Table 1

Key issues identified with potential health research performance metrics

Indicator	Issues identified
Indicator	Conceptualisation	Measurement	Aggregation
Publications	It is unclear how or when publications capture meaningful collaborations versus tokenistic ones.		It is also unclear how to combine article with differing contributions (first, last or any author) to reflects goals of HR development.
Clinical trials	This biases attention to some forms of research (eg, clinical/epidemiological).	The metric cannot easily measure relevance to local needs.
Patents filed		Counts do not distinguish usefulness or quality.
Research institutions	Unclear what constitutes a relevant institution.	Quality hard to assess (in context).	Unclear how to weigh the value of large centres of excellence versus smaller institutions.
Research personnel	Lack of clarity on what constitutes research staff or how to include support elements.	Quality hard to assess.	Unclear how to combine different types of researchers into a single indicator.
Resources for HR	Unclear when or how domestic versus international funding matters to HR performance.	Lack of standard national budget lines to identify comparable spending.
Policies and regulations	Not clear what constitutes relevant policies, and these may be context-sensitive.	Actual impact or influence of policies and regulations hard to evaluate.	Unclear how to combine elements such as policies, supportive regulations and agencies into a single indicator.