Table of Contents

HK J Paediatr (New Series)
Vol 17. No. 1, 2012

HK J Paediatr (New Series) 2012;17;1-2


Paediatric Research: The Essence of Advancement in Paediatrics

GCF Chan

The local paediatricians have just celebrated the 20th Anniversary of the Hong Kong College of Paediatricians. When we looked back in the past 2 decades, the College has undoubtedly improved the quality of the local paediatricians by providing more structural training format and applying stringent accreditation processes for training centres, trainers and trainees. That's what we should be proud of and thankful to the leaders and members who have been serving selflessly towards these goals. However, what is lagging behind is the enhancement of paediatric research in our locality. So far, the College has been focusing on the development of matters related mainly to clinical practice and service of paediatrics, with relatively few attentions being drawn into the promotion of paediatric research. It may be due to the priority setting in the previous years, but as an established professional body now, it may be the right time to revisit our directives. When we look at the objectives of our College, promoting research is listed as one of our missions.

Although not explicitly expressed, there are common resentments towards the term "research" in many paediatricians' mind. "Research" may imply additional workload, negative auditing results that may reveal shortcomings, or high sounding basic or translational research that appears to have no direct relevance to most practicing paediatricians. Some also thinks that research is primarily the responsibility of those working in the University and therefore others do not have to bother. In addition, the difficulties in performing paediatric research also defer paediatricians to venture into this area. The difficulties include the relative low patients' number in most paediatric diseases when comparing to that of the adult counterparts. The inadequate sample size may eventually hinder the recruitment and most centres have to collaborate with others before meaningful study can be conducted. The relatively small patients' population also put paediatrics in a disadvantageous position when paediatricians are vying for research funding allocated by either local academic or health authority, because that may imply "low" social impact. Though most of us know "number" does not equivalent to "impact", unfortunately they have often been linked.

While facing with similar kind of unfavourable factors, paediatricians in most other developed countries still consider research as the prime mover for the advancement in paediatrics. The concept of paediatric research can be very broad, covering issues from healthy children to the sick one; also from clinical to basic science. To cite some examples, part of the research is closely linked to the community and child health issue, such as the original article describing the intermediate term effects of melamine contaminated milk product on the local and China paediatric cohort of this issue. It addresses a locally relevant health related event and has significant impact on future health policy making. It can also relate to clinical paediatric practice, such as verification of existing practice guidelines and changing in the epidemiology of some common paediatric illnesses, such as the article in this issue describing the daytime sleepiness and obstructive sleep apnoea from patients with b-thalassaemia intermedia. It unfolds a new observation in a group of patients previously thought to be relatively asymptomatic. While others are concerning more on hospital paediatric practice, and the article on the prevalence of cytogenetic abnormalities in patients with genitourinary tract defect is one of this example. Finally is the translational and basic research related to paediatric illnesses, such as the article illustrating the alternation of murine neural stem cells under the situation of hypoxic-ischaemic encephalopathy of this issue. Therefore, except for those involved bench laboratory support, paediatric research is something that most paediatricians can participate. However, there are some basic skills that one has to develop. In general, the local paediatricians have been well trained and equipped with the ability to critically appraise research works of others but with much less training in conducting research hands on. The College and both Universities should shoulder the responsibility and provide more training opportunities in this aspect.

In recent years, the accreditation bodies in many countries, including China and Taiwan have already emphasized the importance of research in all fields of medical sciences and significant amount of resources have been invested for this purpose. There have been some research funding from the Hong Kong College of Paediatricians and Hong Kong Paediatric Society supporting some child health related projects in the past, however, they are not offered in a regular basis and were not opened for application. The scope is also too restrictive and narrow. Both organizations should invest more on this important aspect to uplift the standard of local paediatric research in the future. The ultimate benefit will go to our children.

With the establishment of the Centre of Excellence in Paediatrics (CEP) or Children's Hospital in a few years time, we hope that paediatric research will be integrated as a major component from the very beginning. It is because we believe paediatric research is the essence of advancement in paediatrics. Without a significant research component, the hospital will never achieve the excellent status as reflected by the experience of other countries. We sincerely hope that our local paediatricians, College, Hospitals and Universities can work together and aim for this goal. Then we can foresee a more fruitful development of paediatrics in our locality. Only with this, someday we can be the leader, not always the follower.

GCF Chan
Chief Editor


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