The tragedy of unpublished dissertations in Bangladesh

A couple of weeks [before the time of this writing], my wife and I finished putting the final touches to a paper we’ve been working on. In the paper, we try to provide a coherent synthesis of all the Hepatitis B epidemiology research that has been conducted in Bangladesh (with certain qualifications, of course). This meant wading through 30+ years of research. The manuscript is still under review, and I plan to write more about our findings if and when it gets published- but pay that no mind for now, this is but a scaffold for the story I’m about to tell.

One of the high risk groups for Hepatitis B infection and transmission consists of healthcare personnel- more specifically, laboratory technicians who frequently handle Hepatitis B positive specimens and are in greater risk of hospital mishaps like needle-stick injuries. Unfortunately, our literature search yielded precious little data to derive concrete conclusions about the infection rate among this risk group in Bangladesh. However, my grad school supervisor (the manuscript was her idea) mentioned just such a project, conducted a few years ago, which would’ve filled this gap. She would know, she supervised it. Her team investigated infection rates among a group of hospital assistants involved specifically in the management of Hepatitis B patients. This particular group of hospital staff were chosen because of their sub-par biosafety practices. Background data on certain risk behaviors were also collected, which is significant, because it would allow us to infer correlations between Hepatitis B rates and particular risk behaviors prevalent among hospital personnel. This valuable study would be just the perfect addition to the risk group analysis we were conducting in our review article.

Of course, we weren’t be able to access the data, because it was never published.

I don’t know why unpublished studies- specifically, successful results from research projects that do not result in manuscripts, and are therefore not made available to commercial publishers- are called grey literature. Maybe because it contrasts with the black-and-white that we associate with the press. There’s something about this phenomenon that puzzled me for a while. These studies that get stuck in publication hell otherwise seem to tick all the right boxes- experiments were successful, data was appropriately curated and analyzed (in a university dissertation, say), and there are potential publishers, either local or global, who would accept ensuing manuscripts. Not to mention, often times they add significant value to the scientific enterprise, like the example I cited. But for a number of reasons, they aren’t brought into the circulation of scientific knowledge. One may appeal to the existence of databases dedicated to grey literature, but these databases, by their definition, are hard to navigate:

Auger used the term “grey literature” to describe . . . a “vast body of documents”, with “continuing increasing quantity”, that were characterized by the “difficulty it presents to the librarian” [Wiki]

In a large majority of cases, grey literatures may not have Scopus entries at all. In fact, institutions may not even archive the electronic copy of the research report.

A perfect example of this are graduate level dissertations, especially in a country like mine. For a project conducted by a research institute, there’s usually vested interest on part of the institute to get their study published- donors can withhold milestone payments if deliverables (almost always manuscripts or reports) are not forthcoming. That’s not the case with Masters dissertations in Bangladesh, at least not in microbiology or biological science in general. For these students, while there are rewards for publishing manuscripts- they are often less explicit, if not abstract. Manuscript publication isn’t a requirement for dissertations, only recommended; based on the fact that it serves to benefit the student’s scientific career down the line (when they’re applying for doctorate programs, say). So your motivation to publish would be a factor of a large number of variables: how motivated you are to pursue higher studies in the future, how important it is for you to get into a good school or program, how comfortable you are with scientific writing, how primed your dissertation is for a journal publication, and whether you can manage the heavy lifting of putting together a manuscript with a day job and/or married life in tow. It’s a complex utilitarian calculus of costs and benefits. Much less straightforward than the publish, or starve situation characteristic of research institutes.

Also, there are often more subtle reasons for not publishing. Students may think their research isn’t good enough to be accepted in any scientific journal with a peer review process to speak of. I was in this camp for quite a while. It was only after I actually took a week to revisit some of the old results that I realized there’s some measure of novelty in whatever modest dissertation I produced. Alternatively, students who get accepted to good programs right after graduation might not see the value in publishing what to them would seem like very mediocre pieces of research.

I’m not saying the students are wrong in any of these contexts, and I certainly wouldn’t know how to incentivize them to publish in such contexts. Really, I can’t speak to potential solutions to this problem any more than just acknowledging the tragedy.

I would really like to see some numbers on the proportion of graduate level research in Bangladesh that gets stuck in publication limbo this way (I’m willing to bet it’s at least 60%), and maybe even do a deeper survey to get a handle on the extent of scientific value that we’re losing every year.

In our discussion with my grad school supervisor, the healthcare worker study wasn’t the only one she brought up- there was also a much more recent study on Hepatitis B mutation profiles among cancer patients, a nearly unprecedented piece of research in Bangladesh in certain ways.

Fella got busy with life, and really, who am I to judge?

And no, I’m definitely not going to wrap this up by saying something pretentious (but only very tangentially relevant, if at all) like There, but for the grace of God, go I.