Research Article: Anatomy of the Epidemiological Literature on the 2003 SARS Outbreaks in Hong Kong and Toronto: A Time-Stratified Review

Date Published: May 4, 2010

Publisher: Public Library of Science

Author(s): Weijia Xing, Gilles Hejblum, Gabriel M. Leung, Alain-Jacques Valleron, Ida Sim

Abstract: Weijia Xing and colleagues reviewed the published epidemiological literature on SARS and show that less than a quarter of papers were published during the epidemic itself, suggesting that the research published lagged substantially behind the need for it.

Partial Text: Emerging infectious diseases have become a major public health concern over the last two to three decades [1],[2]. When such an outbreak occurs, real-time collection, analysis, and dissemination of epidemiological information are key factors contributing to the effective and rapid control of the epidemic [3]. The first challenge for epidemiologists is to develop new surveillance and alert tools to detect in real time the events emerging anywhere in the world, and not just in highly developed countries [4],[5]. Upon detection of the outbreak, appropriate epidemiological studies should be launched immediately to help identify the causative agent, investigate the possible routes and modes of its transmission, define and validate diagnostic criteria, evaluate candidate treatments, forecast the spread of the epidemic, devise and evaluate evidence-based prevention, and monitor policies and strategies [6]–[8]. Hence, the outbreak of an emerging infectious disease causes a heavy epidemiological workload shared by public health specialists from national and international agencies, and academic epidemiologists. The importance of the rapid diffusion of public health information has long been recognized, and specialized international and national papers or Web bulletins are now made available during the course of outbreaks. However, journals remain the primary channel for communication of research. In this study, we analyzed the process according to which the results of academic epidemiological research are submitted and then formally published, during and after the outbreak of an emerging infectious disease. The proposed analysis concerns both the epidemiologists who submit their research to journals, and the journal editors who make decisions about the publication of the submitted research.

Herein we reported our analysis of the scientific literature on the epidemiology of the SARS epidemic in Hong Kong and Toronto taken as a model of an emerging infectious disease epidemic. We outlined the distribution of the workload among the traditional categories of epidemiological studies and methodologies. We showed that the time to disseminate study results could be quite long, in contrast to what would have been expected during a period of high public health alertness. The length of time to publish study results is dependent on several factors, which may classified as author-related (time to prepare the protocol, the questionnaires, to write the paper, and to choose the journal to submit to, and if rejected by this journal, to choose the next journals to submit to) or journal-related (time to find reviewers, to get reviews, to make a decision for publication, to publish). Our results indicate that the SARS articles submitted during the epidemic that were eventually published were more rapidly processed than control articles.