Participation in international anaesthesia and intensive care meetings represent a unique possibility for exchanging new ideas in research, recent developments in technology and new therapeutic regimens. For active speakers and chairpersons it is also a strategy to maximize personal prestige and national reputations . Additionally, invited lecturers and chairpersons have a powerful position because they may significantly influence the direction of therapeutic strategies and developments. The countries of origin of invited speakers and chairpersons at five important European and four American anaesthesia and intensive care meetings were analysed for the years 1998 and 1999 (Table 1).
Two-thousand three-hundred and thirty-four invited lecturers and 805 chairpersons were found in European conferences. Invited speakers came from 34 different nations. Western Europe dominated the invited lecturers (77.2%), followed by North America (19.6%). Most invited lecturers originated from the USA (n = 386; 16.5%). The host country, especially at the ECA (Germany) often influenced the choice of chairperson. Western Europe had the highest number of chairpersons (n = 623; 77.4%); second was North America (n = 140; 17.4%). Smaller countries showed a higher number of chairpersons per million inhabitants than larger countries (e.g. Switzerland 7.0 per million inhabitants) (Table 2).
Two-thousand three-hundred and ninety-eight invited lecturers and 324 chairpersons were found in the USA meetings. 93.9% of the lecturers originated from the USA, only 2.7% came from Western Europe. 99.1% of chairpersons came from North America, while 0.9% were from Western Europe (Table 3). The quality of invited speakers/chairpersons appears to be substantial for non-active participants who paid their meeting fees and who can expect to meet extraordinary competent experts. These persons should be accepted experts who should have an exceptional reputation through their publications. Without doubt, science has become global, and also anaesthesia and critical care medicine are international medical fields. The question arises why some nations dominate invited speakers/chairpersons at European meetings and why at USA meetings nearly exclusively USA researchers were invited as speakers and chairpersons? Is there some inherent prejudice in the minds of some meeting's organizers about non-USA scientists? A study analysing the countries that publish in important anaesthesia/critical care journals revealed that although the USA is very active in publishing papers in this area, other nations are also very active (e.g. Finland, Sweden, Austria) . It may be assumed that excellent experts in different areas of anaesthesia/critical care medicine can be found in several countries.
The reasons why someone is invited as a speaker/chairperson to an international meeting are multifold and may include, apart from expertise, friendship and economic considerations. As a consequence, host countries prefer domestic speakers and chairpersons. Another important reason for under-representation of other countries at USA meetings may be language barriers (‘cultural bias’). However, researchers from UK as native-English speakers are found very seldom at USA meetings, although several publications in anaesthesia and intensive care medicine journals originated from the UK .
In conclusion, the USA was the nation that presented the highest number of speakers and chairpersons not only at meetings held in the USA but also in Europe. Small nations (e.g. Switzerland, Belgium) showed a higher representation as invited speakers/chairpersons per million inhabitants than larger nations. Enlarging the origin of invited speakers/chairpersons may broaden the spectrum of views on certain medical problems and fertilize the scientific exchange of information in the area of anaesthesia and intensive care medicine.
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