Canadian and International Winners of Major Health Research Prizes, 1959–2018
Total Page：16
File Type：pdf, Size：1020Kb
ANALYSIS Canadian and international winners of major health research prizes, 1959–2018 Robert J. Redelmeier, C. David Naylor MD DPhil n Cite as: CMAJ 2018 November 12;190:E1328-31. doi: 10.1503/cmaj.181056 ommon indicators of excellence in biomedical and health research include publications in top-tier journals, citations KEY POINTS per publication, measurable impacts of research on prac- • The proportion of Canadian-based winners of Canada Gairdner Ctice or policy-making, and major prizes for extraordinary research International Awards has declined significantly since the accomplishments.1 Among major medical research prizes, the best inception of the award in 1959. known is the Nobel Prize in Physiology or Medicine, along with the • The numbers of Canadian-based winners receiving any other major Nobel Prize in Chemistry (often awarded to bioscientists). Other prize has been consistently low (11% overall) as compared with globally prominent awards are sometimes seen as “pre-Nobels,” international winners (50%), with an even larger gap for Nobel prizes. and awarding organizations even advertise their record of early • There were no significant changes over time in the proportions recognition of scientists who go on to win the Nobel Prize, espe- of international or Canadian-based Gairdner laureates who went on to win other prizes. cially as these scientists tend to be awarded after the importance of discoveries has withstood the test of time.2 • These findings cannot be explained by a decline in the quality of Canadian-based research, suboptimal nomination efforts or Canada hosts one prize that falls into this category — the Can- biased adjudication; rather, the most likely explanation of these ada Gairdner International Awards, initiated in 1959 (hereafter, findings is a more rigorous global selection process as the “Gairdner”) (Box 1). Others include the Albert Lasker Basic Medi- Gairdner prize matured. cal Research Award (“Lasker Basic”); the Lasker–DeBakey Clinical • Uneven government support and skewed priority-setting by Medical Research Award (“Lasker Clinical”); and the Louisa Gross federal funders cannot be ruled out as factors. Horwitz Prize (“Horwitz”). Each of these awards has a distin- guished history, rigorous selection criteria and worldwide scope.1 An apparent recent decline in the number of Canadian-based For awards made in the same year, we assigned temporal pre- Gairdner awardees has fuelled speculation about the importance cedence to the Gairdner. The Horwitz and Lasker awards are and causes of this trend. We tracked proportions of Canadian- announced in the fall of each year, generally a few weeks ahead based and international Gairdner awardees, and their success in of the Nobel announcements, which occur by tradition in the first winning other major research prizes, to establish how Canadian or second week of October. The Gairdner announcements have biomedical and health scientists are doing on the global stage. varied in timing, and are now made in April or May. However, the review processes have always predated the other awards’ The arithmetic of excellence announcements and been undertaken independently.3 We grouped prize winners into six time intervals: 1959–1969, 1970– We assembled lists of Gairdner awardees (1959 to the present), 1979, 1980–1989, 1990–1999, 2000–2009 and 2010–2018. Our primary and tracked them forward and back to ascertain which of them analysis was prespecified as comparing the proportions of interna- also won a Nobel Prize (Physiology or Medicine, or Chemistry, tional and Canadian-based awardees who won one or more major back to 1900), a Lasker Clinical or Basic (1946), or a Horwitz prizes other than the Gairdner, and whether that occurred before or (1967). Each individual recipient for the time span from 1959 after the Gairdner was awarded. We undertook a secondary analysis onward was screened to ascertain connections to Canada, such focusing specifically on Nobel Prizes won by Gairdner laureates. as place of birth and location of postsecondary education These analyses make no allowance for differences in the num- (undergraduate, graduate or medical degree). However, the key ber of additional prizes won. Those differences between Canadian factor in attribution was whether the prize-worthy research was and international winners were examined on an exploratory basis. done in Canada. Sources included websites of the relevant prize- For six individuals who won two Gairdners, we treated each giving agencies or foundations, and a wide variety of online award as a separate instance; the same was done when those publications (e.g., obituaries, biographies, award citations and multiple winners became repeat winners of other prizes. This institutional materials), and direct contact with the Gairdner required matching each Gairdner award with any other major Foundation and awardees themselves. prize that preceded or followed it, as shown in Table 1. E1328 CMAJ | NOVEMBER 12, 2018 | VOLUME 190 | ISSUE 45 © 2018 Joule Inc. or its licensors In contrast, we