From health research to clinical practice: understanding pathways that use journal articles and informing impact assessment

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonFor biomedical research to improve clinical practice, and for funding levels to be sustained, it is increasingly important to understand the pathways from research to clinical practice and to assess the societal impact of research. Approaches to research evaluation through traditional study of journals, journal articles and standard citation analysis, have played comparatively small roles in these developments. In this thesis I critically review how I applied existing methods, and developed a new approach, to study two pathways from research to clinical practice. For Pathway 1, questionnaire surveys of clinicians’ views on journals read to inform their clinical practice, and comparisons with impact factors, revealed that a few journals were read widely and considered important by clinicians. Relationships between journal importance and impact factor were complex. For Pathway 2, I applied a novel methodology to identify important citations to four key research papers in an attempt to trace important citations through numerous citing generations. My findings included: few cited papers were important to the citing papers; the number of citation occasions within the citing paper correlated strongly with a cited paper’s importance; self-citations were also important; and it was feasible to trace through a series of generations of citations. Evidence of societal impact of the four key research papers examined in my studies included important papers in subsequent generations cited in clinical guidelines, many of which were international. In assessing the impact of my own studies, I found Pathway 1 papers had societal impact on research evaluation methodology; journal editorial policy; and medical library provision policy and practice. Societal impacts of the new methodology, Pathway 2, included informing further methodological development and research evaluation. My portfolio, together with my critical review, adds understanding and provides additional data to current assessment methods of wider impacts of research, and bases for further studies