Triangulation applied to Jan H. van Bemmel. Methods Inf Med 2006; 45: 656-67.
• 15 Mihalas GI. Romanian medical informatics and professor Jan H. van Bemmel’s support - Dr. Honoris Causa bestowed by Victor Babes University. Methods Inf Med 2006; 45: 668-70.
• 16 van Bemmel JH. A comprehensive model for medical information processing. Methods Inf Med 1983; 22: 124-30.
• 17 van Bemmel JH, Hasman A, Sollet PC, Veth AF. Training in medical informatics. Comput Biomed Res 1983; 16: 414-32.
• 18 van Bemmel JH. The structure of medical informatics. Med Inform 1984; 9: 175-80.
• 19 van Bemmel JH. The promise of medical informatics. MD Comput 1999; 16: 15-6.
• 20 van Bemmel JH. Assessment of education and research in biomedical informatics. Yearb Med Inform 2006; 5-10.
• 21 van Bemmel JH, Willems J. editors. Handboek medische informatica. Utrecht: Bohn, Sheltema & Holkema; 1989
• 22 van Bemmel JH, Musen MA. editors. Handbook of medical informatics. Heidelberg: Springer; 1997
• 23 van Bemmel JH, McCray AT. editors. IMIA year-book of medical informatics, 1992: Advances in an interdisciplinary science; 1993: sharing knowledge and information; 1994: Advanced communications in health care; 1995: The computer-based patient record; 1996: Integration of information for patient care; 1997: Computing and collaborative care; 1998: Health informatics and the Internet; 1999: The promise of medical informatics; 2000: Patient-centered systems. Stuttgart: Schattauer;
• 24 van Bemmel JH, McCray AT. Advances in an interdisciplinary science. Methods Inf Med 1992; 31: 235-46.
• 25 van Bemmel JH. Medical data, information, and knowledge. Methods Inf Med 1988; 27: 109-10.
• 26 Musen MA, Van Bemmel JH. Challenges for medical informatics as an academic discipline. Methods Inf Med 2002; 41: 1-3.
• 27 van Bemmel JH. The young person’s guide to biomedical informatics. Methods Inf Med 2006; 45 (Suppl. 06) 671-80.
• 28 van Bemmel JH. People and ideas in medical informatics - a half century review. Yearb Med Inform 2011; 6: 175-82.
• 29 van Bemmel JH. Medical informatics, art or science?. Methods Inf Med 1996; 35: 157-72 discussion 173-201.
• 30 Haux R. (1996). Medical informatics: once more towards systematisation. Methods Inf Med 1996; 35: 189-92.
• 31 Hasman A, Haux R, Albert A. A systematic view on medical informatics. Comput Methods Programs Biomed 1996; 51: 131-9.
• 32 Haux R. Medical Informatics: Past, Present, Future. Int J Med Inform 2010; 49: 599-610.
• 33 Senn S. Dicing with Death. Cambridge: University Press; 2003
• 34 Hasman A, Haux R. Modeling in Biomedical Informatics - An Exploratory Analysis. Part 1. Methods Inf Med 2006; 45: 638-42.
• 35 Hasman A, Haux R. Modeling in Biomedical Informatics - An Exploratory Analysis. Part 2. Int J Med Inform 2007; 76: 96-102.
• 36 Kulikowski CA. The micro-macro spectrum of medical informatics challenges: from molecular medicine to transforming health care in a globalizing society. Methods Inf Med 2002; 41: 20-4.
• 37 Reichertz PL. Preparing for change: concepts and education in medical informatics. Comput Methods Programs Biomed. 1987; 25: 89-101.
• 38 Blois MS. Medical information science as ‘science’. Med Inform 1984; 9: 181-3.
• 39 Greenes RA, Shortliffe EH. Medical informatics, an emerging academic discipline and institutional priority. J Am Med Assoc 1990; 263: 1114-20.
• 40 Protti DJ, van Bemmel JH, Gunzenhäuser R, Haux R, Warner H, Douglas JV. et al. Can health/medical informatics be regarded as a separate discipline?. Methods Inf Med 1995; 33: 318-26.
