Test of time by Jochen Cals

Jochen Cals, general practitioner and researcher at the department of Family Medicine looks back at his statements belonging to his PhD thesis in 2009.

It is quite a while ago, but most statements will still stand the test of time I suppose. My thesis was titled: ‘Respiratory tract infections in general practice - enhanced communication skills and C-reactive protein testing to optimise management’.  My first 4 statements were findings derived from the trials and studies I did. The first statement (in Dutch) would translate as follows: A point of care test for C-reactive protein and disease-specific training in communication skills are cost-effective in reducing antibiotic prescribing for lower respiratory tract infections. Well, interestingly our findings received lots of media attention, but were also incoorporated in our national guideline on acute cough in 2011. Together with Rogier Hopstaken I built an online training module for GPs to train themselves in using these skills and the point of care test. We have now trained over 3500 GPs nationwide, a huge success. Moreover I was involved in a large European study recruiting over 10000 patients and an Asian trial recruiting 2000 adults and children. Both studies showed similar promising results of the interventions on antibiotic prescribing.

So much for the more boring statements. Let’s continue to the more interesting ones. My fifth statement was: Research meetings in pubs are the fastest way to PubMed. Although I must say that I visit pubs less often now than during my PhD years, I still strongly feel that the best ideas and discussions will not evolve at the routine office place, but will happen if you allow yourself to think freely. Personally I have my best ideas while running or cycling. But since not everyone likes to have research meetings while running in the mud, the pub is a good alternative. Being away from the usual e-mails etc facilitates good discussions and informal meetings at conferences for instance are great stepping stones for future collaboration.

Another statement to revisit would be this one: Reporting a unique researcher identification number on all research output will make life easier and more transparent for authors, editors and readers. Daniel Kotz, a fellow PhD student at the time (now professor at Dusseldorf University) and myself noted that submitting papers was always lots of repetitive work as most contact details have to be entered over and over again. Also finding papers of specific researchers with a common surname can be quite difficult. We wrote a commentary and managed to publish it in The Lancet. It created quite some stir and it is very nice to see that several systems have been developed since then to further strengthen author identification (such as ResearcherID.com, ORCID.org and researchgate.net).

The last statement which struck me when reading back was one on the fact that people with red, ginger or strawberry blond hair would become more rare, but would never go extinct. At the time many media reported on the extinction of red-heads. Red hair is caused by a relatively rare recessive gene, the expression of which can skip generations. Although it is becoming more rare due to more dark-haired/skinned people in countries with relatively more red-heads (such as Scotland and Ireland), red hair is not likely to disappear at any time in the future as the genes will remain in the population. I became a father myself years after my PhD defence. My wife (who is absolutely blond) and I now have 3 children. They are all blond….  so the statement was certainly not true for my own family. Now I’m hoping that my grandchildren will be red-heads!

Jochen Cals