hypothesized that the Gairdner award initially had Box 1: A brief history of the Gairdner award and a modest bias in favour of local talent (a “home-ice edge”) but has 3 selection process grown in stature and now has an adjudication process that combs ANALYSIS At the outset in 1959, the Gairdner award selection process involved the global field of medical research in a fashion similar to other major a group of University of Toronto academics tasked with recognizing prizes. The Gairdner Foundation itself has explicitly rejected this pos- contributions to “rheumatic and cardiovascular diseases.” The sibility. A 1999 monograph celebrating the 40th anniversary of the scope was broadened to “any branch of medicine” in 1962. With the wider mandate, a two-tiered process was initiated, which continues awards asserts, “Though a local foundation might be thought to today. A Canadian-based medical review panel assesses scores of favour Canadians, there is no evidence that the Gairdner has ever nominations and produces a short list from which awardees are done so. Nor has there ever been a ‘quota.’ The Canadians who have chosen by a medical advisory board. won in recent years have been outstanding scientists, and several The first medical advisory board member from outside Ontario was have gone on to win other awards internationally, most notably added in 1974, and it was not until 1991 that the first international Michael Smith, who won the Nobel Prize in Chemistry in 1993.”3 member was appointed. From then on, the medical advisory board As this last assertion implies, an obvious way to test assump- gradually evolved into a more international body, typically including Nobel laureates and other winners of major prizes, along with leaders tions about quality of awardees is through convergent and diver- of major medical faculties from the United Kingdom and the United gent validation. For example, in earlier years, were Canadian Gaird- States. This transformation was completed in 2008 when the ner awardees winning other pinnacle prizes at the same rate as Government of Canada granted $20 million as an endowment to help international colleagues? A much lower rate would imply an early the Gairdner Foundation enhance its international profile, support selection bias favouring Canadian work, particularly if that differ- educational outreach across Canada, and ensure that up to seven awards could be given each year, as described below. ence persisted even as the proportion of Canadian-based winners The number of awardees in the first three decades ranged typically fell. Conversely, if the proportion of international winners of multi- from five to seven per year, and rose as high as nine each decade. ple prizes was consistently higher, it would argue strongly against Numbers fell slightly in the 1990s, a decade of fiscal restraint; one year the possibility that meritorious Canadian-based work was being saw only three awards made. Since 2000, five awards per annum has overlooked in nomination and adjudication processes. been the norm, with minimal variation, except for 2002 when 10 awards were given to celebrate the sequencing of the human genome. Is quality declining? For this analysis, we excluded the Canada Gairdner Wightman Award (initiated in 1976, recognizing excellence and leadership exclusively among Canadian researchers) and the more recent As Table 2 shows, only 5 of 47 (11%) Canadian-based winners (2009) John Dirks Canada Gairdner Global Health Award. ever received another international pinnacle prize, compared with 152 of 302 (50%) international winners (p < 0.001). Of the 152, 77 were multiple winners, leading to a total of 255 major Details of our statistical analysis are presented in Appendix 1 (avail- prizes other than a Gairdner, whereas the Canadian-based able at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj.181056/-/DC1). researchers each won a single additional prize. The five were There were 349 Gairdner awards made from 1959 to 2018, 47 to Michael Smith (Nobel 1993), James Till (Lasker Basic 2005), Canadian-based researchers and 302 to international researchers. Ernest McCulloch (Lasker Basic 2005), Yoshio Masui (Lasker Basic Table 2 shows the respective numbers and proportions of research- 1998) and Anthony Pawson (Horwitz 2004). The proportion of ers who won Gairdner and other awards across the six periods. The Gairdner winners working in Canada who won a Nobel Prize proportion of Canadian-based Gairdner awardees in the first three (Table 3) was also lower: 1 of 47 versus 89 of 302 international decades was markedly higher than the most recent three decades winners or, excluding prior Nobels, 85 of 302 (p < 0.001 for both). (p = 0.009), with a declining proportion of Canadian versus other There were no significant changes over the six decades in the awardees over time based on a test for trend (p = 0.004). proportions of additional prize winners for international (p = 0.7) or Canadian-based (p = 0.8) Gairdner awardees. The putative “golden Competing explanations age” from 1959 to 1989 saw 3 of 35 (9%) Canadian-based awardees win again, as opposed to 2 of 12 (17%) in the next three decades.