In Russia, collaborating across boundaries to tackle the global scourge of diabetes

As a leading cardiovascular disease researcher, Prof. Zhanna Kobalava, MD, of RUDN University works with scientists – and students – from around the world

Kolalava quote

“You are what you eat.” – Victor Lindlahr, 1923

“You are what you write, and how much and where you write.” – Prof. Zhanna Kobalava, MD, 2019

With 35 years’ experience working in cardiology and internal medicine departments, Dr. Zhanna Kobalava of the People’s Friendship University (RUDN) in Moscow understands the value of collaboration. The myth of a single researcher making a breakthrough on their own is just that – a myth, she said, and in medical research, it’s more necessary than ever for institutions and even nations to collaborate to make an impact:

Authoritative medical products are always the result of the work of multinational multi-center teams consisting of scientists from dozens of countries and hundreds of laboratories. Nowadays, authoritative scientific achievements cannot be attributed to a single country, although some countries may stand out in terms of their scientific potential in certain areas.

Even when one country is perceived as a leader, Zhanna added, that reputation is built on international collaboration:

There are emerging topics around which teams of scientists are formed. As fellow of the European Society of Cardiology and member of the American Heart Association and American College of Cardiology, I work on joint projects with cardiologists, endocrinologists and nephrologists from Austria, Great Britain, Germany, Israel, Switzerland, the US, the UK, France and Denmark. Relationships with pharmacological companies that must ensure safety of their drugs are also important. Particular attention must be given to global educational programs aimed at working with the public.

Through her work across the medical profession, Zhanna has forged an interest in cardiovascular disease (CVD) and its relationship to diabetes.

While it’s known that some causes of each disease can be linked to a person’s diet, the classical idiom “You are what you eat” has become, for Zhanna, “You are what you write – and how much and where you write.”

As a new motivational statement, it reflects the dedication of one of Russia’s leading CVD researchers to the pursuit of scientific truth.

By educating students from more than 150 countries, RUDN University provides an excellent start for their scientific careers. As head of the department of internal diseases at RUDN University — where she was once a student — Zhanna is an active faculty member involved in the advanced training of medical professionals while splitting her time between teaching future cardiologists and conducting her research. She also heads up the department of internal diseases, which offers courses in cardiology and functional diagnostics for continuous medical education.

Doctors collaborating at the People’s Friendship University in Moscow (© RUDN University)

The impact of cardiovascular disease in Russia

As a growing public health problem across the world, CVD is the number one cause of death (and premature death) in Russia. Elsevier’s Scopus lists several studies highlighting the economic impact on Russia’s health systems; figures published in 2013 estimate the financial cost to be in the hundreds of billions in Russian rubles – equal to 2.8 percent of the Russian Federation’s gross domestic product.

In Russia, nearly 8.5 million people have diabetes, according to the International Diabetes Foundation. “Approximately every other patient with diabetes dies from cardiovascular diseases,” Zhanna said.

Providing the best patient care and treatment plans in the fight to combat CVD comes from the extensive medical literature on pre-existing diabetes cases. Which brings Zhanna’s motto – “You are what you write and how much you write” – to life each day she arrives to work at RUDN University, in southwestern Moscow.

Vladimir Filippov, PhD, Rector of the Peoples' Friendship University“Professor Kobalava's articles have received over 600 citations,” commented RUDN University Rector Dr. Vladimir Filippov.

“In sports, such stars become champions and record holders. Teams, coaching staff and traditions are formed around such leaders, he said. “In the university setting, such scientists set the bar for the research culture.”

Zhanna’s research is published in many highly-respected academic journals internationally, including Elsevier’s The Lancet. Highly cited scientists are the ones who become ambassadors of their universities in the international scientific arena, Vladimir explained:

Colleagues want to work on their teams, and scientific schools are formed in accordance with their work model; scientific knowledge becomes a global asset through their research and speeches, projects and collaborations with foreign partners.

Zhanna herself is quick to acknowledge the value of collaboration in the publication process:

It is impossible for a single author to get the author’s work published in top journals on cardiology or internal medicine. This requires continuous and disciplined work of an entire international team. The status and competences of each team member must be impeccable.

The importance of collaboration and mutual support extends to RUDN University and the role it plays in the international research community. “We introduce new countries to the world community,” Zhanna said. “For example, together with graduate students from Kazakhstan, we created a register for early detection of diabetes and for adequate diagnosis of heart failure in cardiac patients, which will significantly increase the odds of recovery. In September, a graduate student from the Republic of Chad successfully defended his thesis titled ‘Subclinical myocardial damage in young patients with type 1 diabetes.’”

Making sure research survives the “information storm”

With CVD being a leading cause of death and disability in many other countries as well, the volume of scientific literature to sift through is staggering: 3 million articles published in 2018 alone. That makes finding high quality information a challenge:

“We live in an information storm surrounded by a large amount of low-quality content, and rating of journals by the level of the review process is extremely important,” Zhanna said, referring to RUDN Univeristy’s practice of monitoring journal rankings using tools like Scopus.

“Each work should be published in the best possible journal,” she added, and we know which journal to target for each particular work. We specifically monitor journal ratings and have our own blacklist of journals.

“From our perspective, publishing works in such journals can harm an author’s professional reputation, because this would suggest that the author is not competent.”

While Zhanna’s work and the approach of the RUDN University is characterized by collaboration and a rigorous emphasis on expertise, there is still room for improvement, as interdisciplinary support needs to extend beyond research into other professions.

“We practitioner scientists do not receive enough support from medical writers, translators, editors, and statistical planning specialists,” she said. “We have a lot of quality material but often not enough technical support.

“For example, despite the urgency of the problem (initial results of the clinical use of an innovative drug in patients with heart failure), it took us two years to prepare our article for publishing in the British Medical Journal. A significant amount of time was spent on diplomatic correspondence with reviewers, and not every scientist possesses proper communication skills. The success of an article in a Q1 journal depends on the teamwork of various professionals – not only doctors, but also writers, and even mathematicians.”

The idea that collaboration and cooperation extend beyond national borders when the scientific method is at-play was expressed more than a century ago by the great Russian playwright (and physician) Anton Chekhov in his Note-Book:

There is no national science just as there is no national multiplication table; what is national is no longer science.

In that vein, Zhanna’s specialty of establishing the connection between CVD and diabetes – and her practice of bringing in international expertise – has positioned her as a leading clinical, health and cardiology expert not only in Russia but the world.

Author interview and translation contributed by Yana Revyakina.

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