Yacoub AA. Medical research in Iraq: a survey of medical journals. MJBU 1987;6(2):79-83.

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Medical Research in Iraq: A Survey of Medical Journals
Alim Abdul-Hameed Yacoub
Alim A-H Yacoub MBChB DPH MSc PhD MFCM MIBIOL, Lecturer
Department of Community Medicine, College of Medicine Basrah, Iraq
Abstract:
A survey of articles published in three medical journals was carried out to identify current trends
in medical research in Iraq. It was shown that population based surveys constitute a significant
proportion of the published original articles (38%). Some methodological problems were identified
and corrective measures were suggested. It is thought that there exists a need for workers in basic
and clinical subjects to develop a minimum level of statistical and epidemiological skills. These
could be provided through continuing education programmes.
‫الخالصة‬
‫ا‬ ‫طبيعة‬ ‫لمعرفة‬ ‫عراقية‬ ‫طبية‬ ‫مجالت‬ ‫ثالث‬ ‫في‬ ‫المنشورة‬ ‫للبحوث‬ ‫مسح‬ ‫اجراء‬ ‫تم‬ :
‫ال‬ ‫في‬ ‫القطر‬ ‫في‬ ‫الجارية‬ ‫لبحوث‬
‫مجال‬
‫ال‬
‫ط‬
( ‫األصلية‬ ‫البحوث‬ ‫من‬ ‫مهمة‬ ‫نسبة‬ ‫تشكل‬ ‫السكانية‬ ‫البحوث‬ ‫ان‬ ‫وجد‬ ‫لقد‬ . ‫بي‬
٣٨
.)٪
‫الخاصة‬ ‫المشاكل‬ ‫بعض‬ ‫شخصت‬ ‫كما‬
‫قبل‬ ‫من‬ ‫واالحصائية‬ ‫الوبائية‬ ‫المهارات‬ ‫الكتساب‬ ‫ماسة‬ ‫حاجة‬ ‫هناك‬ ‫انه‬ ‫ويعتقد‬ .‫لها‬ ‫المناسبة‬ ‫الحلول‬ ‫واقترحت‬ ‫البحوث‬ ‫بمنهجية‬
‫الطبية‬ ‫المواضيع‬ ‫في‬ ‫العاملين‬
‫السر‬
‫التعليم‬ ‫طريق‬ ‫عن‬ ‫واألساسية‬ ‫يرية‬
.‫المستمر‬
Introduction:
Research in the field of medicine is considered an important facet which contributes to the
improvement of the health status of the population. Health, in this context, should not only be
viewed as a desired outcome but also as an important resource for development. Priorities in
medical research have to be established in each country because of the limited funds and facilities
available to carry out such research. In developing countries, the establishment of such priorities
is even more critical considering the pattern of public health problems which are quite different
from the developed ones. In a recent Editorial)1)
the problems facing the choice of the system of
research to be adopted have been highlighted. Two types of research were considered, one based
on what has been called high cost technology and the other based on population surveys.

7. The MJBU, Vol 6, No.2: 1987
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In this paper, the results of a survey of medical journals published in Iraq are reported. The survey
was carried out to identify the current trend in medical research in this country and to highlight the
increasing tendency towards «population based surveys» type of research. The study was also
carried out to examine critically the soundness of the methodologies followed while conducting
such surveys. It is hoped that such a survey would help in suggesting some remedial measures
which could improve the validity and the utility of the results obtained from such research.
Materials and Methods:
The following journals were selected for the purpose of the study:
1- Journal of the Faculty of Medicine, Baghdad: the issues published during the period from 1984
to 1986 (inclusive) were examined.
2 -The Medical Journal of Basrah University: the issues published from 1979 to 1982 were
examined.
3- Iraqi Medical Journal: issues which came out in 1983, 1984 and 1985 were examined.
The articles published were considered original if the research results in the generation of new
information, for example obtaining data on morbidity or mortality of diseases in an area where
such data have not been available before. Research was not considered original if based on data
which were routinely recorded.
Results:
I. General findings:
The total number of articles reviewed in the three journals during the stated period were 234. Table
1 shows the distribution of these articles in the three journals, the number of original articles
published and the number of population based studies. There were 80 original articles out of which
30 were population surveys (38%); these were distributed as follows, 9 out of 23 (39%) in the
Journal of the Faculty of Medicine, 10 out of 20 (50%) in the Medical Journal of Basrah University
and 11 out of 37 (30%) in the Iraqi Medical Journal.

