Major awards such as the Nobel Prize in Physiology or Medicine may help motivate successive generations of scientists and deepen public awareness and political support for research.1 However, little is known about how decisions of prize-giving bodies have changed as medical science has globalized and biotechnology accelerated. We examined temporal changes in demographics and time to recognition for researchers awarded a Nobel Prize in Physiology or Medicine.
We reviewed the official Nobel website2 to identify laureates from 1950 through 2015 and acquire demographic data and Nobel citations. The scientists were divided into remote and recent subgroups each spanning 33 years (1950-1982 and 1983-2015). Using Thomson Reuters Web of Science database,3 we developed an algorithm to identify the single year best representing the period when each laureate’s landmark publications appeared. Each laureate's 5 top-cited publications were identified. Review articles and those on topics not referenced by the Nobel citation were excluded. Landmark years were defined by publications with citation counts at least triple the next relevant article, or the median year of each laureate's 2 or 3 top-cited articles. When only one eligible article remained after exclusions, the next 5 top-cited publications were identified and the process was repeated. Only one laureate’s profile was not amenable to this analysis owing to a unique publication history.4
Microsoft Excel 2013 (version 15.0) and Statview (version 5.0) by SAS were used for statistical analyses. Temporal calculations were based on calendar years. Groups were compared with a 2-tailed t test (for continuous variables) or a 2-tailed Fisher exact test (for proportions) with a significance threshold of P < .05 and 95% confidence intervals calculated where relevant. Analyses of intergroup temporal differences were repeated using Kaplan-Meier methods and log-rank tests. Sensitivity analyses were undertaken by testing 10 other cut points for the remote and recent subgroups, ranging from 1977 to 1987 as ending the remote period.
The 154 identified laureates included 79 in the remote and 75 in the recent subgroups. Eleven were women, with significantly higher proportions more recently (10/75 [13%] vs 1/79 [1%]; P = .004); 91% (140/154) were born in the United States, United Kingdom, Europe, Australia, Canada, or New Zealand. Twelve of 14 (86%) born elsewhere received an MD, PhD, or postdoctoral training in North America, Europe, or Australia. Only 3 laureates, all recent, were associated primarily with Asian institutions.
The mean age of recent laureates was 7.6 years (95% CI, 4.1-11.1) older than remote laureates (63.0 vs 55.4 years; P < .001). Mean ages at time of landmark publications were not significantly different (45.3 vs 44.6 years; difference, 0.7 years [95% CI, −2.02 to 3.42]; P = .60), whereas the mean delay from landmark publications to Nobel recognition was 6.6 years longer (95% CI, 3.8-9.4) for recent vs remote laureates (17.4 vs 10.8 years; P < .001). These results were confirmed with log-rank tests (Figure 1 and Figure 2). With sensitivity analyses, no significant differences in mean ages at the time of landmark publications emerged; differences and P values ranged from 1.6 years (P = .26 for the remote subgroup ending in 1978) to 0.7 years (P = .64 for the remote subgroup ending in 1983). In contrast, differences in mean ages at the time of winning a Nobel Prize were significant (P < .001) across all cut points (ranging from 7.1 years for the remote subgroup ending in 1983 to 8.1 years for the remote subgroup ending in 1979).
Nobel laureates in medicine from 1950 through 2015 embodied a narrow range of demographic characteristics. Despite this consistency, significant differences were found in the mean age at which scientists in remote and recent eras became laureates. The delay was not explained by increasing delays before publication of relevant work.
These findings confirm other publications5,6 showing an aging of Nobel laureates in various disciplines, but differ in that this study did not find a lengthening of time to major discoveries.6 This difference may be due to reliance on an impartial citation analysis. None of the studies offers insight into causes of delayed recognition. However, judging a discovery to be Nobel-worthy in recent years may rely more heavily on the test of time, given the accelerating pace of medical research, the growing global population of scientists, and higher evidentiary standards before clinical translation occurs. Whatever the cause, these trends may slow the pace of geographic and gender diversification of Nobel laureates.
Corresponding Author: C. David Naylor, MD, DPhil, Department of Medicine, University of Toronto, c/o 4 Shorncliffe Ave, Toronto, Ontario, Canada M4V 1T1 (david.naylor@utoronto.ca).
Published Online: October 3, 2016. doi:10.1001/jama.2016.15702
Author Contributions: Dr Naylor and Mr Redelmeier had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design; acquisition, analysis, or interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; and statistical analysis: Both authors.
Administrative, technical, or material support: Redelmeier.
Conflict of Interest Disclosures: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.