An Environment that Enables Impactful Research

February 23, 2018
Michael J. Pencina, PhD & Manesh Patel, MD

Whenever a list of highly cited researchers--such as this one from Clarivate Analytics--is released, naturally one of the first questions that many people have is, “who’s on it?” Of course, we both feel honored to be recognized in the company of many of our Duke colleagues for the resonance that our research has had with others in our fields. But as we reflect on this recognition, it strikes us that “where” and “how” may be equally important questions to answer.

The strong commitment to team science that exists across Duke Health and the Duke Clinical Research Institute has been the key to our success. The ecosystem of quality spanning the clinical research spectrum from design to data, from project management to analysis, enables us to ask questions driven by the experiences of clinicians and patients in “real-world” practice settings. These are the kinds of research questions that yield answers with meaningful impact. Clinical researchers at Duke have the time, support, and a sustaining environment that allows them to be curious and provides the valuable space needed to shape research and pursue clinical answers. These answers are not always comfortable. All too often they run counter to conventional wisdom or overturn some orthodoxy. Some of our most-cited papers are those that, after the best possible resources were applied to answer fundamental questions, found unexpected and sometimes unpopular answers that have nonetheless gone on to change clinical care.

The quantitative expertise Duke is able to marshal, when combined with a tradition of asking and answering meaningful questions, helps ensure that research is trustworthy as well as impactful.

Within the ecosystem for clinical research created between the DCRI and the clinical enterprise, we’ve also been able to bring the right data to bear on those questions. We benefit here from a long, deeply engrained history of working with teams, colleagues, and friends around the world to collect and share high-quality data. At the same time, we work in an environment that recognizes the vital importance of a deep understanding of the data we rely on in developing impactful research.

The flip side of drawing questions directly from clinical practice is using optimal methods to analyze data to answer those questions. Importantly, newer methodologies are being driven by practical questions rather than theoretical embellishments. And regardless of the methods used for data and analysis, there is comprehensive attention to reproducible research, with appropriate redundancy baked in to help check for errors and bias. 

The quantitative expertise Duke is able to marshal, when combined with a tradition of asking and answering meaningful questions, helps ensure that research is trustworthy as well as impactful. This continuing tradition can be seen today in one of our collaborative projects, which applies cutting-edge machine learning techniques to evaluate coronary imaging.

Finally, there is the Duke culture that emphasizes publishing research findings regardless of whether we or the sponsor like the results. This imperative to publish all that we learn fosters transparency, builds trust, and furthers academic collaboration. At the same time, it undoubtedly allows others to cite our work with confidence, which hopefully leads beyond dissemination to action that improves patient outcomes. In the end, we owe our place among this group of highly cited Duke researchers to our colleagues and to an environment characterized by a culture that supports scientific discovery, broad collaboration, and delivery and dissemination of actionable results. And now, with Duke Forge joining with the DCRI and a clinical enterprise focused on high-value, evidence-driven practice, the future looks even brighter for more highly cited authors from Duke.

Michael J. Pencina, PhD, is Director of Biostatistics for the Duke Clinical Research Institute and Professor of Biostatistics at Duke University.
Manesh Patel, MD, is Chief of the Division of Cardiology and a Professor of Medicine at Duke University School of Medicine.


Michael Pencina, PhD