Institutions rule? The contribution of specific organizations to endometriosis research
National particularities exist for endometriosis R&D. But in the end, research is carried out in individual institutions with their own resources and research programs. They include healthcare organizations – such as hospitals, education-related ones (e.g., universities or technical schools), but also government organizations (e.g., environmental regulation agency, local governments…), private companies, non-profits, archives (e.g., museums) and various R&D facilities.
Thanks to the developed dataset, it is possible to link endometriosis publications to these individual organizations with a respectable level of certainty (e.g., to study the prioritized topics in each institution). To the extent of my knowledge, this article features the first map of endometriosis R&D at this level of granularity. Each dot represents an institution, and its size is (roughly) proportional to the number of endometriosis publications – bigger dots are larger producers of scientific output on that metric. Clicking on an institution can reveal exciting details about its characteristics and priorities, e.g., in terms of covered topics. Feel free to explore the map, but also to use the search tool if you look for what the organization next door is doing!
The World of endometriosis research (1925-2020)
Note: Map based on 29,567 publications with a least one institution that could be geographically localized (including the 25,378 publications with information on topics). Institution data is derived from GRID, Google Maps and enriched through manual completion. Some classification errors are possible. The data covers 4,174 individual institutions (excluding special categories such as references to a city only rather than to an identifiable institution). Only institutions that have produced at least two endometriosis-related publications over the 1925-2020 period are shown on the map. Each author involved in a publication is considered to provide a contribution to its completion. The number of contributions (i.e., of author-publication pairs) is computed for each institution, distinguishing males and females (when gender is attributable to the person with a certainty above 74%). Gender contribution is the ratio of each gender to the total number of contributions (excluding authors whose gender is undetermined). Gender contribution is thus different from the number of unique individual authors. It focuses on the effort dedicated by each gender to the total scientific output (i.e., the number of author-publication pairs). In particular, the same person can be counted several times if he or she was involved in more than one publication from that institution.
The top institutions regarding endometriosis reflect the national divisions shown in the previous section, but with some surprises. Indeed, the highest number of endometriosis publications over the period hail from the University of Sao Paulo (417), Yale University (389) and the University of Milan (327). The following positions are held by major healthcare organizations, such as the Brigham and Women’s Hospital (327), the Cleveland Clinic (250) and the University Hospital of Leuven (247). Gender balance and prioritized topics obviously vary significantly across the spectrum of involved institutions.
The only way to derive more specific insights is to break down the information by types of institutions. This will allow us to see if some patterns emerge (beyond the fact that zoological museums are probably not the leaders in endometriosis R&D, of course). The first basic idea is to assess the level of effort of the different types of institutions to the endometriosis literature. This effort can be estimated through the number of publications involving at least one institution from a given type.
The quantitative domination of healthcare and education organizations in endometriosis research (1925-2020)
Note: Graph based on 29,567 publications with a least one institution that could be geographically localized. Each publication is counted at most once for each type of institution, even if multiple institutions from the same type are involved in this publication. However, a single publication can be counted for multiple types of institutions (hence the total sum is above 29,567).
Without surprise, educational and health institutions largely dominate the landscape, as they are involved in 63.7% and 56.6% of the endometriosis publications, respectively. This situation is indeed expected for a predominantly biomedical field. Other types of institutions are much more marginal, as they are involved in at most 5% of publications or below. In particular, the effort of companies and non-profits remains relatively limited despite their recent growth and potential to bring substantial benefits to the endometriosis R&D. This can, of course, reflect different priorities, resources, and constraints.
As a matter of fact, we can easily spot some patterns regarding the topics covered by the different types of institutions. The attention dedicated by each type of institution to the broad topics shows their diverse priorities.
Distinctive priorities in terms of broad topics depending on the type of institution (1925-2020)
Note: Graph based on 29,567 publications with a least one institution that could be geographically localized (including the 25,378 publications with available topics). Institution data is derived from GRID, Google Maps and enriched through manual completion. Some classification errors are possible. The share of topics is based on the average of all publications with a least one contributing institution from the mentioned type. Some types of institutions (with few publications / challenging interpretations) are not shown on the graph. The data for all types is based on the entire sample of 28,521 publications with an available abstract (including those with no geographical information).
Healthcare and Education institutions feature a breakdown by topics that is very similar to all publications. It makes sense since these organizations are the major contributors to endometriosis R&D as a whole and thus have a disproportionate weight in the total. A notable specificity is the fact that healthcare institutions tend to contribute slightly more to “anatomy and classification” (12.45% versus 11.96% for the average) and “treatment” (20.38% versus 19.72%). This emphasis is likely due to the fact that surgery is performed in this type of organization (see below for detailed topics). Similarly, education institutions tend to have a higher share of scientific output dedicated to “mechanisms and causes” (22.66% compared to an average of 20.53%), which also makes sense given the knowledge-oriented mission of universities. Facility and government institutions are a little bit tricker to interpret given the diverse organizations categorized as such. However, they also seem to be firmly focused on “causes and mechanisms”. Regarding companies, they are particularly oriented towards “mechanisms and causes” (23.32% versus 20.53%), but also “treatment” (22.65% versus 19.72%). However, their most striking feature is their attention to “economic and health burden” (3.49% instead of an average of only 1.37%). All these patterns can be interpreted as the fact that these companies mainly aim at developing drugs, tests, or other medical interventions to be put on the market. Last but not least, Nonprofit organizations are most notable for the overrepresentation of “symptoms and daily life” (11.47% versus 9.98%) in their priorities.
In a nutshell, we can see some broad differences that are aligned with what we may expect of each type of organization, given their missions. However, they shall not be exaggerated, as the absolute differences are tiny. Exploring the detailed topics could help us to refine our vision of these priorities. The following graph shows the representation ratio of each detailed topic for a given type of institution to make it more visible. The institution type can be selected using the button in the top left corner. The black vertical line represents the average for all publications. When a bar is to the right, it means that this detailed topic is overrepresented in the publications involving this type of institution. When it is below, it is underrepresented.
Over and underrepresented detailed topics by type of institution (1925-2020)
Note: Graph based on 29,567 publications with a least one institution that could be geographically localized (including the 25378 publications with available topics). Institution data is derived from GRID, Google Maps and enriched through manual completion. Some classification errors are possible. The ratio compares the share of the topic for all publications with the average one for publications with at least one contributing institution from the mentioned type. Some types of institutions (with few publications / challenging interpretations) are not shown on the graph. The data for all types is based on the entire sample of 28,521 publications with an available abstract (including those with no geographical information). The black line corresponds to the share of topics for all publications.
This data enables us to confirm the priorities of the different institutions. For instance, private companies indeed strongly prioritize economic issues, epidemiological studies (probably to estimate the potential market for products), hormonal/pharmaceutical interventions and mechanisms/causes on which their products may act (e.g., genetics, hormones…). The fact that education and healthcare institutions are very close to the average is also confirmed for most detailed topics. They still have some specificities (e.g., a higher focus on surgery/anatomy-related topics for healthcare organizations). Government-related institutions seem to be particularly concerned with specific risk factors (environmental, lifestyle and others), maybe stemming from the public health responsibilities of these stakeholders. Nonprofits are also notable for their concerns for research priorities, economic issues and symptoms/daily life. It can reflect the fact that associations can push for these aspects of high interest to patients.
Feel free to explore the topics to see to what extent the different types of institutions tackle the detailed topics that interest you the most.