Einstein Francisco Camargos
Another successful Brazilian Congress of Geriatrics and Gerontology has come to an end, in which awards were given to the three best papers in each area (geriatrics and gerontology). The Congress was held in the city of Rio de Janeiro from June 6-8, 2018. A total of 743 papers were submitted, of which 20% were rejected because they did not meet the minimum criteria for an acceptable paper, mainly for not being characterized as academic/scientific research.
In a more detailed analysis, we noted that most rejected papers were literature reviews, which, although of value if published in pertinent journals, do not generate scientific knowledge at a level compatible with that of a national congress. The Scientific Committee also drew attention to the number of “case reports” and “experience reports” submitted that were rejected because they reported on situations considered part of the everyday, ordinary activities of those who work with older people. According to Parente et al., “reports are a detailed description of clinical cases that contains important features of the signs, symptoms and other characteristics of the patient, including the therapeutic procedures used and the outcome of the case. They have a clear indication for rare disease settings, in which both diagnosis and treatment are not fully established in the literature.”1 In this respect, simply reporting the experience of accompanying an older patient after a stroke event to physical therapy sessions, for example, is not a priori a report of broad scientific interest.
Conversely, very interesting studies were presented at the Congress, which highlights the vast and largely unexplored field of aging research in Brazil. The abstracts of the “TOP 10' studies, both in geriatrics and gerontology, are published in the current issue. They had their quality independently certified by two reviewers, were selected for oral presentation at the Congress, and participated in the competition for the best paper awards. For ease of reference, we point out a representative of basic laboratory research (“Effects of treatment with gold nanoparticles on biochemistry and cognition in a tauopathy model”), a representative of cohort study (“Dementia conversion rate in a sample of Brazilians with low level of education and mild cognitive impairment”), and an original study assessing services of interest to older people in Brazil (“Urgent and emergency care for older people: prevalence of services provided by SAMU-CE 192”), among others. These studies are important, as they allow us to better understand our country and establish social priorities.
A more comprehensive question we might ask, however, concerns the waste of large amounts of time and money in producing irrelevant studies, especially in times of severe shortage of resources for science and technology — and, unfortunately, our field reproduces this trend. In the 2018 Congress, 5% of all submitted (and approved) papers were based on “profiles” (of hospitalizations, medications, morbidities, anthropometric profile, profile of institutionalized older people, etc.), as if we were still unaware of the main problems and challenges faced by health professionals and multidisciplinary teams. There are important knowledge gaps in geriatrics and gerontology that need to be bridged. Areas such as nutrition, physical therapy, speech therapy, biology, pharmacy, psychology and sociology have important contributions to make to the Brazilian society, and should therefore take the leading role in research on aging and older people.
Science production means more than merely launching ideas or reproducing studies. In many cases, a simple question and a simple study are more interesting and relevant than complex and expensive research. I recall here a simple study, submitted as a free paper to the 2014 Congress, entitled “Salt Preferences of Normotensive and Hypertensive Older Individuals.” The participants were offered samples of French bread rolls with three different salt concentrations (421.2, 648.0, and 874.8mg sodium/100 g of bread) and asked to state which sample they preferred. The authors concluded that the simple addition of spice (oregano) to the bread shifted the preference to the less salty samples. This study, conducted at Ribeirão Preto Medical School - University of São Paulo, ended up being published in the prestigious Journal of Clinical Hypertension.2
Our money and efforts should be directed to serious academic/scientific research that can give something back to society. Quoting Claude Bernard: “The idea is the seed; the method is the soil which furnishes the conditions for developing and prospering it, and bringing forth its best fruits, according to nature. Considered by itself, the experimental method is nothing.”3
Einstein Francisco Camargos
1. Parente RCM, Oliveira MAP, Celeste RK Relatos e Série de Casos na Era da Medicina Baseada em Evidência. J Bras Video-Sur. 2010;3(2):67-70.
2. Villela PT, de-Oliveira EB, Villela PT, Bonardi JM, Bertani RF, Moriguti JC, et al. Salt preferences of normotensive and hypertensive older individuals. J Clin Hypertens (Greenwich). 2014;16(8):587-90. https://doi.org/10.1111/jch.12365
3. Maia NF. A Feitura da Ciência. In: Maia NF, ed. A ciência por dentro. 3a ed. Petrópolis: Vozes; 1992. cap. VII.