In 2022, many CCTS authors make outstanding contributions to our journal. Their articles published with us have received very well feedback in the field and stimulate a lot of discussions and new insights among the peers.
Hereby, we would like to highlight some of our outstanding authors who have been making immense efforts in their research fields, with a brief interview of their unique perspective and insightful view as authors.
Outstanding Authors (2022)
Matthew D. Cham, The University of Washington Medical Center, USA
Outstanding Author
Matthew D. Cham
Dr. Matthew Cham is a Professor of Radiology, the Director of Cardiac MRI, and the Cardiothoracic Imaging Fellowship Director at The University of Washington Medical Center in Seattle, USA. Before joining the University of Washington, Dr. Cham was the Director of Cardiac Radiology at the Weill Cornell and Icahn Mount Sinai Medical Centers in New York City where he helped to create one of the largest cardiovascular CT/MRI programs in the country. He has been awarded Radiology Teacher of the Year at Cornell, Mount Sinai, and the University of Washington. Dr. Cham currently serves as the Chair of Cardiac Online Longitudinal Assessment in the American Board of Radiology and Chair of Enduring Materials in the American College of Radiology. He has authored over 80 peer-reviewed publications and textbook chapters in cardiothoracic imaging. He has delivered more than 200 invited lectures in North America, Europe, and Asia. You may visit Dr. Cham’s homepage here.
CCTS: What are the most commonly encountered difficulties in academic writing?
Dr. Cham: In recent months, the greatest challenge is probably the lack of time. The COVID-19 pandemic has had numerous downstream effects on healthcare. More patients are now returning to the hospital for routine care after avoiding it during the pandemic. This return to normalcy has substantially increased clinical volumes throughout the healthcare system, increasing the demand for physicians’ time, and reducing their overall availability for academic writing. Job-related burnout and the promotion of personal well-being have become hot topics in Radiology and other specialties.
This phenomenon affects the entire creative workforce including faculty and trainees alike as they are all active participants in direct patient care. Although medical institutions generally reward faculty and trainees for academic productivity, this is often of secondary importance when patient care is at stake, and rightfully so. In my various editorial and organizational roles, I have noticed that physicians have become less engaged in academic endeavors compared to pre-pandemic years. Manuscript reviewers typically comprised physicians volunteering their scarce free time; this volunteerism has also declined in recent months. Some journals have started accepting manuscript reviews from trainees such as Residents and Fellows due to a chronic lack of reviewers or reviewer availability.
The amount of publisher support staff has noticeably decreased as well, with many submission sites driven by an automated self-serve interface. This further increases the burden upon authors to independently navigate the complex manuscript submission process and deliver a polished product from day one. Authors may now have to master the use of photo-editing software such as Photoshop to professionally annotate images and diagrams as the publisher may no longer have adequate staffing to provide these services. These experiences can be stressful and discouraging for junior faculty and trainees who are exploring their interest in academia. Despite this gloomy backdrop, I remain optimistic that this is just a transient phase that will eventually recover along with the economy.
CCTS: Science advances rapidly day by day. How do you ensure your writing is up-to-date and can give new insights to the field of research?
Dr. Cham: In diagnostic radiology, science has indeed progressed faster than ever before. With the widespread development and adoption of deep learning and other forms of artificial intelligence, new data are being churned out faster than experts can keep up with. Writing about artificial intelligence software applications is particularly challenging because most of the software innovations are proprietary technologies that are not publicly available. The scientific manuscripts that emerge from these technologies can be peer-reviewed, but oftentimes the software itself cannot be tested.
This situation is quite different from more traditional scientific manuscripts that are based on clinical trials because the conclusions from trials can be vetted against the reviewers’ personal experiences and the existing literature. With artificial intelligence research, each software application is unique and deep learning technology itself relies on complex algorithms that their own engineers may not entirely comprehend. Even when software becomes commercially available, it is often difficult to compare one with another because most institutions will not purchase multiple versions of the same software tool. This means that most reviewers or experts will not have personal access to a truly complete library of commercial software.
The solution to keeping up is to gain exposure to as many of these innovations as possible. This can be achieved through various means including scientific meetings, vendor exhibits, research collaborations, and published literature. Software applications that are consistently performing better than expected tend to be mentioned more in these forums, much like a star athlete or an A-list celebrity. Just like sports and Hollywood, the landscape evolves quickly and changes constantly. It can be overwhelming even for experts to keep up with the rapidly growing field. It’s imperative to keep this in mind when authoring content for trainees and early career physicians, focusing only on immediately available innovations that are likely to remain clinically relevant for at least 4 years.
CCTS: Is there any interesting story during academic writing that you would like to share with us?
Dr. Cham: Here’s a story relating to copyrights. The hurdles we jump through to protect them, and how much of it may be unnecessary. While authoring a manuscript, I noticed that deidentified MRI images that I personally acquired and created were posted on a US-based medical education website without my permission. When I contacted the website administrator, I was notified that deidentified medical images are public property and that no lawyer has been able to successfully force them to take down their posted images. Indeed, when I sought advice from my University’s legal team, there was in fact no recourse for this copyright dilemma. What’s interesting is that my images were being used to generate revenue for that website via banner ads. I bring this up because authors like myself jump through so many hoops each year to request permission and occasionally pay usage fees for re-printing deidentified medical images that have been published elsewhere, rather than just acknowledging the source material and citing it as a reference. Why do we jump through so many hoops when the law considers deidentified medical images to be public domain? Publishers and authors alike would probably save a lot of time and effort if policies relating to these cases were revisited.
CCTS: Is it important for authors to disclose Conflict of Interest (COI)? To what extent would COI influence research?
Dr. Cham: A COI is important to disclose because it’s an indirect indicator of an author’s credibility on the subject matter that is being discussed. It’s a very delicate ecosystem. On one hand, industry sponsorship is a necessary propellant for the tremendous technological progress that is evident throughout our healthcare system. On the other hand, industry sponsorship can falsely elevate the perceived value of some innovations when authors are reliant on a sponsor for funding or other personal gain. There is also the potential for authors to understate the flaws of a product if such revelations could harm the sponsor’s profit margins. COI should be disclosed when they apply to the research results or products that are being discussed. The audience needs to know when an author or speaker is reliant on a sponsor to maintain funding or for other personal gain.
There are times when the politics and optics surrounding COI can defeat the very purpose of disclosures. In the early 2000s, there was a major tobacco settlement awarding millions of dollars to various cities across America. Much of these funds went towards debt relief and community infrastructure such as local zoos, instead of the hospitals or towards anti-smoking campaigns. At the time, the tobacco funds were sometimes considered “blood money” and many hospitals distanced themselves to preserve the optics of a healthcare system that is free of tobacco influence. This may initially seem like a commendable position; however, none of the animals at the zoo would benefit from smoking cessation programs or lung cancer programs which theoretically would have been the best use of tobacco funds according to the Centers for Disease Control and Prevention (CDC). In the end, only a tiny fraction of tobacco funds was spent towards mitigating the harms of tobacco in America. And yes, there were no smoking camels at any of our zoos. In the future, I hope that our healthcare systems and medical communities do not shy away from utilizing funds simply to preserve optics at the expense of improving the lives of our patients.
(By Brad Li, Eunice X. Xu)