Analysis of Research Activity in Gastroenterology: Pancreatitis Is in Real Danger

Abstract

Objective: Biomedical investment trends in 2015 show a huge decrease of investment in gastroenterology. Since academic research usually provides the basis for industrial research and development (R&D), our aim was to understand research trends in the field of gastroenterology over the last 50 years and identify the most endangered areas.

Methods: We searched for PubMed hits for gastrointestinal (GI) diseases for the 1965-2015 period. Overall, 1,554,325 articles were analyzed. Since pancreatology was identified as the most endangered field of research within gastroenterology, we carried out a detailed evaluation of research activity in pancreatology.

Results: In 1965, among the major benign GI disorders, 51.9% of the research was performed on hepatitis, 25.7% on pancreatitis, 21.7% on upper GI diseases and only 0.7% on the lower GI disorders. Half a century later, in 2015, research on hepatitis and upper GI diseases had not changed significantly; however, studies on pancreatitis had dropped to 10.7%, while work on the lower GI disorders had risen to 23.4%. With regard to the malignant disorders (including liver, gastric, colon, pancreatic and oesophageal cancer), no such large-scale changes were observed in the last 50 years. Detailed analyses revealed that besides the drop in research activity in pancreatitis, there are serious problems with the quality of the studies as well. Only 6.8% of clinical trials on pancreatitis were registered and only 5.5% of these registered trials were multicentre and multinational (more than five centres and nations), i.e., the kind that provides the highest level of impact and evidence level.

Conclusions: There has been a clear drop in research activity in pancreatitis. New international networks and far more academic R&D activities should be established in order to find the first therapy specifically for acute pancreatitis.

Fig 1

A–B. Inflammatory GI diseases. From 1965 to 2015, the great loss of interest in pancreatology was accompanied by a major increase of research in the lower GI disorders, namely, the IBD and IBS. C–D. Malignant GI diseases. The biggest increase was found in research activity on pancreatic cancer.

Fig 2

A–B. Pancreatic diseases. The relative interest in pancreatitis dropped from 18.1% to 5%. C. Dynamic of pancreatic research. The biggest rise of pancreatic research activity in the last five years was in experimental pancreatic cancer. However, the number of clinical trials–especially on pancreatitis–started decreasing.

Fig 3

A. Published articles per continent. 47.8% of all the articles came from Europe and 28.8% from North America. B. Published articles per country. The USA, Germany, Japan and China together account for more than 50% of all published articles in pancreatology.

Fig 4

A. Map of published articles. The USA was involved in the largest number of research articles, followed by Germany, Japan and China. B. Map of published articles per population. The Scandinavian countries are clearly the most active in pancreatic research per capita.

Fig 5

A. Map of registered trials. The big countries hold clear leading positions. B. Map of registered trials per population. Comparing the registered clinical trials per population of 10 million, Dutch researchers are the most active.

Fig 6

A. Map of average impact factor/country. There are no big differences between the average IF/country. B. Average impact factor per country. Over 30 countries achieved an average IF higher than 5. Values are expressed as means ± standard error (S.E.M.).

Fig 7

A. Average impact factor by number of centres and nations. Both multicentre and multinational approaches increase the impact of the papers. *: p = 0.009 vs. single centre single nation; **: p˂0.001 vs single centre/single nation; ***: p˂0.001 vs 2–5 centres/2–5 nations and vs multicentre/single nation; ****: p˂0.001 vs all groups. Values are expressed as means ± standard error (S.E.M.) B. The share of average impact factor categories. There is a strong correlation between the number of countries per study and the quality of the article.