• 41 McCray AT, Gefeller O, Aronsky D, Leong TY, Sarkar IN, Bergemann D. et al. The Birth and Evolution of a Discipline Devoted to Information in Biomedicine and Health Care: As Reflected in its Longest Running Journal. Methods Inf Med 2011; 50: 491-507.
• 42 Hasman A, Ammenwerth E, Dickhaus H, Knaup P, Lovis C, Mantas J. et al. Biomedical informatics – a confluence of disciplines?. Methods Inf Med 2011; 50: 508-24.
• 43 Mitchell JA, Gerdin U, Lindberg DAB, Lovis C, Martin-Sanchez FJ, Miller RA. et al. 50 Years of Informatics Research on Decision Support: What’s Next. Methods Inf Med 2011; 50: 525-35.
• 44 Bellazzi R, Diomidous M, Sarkar IN, Takabayashi K, Ziegler A, McCray AT. Data Analysis and Data Mining: Current Issues in Biomedical Informatics. Methods Inf Med 2011; 50: 536-44.
• 45 Geissbuhler A, Kimura M, Kulikowski CA, Murray PJ, Ohno-Machado L, Park HA. et al. Confluence of Disciplines in Health Informatics: An International Perspective. Methods Inf Med 2011; 50: 545-55.
• 46 Beuscart R. Know thyself. Methods Inf Med 2013; 52: 536-7.
• 47 Elkin PL, Brown SH, Wright G. Biomedical Informatics: We Are What We Publish. Methods Inf Med 2013; 52: 538-46.
• 48 Geissbuhler A, Hammond WE, Hasman A, Hussein R, Koppel R, Kulikowski CA. et al. Discussion of ‘Biomedical Informatics: We Are What We Publish‘. Methods Inf Med 2013; 52: 547-62.
• 49 http://www.methods-online.org. Last access August 18, 2013
• 50 Haux R, Aronsky D, Leong TY, McCray AT. Methods in year 50: preserving the past and preparing for the future. Methods Inf Med 2011; 50: 1-6.
• 51 Bickeböller H, Haux R, Winter A. “Tradition is not preserving the ashes, it is passing on the fire”. On strengthening ties with GMDS. Methods Inf Med 2013; 52: 1-2.
• 52 van Bemmel JH. Medical informatics is interdisciplinary avant la lettre. Methods Inf Med 2008; 47: 318-21.
• 53 Facilitating Interdisciplinary Research.. Washington DC: National Academies Press;
• 54 Choi BC, Pak AW. Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness. Clin Invest Med 2006; 29: 351-64.
• 55 Winter A, Haux R, Ammenwerth E, Brigl B, Hellrung N, Jahn F. Health Information Systems - Architectures and Strategies. London: Springer; 2011
• 56 Haux R, Hein A, Eichelberg M, Appell JE, Appelrath HJ, Bartsch C. et al. The Lower Saxony research network design of environments for ageing: towards interdisciplinary research on information and communication technologies in ageing societies. Inform Health Soc Care 2010; 35: 92-103.
• 57 Mantas J, Ammenwerth E, Demiris G, Hasman A, Haux R, Hersh W. et al. (IMIA Recommendations on Education Task Force). Recommendations of the International Medical Informatics Association (IMIA) on education in biomedical and health informatics - first revision. Methods Inf Med 2010; 49: 105-20. Translated and reprinted in various languages.
• 58 Blas MM, Curioso WH, Garcia PJ, Zimic M, Carcamo CP, Castagnetto JM. et al. Training the biomedical informatics workforce in Latin America: results of a needs assessment. BMJ Open 2011; 1: e000233.
• 59 Hersh W. The health information technology work-force: estimations of demands and a framework for requirements. Appl Clin Inform 2010; 1: 197-212.
• 60 Kampov-Polevoi J, Hemminger BM. A curricula-based comparison of biomedical and health informatics programs in the USA. J Am Med Inform Assoc. 2011; 18: 195-202.