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II. Aims of the population surveys reported in the three Journals:
By reviewing these studies, it could be inferred that they were carried out for one or more of the
following purposes:
1- To determine the normal values of certain biological or medical characteristics in a set or a
subset of the Iraqi population. Eleven articles were published reporting work carried out in this
direction.
2-To measure the distribution of medical or biological phenomena (disease, smoking, pregnancy...
etc), (Fifteen articles).
3-To measure the distribution of certain abnormal constituents or characteristics in certain
population groups. Three articles were considered in this category.
4-To measure the impact of a programme on the health status of the population. One article only
was considered in this category.
III. Defects in methodology:
These can be grouped under three headings:
1- Measurement of indices different from what has been stated in the aim of the study. In three
articles, for example, the authors aimed at measuring the incidence while in actual facts they
measured the prevalence.
2-The target population is different from the reference population. The former is the population
from which the sample selected while the reference population is that to which the study results
should apply. In a methodologically sound the target population should be representative of the
reference population. A common limitation of the studies reviewed is that the authors were aiming
at measuring the frequency or distribution of a characteristic in normal Iraqi population while their
target population was based on a highly selected group with respect to their residence, age or even
on patients attending a hospital or an outpatient. For example, measurement of the incidence of
viral hepatitis in Iraqi population was carried out by testing sera collected from patients attending
special clinics. In another study the measurement of acid phosphatase in Iraqi population was based
on selecting uncontrolled patients attending Medical City in Baghdad.

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4
3- Defects in the selection of samples from the target population. These are mainly:
(a) The lack of sound criteria according to which random samples were selected. It is well known
that randomness is the only method by which one can ensure a representative sample. In only two
articles the rules by which the samples were selected, were clearly stated.
(b) In ALL BUT ONE article the method by which the sample size was determined, was
mentioned. It seems that the determination of the sample size was quite arbitrary in most of the
studies reviewed.
Discussion and conclusions
This survey is far from being comprehensive since articles published in foreign journals and
possibly few other non-medical Iraqi ones were not included. However, it is unlikely that their
inclusion would have altered the conclusions to be drawn from this survey for two reasons; first
such articles represent only minor fraction of the total articles published and second these articles
reflect a highly selected type of work which cannot provide a profile of pattern of research going
on in Iraq. The results reported in this paper have provided an insight into the current trend in
medical research carried out by Iraqi scientists and showed that a significant proportion of such
research was of the population based type of surveys. This is certainly a trend to be welcomed
since one can never overestimate the importance of such studies in providing a baseline data for
future studies, in assessing the effectiveness of health services or in evaluating a specific
intervention programme.
In developing countries, the balance between basic research, with its need for highly sophisticated
and expensive requirements, and applied research has to be rightly struck. WHO in its directives
and funding policies encourages applied and operational research in developing countries because
of its direct relevance to national health programmes2
. The utility of population surveys in this
respect could be greatly undermined if sound criteria for the design of the study or the choice of
the samples were not adhered to3,4
. This has been clearly shown in this study whereby defective
methodology had detracted from the validity and, thus, the applicability of the results of the
reported articles.

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5
In addition to the growing awareness of the importance of population surveys, it seems that many
workers in basic medical and clinical sciences resort to such surveys because of the lack of
facilities and equipment to carry out technically sophisticated research. However, they set up to
conduct applied research without being backed with the necessary skills required for such
endeavours. Corrective measures are urgently required and these include:
1- Workers planning to conduct population surveys should seek the advice of the statistician and
epidemiologist at the planning and implementation of the work and not only at the analysis stage
when it might be late.
2- Workers in basic and clinical research should develop a minimum level of skills which would
enable them to conduct population surveys regarding problem which they are interested in; the
role of continuing education through courses and seminars is very important in the acquisition of
such skills. Departments of Community Medicine can play a vital role in this context.
It is hoped that this paper would stimulate interest in, and create a concern about, some aspects of
medical research carried out in Iraq, and that it provided guidelines for corrective measures for
some problems which might undermine the value of such research.
Table 1
The distribution of published articles according to type of research in the three reviewed
Journals
Journal Total number of
articles
Number of Original
Papers
Number of
population surveys
Journal of Faculty of
Medicine
116 23 9
Medical Journal of
Basrah Univ
44 20 10
Iraqi Medical J 74 37 11
Total 234 80 30

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References:
1- Al-Dabagh, MA, Medical Research and Developing Countries (Editorial). The Journal of
Faculty of Medicine, Baghdad. 1986, 28, 7-9. Articles reviewed in this paper could be referred to
individually in the following Journals:
- Journal of Faculty of Medicine, Baghdad. 1982-186, Vols. 26-28.
-The Medical Journal of Basrah University. 1979-1982, Vols. 2-5.
Iraqi Medical Journal. 1983-1985. Vols. 31-33.
2- WHO, The silver anniversary of the advisory committee for medical research, WHO Chronicle
1984, 38, 11-24.
3 Cartwright A., Health Surveys in Practice and in Potential, King Edward's Hospital Fund for
London, London, 141-177.
4- Hill AB, A short textbook of medical statistics, Hodder & Stoughton, London., 13-21 and 254-
264.