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What is an “Impact Factor”?

Simply put, impact factor (I.F.) is a ratio which attempts to quantify the influence a publication in a particular journal (think Science or Nature) has on its field of study.

I.F. = A/B,

where A is the number of citations articles of journal X receive in a given year, and where B is the number of published articles which appeared in journal X in a given year.

In medicine, impact factor is sometimes used to compare the relative prestige of publishing in one particular journal over another. While I.F. can be a useful tool for assessing the audience one’s academic work will reach, the mindset it creates can distract from the underlying purpose of medical research and, in extreme cases, affect the quality of work submitted for publication.

One must ask: What is my end goal? Am I seeking to publish solely in order to land a more prestigious residency? To secure bragging rights at the next medical school happy hour?

I found my answer to these questions on a rainy, February Saturday in Dearborn, MI. I was attending a meeting of the Michigan Society of Thoracic and Cardiovascular Surgeons – Quality Collaborative (MSTCVS-QC), having been invited by my mentors who were facilitating various parts of the meeting and, importantly, sharing preliminary results of research similar to that which I had recently begun working on with them.

A full house as the winter MSTCVS-QC meeting gets underway

The meeting claimed to bring cardiothoracic (CT) surgeons, perfusionists, nurses, health administrators and allied health professionals together under one roof to discuss progress towards improving CT patient outcomes in the State of Michigan. My expectations were mixed. While I had positive experience with my surgeon-mentors at UMMS, I was also aware of the popular stereotype of the CT surgeon: fiercely independent, capable and extremely self-confident. Would they be willing to candidly discuss areas for improvement in their own practices in front of an audience of peers?

I was impressed then when, one by one, surgeons from around our state addressed the group to share their institutions’ triumphs and struggles in improving patient outcomes. Centers of excellence readily divulged the details of unique practices that may decrease the incidence of pneumonia following surgery, while those seeking further reduction in stroke rates discussed stumbling blocks with equal candor. Despite being in competition in the same marketplace, all 33 of Michigan’s adult cardiac surgery programs were freely sharing data and experience for the betterment of their patients.

Dr. Richard L. Prager leads discussion on state quality improvement efforts

Indeed, the experience shared at the MSTCVS-QC meeting has impact far beyond Dearborn’s city limits. Researchers around the state actively collaborate to leverage this data to drive future quality improvement – just this past January, a group from the MSTCVS-QC presented an abstract describing an association between the transfusion of units of red blood cells and pneumonia following coronary artery bypass surgery (a “dose-response association”). Utilizing these findings and others like it, patients and their healthcare providers might reduce the risk of pneumonia through informed decision-making.

Which leads me back to my original question: What is the end goal of my research experience?

Watching healthcare leaders from around Michigan share their experience and findings left no doubt in mind: I invest time and energy into research because of its potential to add value to our patients’ care.

It is exciting to think that one’s work might influence the standard of care at a statewide level ; it is also likely rather naïve as such changes in practice take time and a substantial body of evidence. However, it motivates me to consider that the hours I spend bumping numbers around in a statistical package on my computer might one day play some part, be it small, in helping a patient recover faster and live longer.

The winter sun setting, I left the MSTCVS-QC meeting with nervous excitement. While I had several years’ experience with research from undergrad, it was in bench work where the impact of one’s findings seems distant and perhaps intangible. Could the product of my summer work add to our state’s growing narrative on CT surgery quality improvement?

Time will tell!