According to the current European political authorities, laboratory
technicians should be authorised to manage clinical laboratories. It takes
two years of university education to become a laboratory technician. In
several European countries, clinical laboratories are currently being
managed by more trained laboratory medicine specialists. For example, in
France, at least nine or ten years of university education are necessary for
such specialists (called biologistes) to become respectively pharmaceutical
doctors or medical doctors specialised in laboratory medicine. Two or more
additional years may be necessary for some of them to specialise in some
particular laboratory medicine disciplines. Currently, in France, most of
the several thousands of biologistes thus work in clinical laboratories,
either in or near the hospitals or in commercial laboratories outside the
hospitals.
In France as well as in Europe, many laboratory medicine specialists
consider that the best way to improve the quality of laboratory medicine is
by raising the quality of the individual professionals. In this context,
some highly trained European laboratory medicine specialists, including some
French biologistes, have developed the initiative of an European register of
Clinical Chemistry (the so-called EC4 register) [1]. Among the many
requirements implied by this register, an European Clinical Chemist should
be able to publish in international scientific journals. Our aim was to see
whether or not the two above mentioned categories of French biologistes were
significantly contributing to the international biomedical literature.
We used the MEDLINE “Journal Browser” function
(http://www.ncbi.nlm.nih.gov/PubMed/). We selected some journals related to
laboratory medicine (according to its French definition) with various impact
factors [2] and written in American/English or in French. In each journal,
we took into account, over a minimal three-month period, at least the 200
most recent references (or all references if less than 200 references were
available), in which the address of the main author was indicated (i.e. the
only one which is often indicated in MEDLINE). The sourced journals were
(with percentages of French main authors for each Journal): Pathol Biol
(77.3%), Clin Chem (4.7%), Clin Chem Lab Med (12.1%), Ann Clin Biochem
(1.6%), Ann Biol Clin (95%), FEBS Lett (9.3%), Clin Biochem (3.5%), Clin Lab
Med (0.9%), Arch Pathol Lab Med (1.1%), Scand J Clin Lab Invest (0.5%),
Scand J Clin Lab Invest Suppl (2%), Am J Clin Pathol (3.1%), Ther Drug Monit
(7.2%), Clin Microbiol Rev (3.9%), J Clin Microbiol (8%), J Antimicrob
Chemother (9.2%), J Med Virol (6.4%), Ann Trop Med Parasitol (4.3%),
Zentralbl Bakteriol (1%), Eur J Clin Microbiol Infect Dis (10.3%), Scand J
Infect Dis (4.9%), Scand J Infect Dis Suppl (1.3%), Antimicrob Agents
Chemother (7.9%), Infect Control Hosp Epidemiol (8.1%), J Hosp Infect
(7.5%), Infect Immun (5.9%), Epidemiol Infect (0.9%), Hematol Cell Ther
(67%), Immunol Today (7.4%), Blood Coagul Fibrinolysis (10%), Thromb Haemost
(8%), Blood (6.6%), Blood Rev (2%), Tranfus Sci (9.4%), Semin Hematol
(3.7%), Ann Hematol (2.8%), Tranfus Med (2.4%), Tranfus Med Rev (2.2%). The
total number of references that we took into account is 9627 (mean by
journal  standard deviation = 253  79).
The figures in table 1 are in general agreement with the figures obtained by
others [3], and suggest that our journal selection and number of references
are representative of the current laboratory medicine publishing situation.
In table 2, the only two references having their main author address in a
French commercial laboratory are a short letter written in American and an
article written in French [4, 5].
The main conclusion that we can thus derive from our survey is that, bearing
in mind that approximately half of the thousands of French biologistes
currently work in commercial laboratories, a very large proportion of them
do not actually contribute (table 2), and therefore not satisfy the above
mentioned EC4 register requirement.
REFERENCES
1) Sanders GT, Kelly AM, Breuer J, Kohse KP, Mocarelli P, Sachs C. Guide to
the EC4 register European Clinical Chemist. Eur J Clin Chem Clin Biochem
1997; 35:797-803.
2) Journal Citation Reports on microfiche. Institute for Scientific
Information. Philadelphia, USA, 1998.
3) Hefler L, Tempfer C, Kainz C. Geography of biomedical publications in the
European Union, 1990-98. Lancet 1999; 353:1856 (comment by Takei N, in
354:516-7).
4) Lepargneur JP, Heller R, Soulie R, Riegel P. Urinary tract infection due
to Arcanobacterium bernardiae in a patient with a urinary tract diversion.
Eur J Clin Microbiol Infect Dis 1998; 17:399-401.
5) Felden F, Croizier A. [VIDAS Stallertest: clinico-biological evaluation
of a new global test for respiratory allergy]. Pathol Biol (Paris) 1998;
46:819-23 [Article in French].
Table 1: numbers and percentages of references originating from the twelve
first countries (or groups of countries) according to their main author
addresses
numbers percentages
U.S.A. 2570 26.7
U.K. 1145 11.9
France 1015 10.5
Scandinavia 839 8.7
Germany + Austria 761 7.9
Japan 476 4.9
Benelux 462 4.8
Italy 392 4.1
Canada 392 4.1
Spain 272 2.8
Australia 166 1.7
Switzerland 118 1.2
other countries 1137 11.8
total 9627 100
Table 2 : addresses of the French main authors
numbers percentages
commercial laboratories 2 0.02
hospitals 719 7.4
others 294 3.1
total 1015 10.5
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