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The continuing need to publish laboratory science in clinical journals
  1. UK editor
  2. Division of Ophthalmology, University of Bristol, Bristol Eye Hospital, Lower Maudlin Street, Bristol BS1 2 LX, UK

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    Over the past decade the BJO has continued to emphasise the importance of basic science findings, and thus generated a section dedicated to “Laboratory science” for this purpose—but why, and should we continue? There is always some deliberation when wearing a clinical hat. Questions arise such as is it science for science's sake? And although we learn, do we move on? We are very much in the era of evidence based medicine1 and, as such, we are compelled to deliver an optimal service with maximal therapeutic benefit. Although this undoubtedly is what we should be doing and what the public expects (at least in the short term), there is an unarguable necessity to understand the underlying molecular and cellular biology and pathology to improve what are, mostly, unsatisfactory therapies. Indeed from what evidence and data do we generate such evidence based practices? TheBJO has always made concerted efforts to deliver science to both their scientific peers and the clinical audience by, for example, endorsement of basic science by lead editorials. Such editorials were either to emphasise the importance of scientific knowledge to the clinician2 or, for example, to highlight and discuss the merits of individual laboratory science manuscripts in that issue.3 4 However, a BMA sponsoredBJO readership survey showed that laboratory science is one of the least read sections of the journal.

    Why should we continue? Firstly, as shown in the 1999 special issue dedicated to impact of new technologies in ophthalmology (BJO1999;83:issue11 (Nov)), were the highlighted benefits of laboratory science in the advancement of diagnostic tools—for example, imaging, and therapies—for example, gene therapy. Indeed without such basic science investment none of the developments in that issue, some of which are now entering our clinical practice, would have been possible.5 TheBJO would fail in its remit to deliver such advances in ophthalmology if it did not publish relevant laboratory science. The future of medical research is dependent upon the translation of laboratory findings directly into patient management, and continuing to publish such work in theBJO will target an audience most interested in the future development of patient care. Secondly, we should all be encouraged in some capacity or other to directly or indirectly generate and support research developments. In the UK the Wellcome Trust6 has recently documented its continued support of vision research. The Wellcome Trust summarised its review of the burden of human suffering associated with visual disease and disorders, both in the United Kingdom and worldwide. Acknowledging the considerable extent of visual handicap and the present economic cost of eye disorders, the Wellcome Trust continues to support vision research, not only via project grants but also by research training fellowships (£32m over past 10 years). With the support of such schemes, vision research has grown, although more slowly than other fields of biomedicine. Across the Atlantic, the Association for Research in Vision and Ophthalmology (ARVO) and the National Institutes of Health continue to actively promote vision research. Moreover, the ARVO annual meeting is a great testament to promoting research and, particularly, the interaction between basic scientists and clinicians. The future should be viewed with great optimism and excitement for such developments. By increased knowledge of underlying biological and pathological processes of visual disorders we will undoubtedly improve patient care further. Of course there are many journals available for publishing laboratory science. Basic and clinical scientists are arguably further conditioned by impact factors and, in the UK, by scoring well in the research assessment exercise. Everyone wishes to publish in the best quality journals but also needs to target the most appreciative audience. An international journal such as theBJO has published formative laboratory science articles with direct clinical relevance on such topics as diabetic retinopathy and growth factors, improved diagnostic molecular biological techniques, biology of trabecular meshwork, immunopathology of thyroid eye disease, and many papers on molecular and genetic ophthalmic research. We are now entering an exciting era of both functional genomic and proteomic research that will increase our understanding of both gene and protein changes during disease, and avenues may open to improve current and future therapies. These innovations have a major part to play in a spectrum of basic science studies, including degenerative disorders, glaucoma, cataract, and immunobiology of inflammation and infection. The information that will be gained is of interest to the clinician as well as to scientific peers.

    Publishing in the BJO will help target appropriate audiences and help foster closer collaboration between clinicians and scientists. Continued reporting of laboratory science in the BJO means that the journal publishes a range of visual science from the laboratory to pilot clinical studies that leads us to the evidence we require to embark on clinical trials and ultimately best evidence based service delivery.


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