• 61 Kulikowski CA, Shortliffe EH, Currie LM, Elkin PL, Hunter LE, Johnson TR. et al. AMIA Board white paper: definition of biomedical informatics and specification of core competencies for graduate education in the discipline. J Am Med Inform Assoc 2012; 19: 931-8.
• 62 Röhrig R, Stausberg J, Dugas M. GMDS project group “Medical Informatics Education in Medicine”. Development of national competency-based learning objectives “Medical Informatics” for undergraduate medical education. Methods Inf Med 2013; 52: 184-8.
• 63 Sarkar IN. Biomedical informatics and translational medicine. J Transl Med 2010; 8: 22.
• 64 Geissbuhler A, Kimura M, Kulikowski CA, Murray PJ, Ohno-Machado L, Park HA. et al. Confluence of disciplines in health informatics: an international perspective. Methods Inf Med 2011; 50: 545-55.
• 65 Hasman A, Ammenwerth E, Dickhaus H, Knaup P, Lovis C, Mantas J. et al. Biomedical informatics - a confluence of disciplines?. Methods Inf Med 2011; 50: 508-24.
• 66 Kulikowski CA. IMIA: coalescing medical informatics worldwide for 40 years. Yearb Med Inform 2007; 176-85. Erratum in: Yearb Med Inform 2008:19.
• 67 Maojo V, Crespo J, Garcia-Remesal M, de la Iglesia D, Perez-Rey D, Kulikowski CA. Biomedical ontologies: toward scientific debate. Methods Inf Med. 2011; 50: 203-16.
• 68 Maojo V, Garcia-Remesal M, Bielza C, Crespo J, Perez-Rey D, Kulikowski C. Biomedical informatics publications: a global perspective. Part I: Conferences. Methods Inf Med 2012; 51 (Suppl. 01) 82-90.
• 69 Maojo V, Garcia-Remesal M, Bielza C, Crespo J, Perez-Rey D, Kulikowski C. Biomedical informatics publications: a global perspective. Part II: Journals. Methods Inf Med 2012; 51: 131-7.
• 70 Mitchell JA, Gerdin U, Lindberg DA, Lovis C, Martin-Sanchez FJ, Miller RA. et al. 50 years of informatics research on decision support: What’s next. Methods Inf Med 2011; 50: 525-35.
• 71 Schuemie MJ, Talmon JL, Moorman PW, Kors JA. Mapping the domain of medical informatics. Methods Inf Med 2009; 48: 76-83.
• 72 Shortliffe EH. The future of biomedical informatics: a perspective from academia. Stud Health Technol Inform 2012; 180: 19-24.
• 73 Spreckelsen C, Deserno TM, Spitzer K. Visibility of medical informatics regarding bibliometric indices and databases. BMC Med Inform Decis Mak 2011; 11: 24.
• 74 Haux R, Ammenwerth E, Häber A, Hübner-Bloder G, Knaup-Gregori P, Lechleitner G. et al. Medical informatics education needs information system practicums in health care settings - experiences and lessons learned from 32 practicums at four universities in two countries. Methods Inf Med 2006; 45: 294-9.
• 75 Knaup P, Haux R, Häber A, Lagemann A, Leiner F. Teaching the fundamentals of information systems management in health care. Lecture and practical training for students of medical informatics. Int J Med Inform 1998; 50: 195-205.
• 76 http://www.efmi.org. Last access October 6, 2013
• 77 http://www.ncbi.nlm.nih.gov/pubmed. Last access October 6, 2013
• 78 http://www.hon.ch. Last access October 6, 2013
• 79 Wolpert AJ. For the sake of inquiry and knowledge - the inevitability of open access. N Engl J Med 2013; 368 (Suppl. 09) 785-7.
• 80 Butler D. Investigating journals: The dark side of publishing. Nature 2013; 495: 433-5.
• 81 Aronsky D, Talmon J. et al. Writing for publication in biomedical informatics journals. Stud Health Technol Inform 2013; 192: 1253.