A profile of research presented at the Sri Lanka College of Paediatricians ( 1997-2007 )

The main forum at which paediatricians in Sri Lanka disseminate their research findings is provided by the annual scientific sessions of the Sri Lanka College of Paediatricians (SLCP). Peer reviewed research papers, published in abstract form provided us with a ready resource for identifying priorities and trends in research, carried out locally. We describe a profile of research, which was presented at the SLCP, between 1997 and 2007.


Objectives
To identify research topics, research methodologies and institutional affiliations of authors whose work was presented at the SLCP from 1997 to 2007.

Method
A descriptive retrospective study was undertaken of oral and poster presentations published in abstract form by the SLCP from 1997 to 2007.A database created using SPSS version 15.0 helped analyze study design, setting, data collection method, topic of study, authorship, institutional affiliations, international collaboration, ethical approval and the subsequent publication rate.Categorization of projects into audits and research was attempted using NICE guidelines 1 .

Results
Ten scientific sessions were held during the eleven years under study.This included two international conventions hosted by the SLCP.Of a total of 298 published abstracts, 278 were based on research projects and 20 were case series.Plenary lectures were excluded.2) and therapeutic regimes (5).
Research on therapeutics focused on new regimes using medications already accepted as treatment options.The two main diseases studied were nephrotic syndrome (5) and thalassaemia.There were no clinical trials on new medications.
One hundred and ten abstracts made no mention of the sampling method.Simple random sampling 50 (18%) was the often mentioned method; cluster sampling was also used.Random allocation to study and control groups was described (5)  In 65% of papers the first or last author had a university affiliation.
Eight percent of studies were multi-centred and international collaboration was present in 7.7%.All but five research projects were self funded.
Most frequently researched areas of paediatrics were, in descending order: infections, therapeutics, nephrology and neonatology.Respiratory tract infections (6), diarrhoeal infections (6), central nervous system infections (5), dengue (5) and neonatal sepsis (5) were the commonly researched infectious diseases (Table 2).Morbidity and mortality patterns ( 6) and low birth weight (9) were the core areas studied regarding neonatology.Nutritional topics covered related to breast feeding ( 11), obesity ( 6) and protein calorie malnutrition (4) but there wasn't a single study on micronutrient deficiencies.Rheumatology, immunology and dermatology had received little attention with regard to further studies.Among the emerging health topics that lacked research, were environmental toxins, health economics and client satisfaction.
The subsequent publication rate in the Sri Lanka Journal of Child Health, which is the official publication of the SLCP, was 30%.

Discussion
A review of this nature enables assessment of scientific productivity, in terms of quality and quantity.It is hoped that the under researched areas in paediatrics during the past decade will be corrected in the future.
A limitation of our study was that some items we analysed were not requirements for submission of abstracts.Therefore their non visibility in the abstract did not necessarily mean its absence from the study or lack of adherence to sound scientific methodology.
Most of the research presented at the SLCP was of a descriptive nature.Interventional studies were rare.This may be due to research on children being restricted, due to their increased vulnerability, but the need for experimental studies cannot be completely ignored if children are not to become therapeutic orphans.
Differentiating between research and audit can be difficult 2,3,4 .We considered studies that generated new knowledge as research and studies that brought about improvement in standard of care as audits and concluded that several research projects were in fact audits.
There was an overall shortage in mention of ethical approval.This cannot be attributed to an editorial oversight alone because ethical review was perhaps deemed unnecessary by the researchers, due to many studies being locally organized audits 5 .We recommend that clinical audits are scrutinized by ethics committees due to use of patient information, and possible publication of results.
In analyzing scientific presentations on topics related to paediatrics over a decade, it was noted that some emerging infections in adults e.g.leishmaniasis and HIV had not surfaced as important issues among children 6 .
We did not include research presented outside the SLCP, either within or outside Sri Lanka because these abstracts were a representative sample of research carried out locally by paediatricians.The low rates of interventional studies and research by paediatricians in Ministry of Health perhaps indicates the lack of research support and time constraints for research.Therefore we wish to highlight the need for greater emphasis on research output and provision of research grants to paediatricians, through their workplaces.

). Table 1 Study designs (n=298) Study design Number (%)
but sample size calculation prior to commencement of research was evident only in two studies.The study duration varied widely from a single day to 8 years.Statistical analysis of data was mentioned in 90 studies but only 20 mentioned the statistical test, Z score, the most commonly mentioned statistical test.