January - March 2007: 
Volume 20, Issue 1

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Research in pulmonology in Greece and its international impact
The aim of this article is to raise concerns about the future of pulmonology in this country rather than to evaluate clinics and hospitals or allocate responsibilities. For this reason, names of colleagues are not mentioned, even though several have become known from their publications in the international literature. The reader who wishes to be informed about the research activity of the clinics, the people involved and their the interests should do so through the internet, using Scopus.
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The following search was conducted during August 2006 and thus some data may have changed in the meantime. However, it will subsequently become evident that the most difficult part is the successful development of a clinic that further defines its research activity. Scopus is the largest abstract and citation database of research literature. It covers 15,000 academic journals, over 28 million abstracts and 245 million references; 5,900 journals are related to Life and Health Sciences and the Medline Medical Information Database is fully covered.

This search covers the period between 2000 and August 2006. During this time 2,110 articles related to pulmonology were published from Greece, estimated as approximately 3% of the country’s overall research activity. The most active research groups in Greece come from the areas of cardiology, epidemiology and oncology. The most active researcher in the area of pulmonology is ranked 16th on the list of Greek researchers, based on the number of international publications.

Among the five most active researchers in the area of pulmonology, three are academic professors of pulmonology in peripheral medical schools across the country. The fifth is also an academic in a pulmonology clinic of a peripheral medicine department while the first and the sixth are professors of intensive care. Most of the articles have been published in Chest, European Respiratory Journal and Respiratory Medicine. Several publications, especially in the areas of physiology, epidemiology and infectious diseases, were conducted through collaboration between pulmonologists and the corresponding specialties, resulting in the appearance of colleagues of these specialties as high ranking on the list of researchers on pulmonology subjects.

The search for published articles with reference to their subject yields some interesting results. During 2000 and 2006, 27,664 articles referring to asthma were published internationally with Holgate ST, Barnes PS and Weiss ST being the main researchers. The two journals with the most publications on asthma were not pulmonological (Journal of Allergy and Clinical Immunology and Clinical Experimental Allergy). Publications on asthma cover 1/5 of the total number of publications in Scopus for this period of time. Altogether, the most important researchers were also Holgate ST and Barnes PS. Amongst the three journals that published most articles on asthma, two were pulmonological (Chest and American Journal of Respiratory and Critical Care medicine).

It is noteworthy that during 2000-2006 only 6,228 articles on chronic obstructive pulmonary disease (COPD) were published, corresponding to approximately 25% of the number of articles on asthma. All the publications were in recognized international pulmonological journals (Chest, Respiratory Medicine, European Respiratory Journal, Thorax and American Journal of Respiratory and Critical Care Medicine). No Greek researcher is on the list of the 100 most important researchers on COPD of asthma.

The number of articles referring to intensive care was approximately the same as those referring to asthma (25,401). The journals that published most articles are not pulmonological (Critical Care Medicine, Intensive Care Medicine, Critical Care, Pediatric Critical Care, Pediatrics, Journal of Hospital Infection, etc). The first Greek researcher on the list of the most active researchers in that area is ranked at the 95th place.

Search results on lung cancer are similar to those on intensive care. The search revealed 29,058 articles. The journals that mainly published them were Lung Cancer, Cancer Research, Clinical Cancer Research and International Journal of Cancer. The first Greek on the list of researchers is at the 72nd place and unfortunately is not a pulmonologist. Over 20,500 articles on tuberculosis and 17,985 on pneumonia were found. No Greek was on the list of the 100 most important researchers on either subject.

 This search was concluded with two other subjects with a limited number of publications: 2,122 articles on interstitial diseases were found, mainly published in pulmonological journals (Chest, American Journal of Respiratory and Critical Care Medicine, European Respiratory Journal). The most important researchers internationally were Colby TV and Du Bois RM whereas the first Greek researcher is at the 39th place; 3,078 articles on pleural diseases were also found, mainly published in Chest, Annals of Thoracic Surgery and Lung Cancer. The most important researcher by far was Light RW and surprisingly there are three Greek researchers on the list of 100, two of whom are in the first 20.

The presentation of these search results may allow the reader, either specialist or resident pulmonologist, to derive his/her own conclusions. Pulmonology in Greece is in a developing phase. Active pulmonology clinics operate in most peripheral medical schools. Research in traditionally pulmonological subject areas such as COPD should be expanded internationally as well as in Greece. Specialized research subjects, such as pleural and interstitial diseases, that have been adequately developed in Greece should be further supported to attract even foreign researchers to this country. Asthma, tuberculosis and intensive care are equally popular research areas based on the number of published articles. Lung cancer appears not to be a major subject of research among pulmonologists in Greece, an observation that should raise concerns.

Without ignoring the significant clinical practice carried out in pulmonology clinics in this country, we should all cooperate for better resident training in as well as in clinical practice research. The Hellenic Thoracic Society and the pulmonology clinics already have substantial experience. Personal views on the relevance of pulmonology to other specialties can be reevaluated through thorough study of the international literature data. It is important for those who define the future of pulmonology to see far ahead. Search and evaluation of data available in international databases, such as Scopus, can contribute significantly.


1. www.scopus.com