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Research in the Teaching of English ( RTE ) is a broad-based, multidisciplinary journal composed of original research articles and short scholarly essays on a wide range of topics significant to those concerned with the teaching and learning of languages and literacies around the world, both in and beyond schools and universities.

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Alfredo Artiles, Stanford University; Yona Asfaha, University of Asmara; April Baker-Bell, Michigan State University; Faythe Beauchemin, University of Arkansas; Pietro Boscolo, University of Padova; Maria Botelho, University of Massachusetts, Amherst; Maureen Boyd, University at Buffalo; Ayanna Brown, Elmhurst College; David Bwire, College of New Jersey; Blanca Caldas Chumbes, University of Minnesota; Gerald Campano, University of Pennsylvania; Antonia Candela, Centro de Investigación y Estudios Avanzados; Angela Cannon, Bloomington, IN; Limarys Caraballo, Teachers College, Columbia University; Lucia Cardenas, Michigan State University; Thandeka Chapman, University of California, San Diego; Caroline Clark, The Ohio State University; Catherine Compton-Lilly, University of South Carolina; Jamal Cooks, San Francisco State University; Marcus Croom, Indiana University; Denise Dávila, University of Texas at Austin; Adrienne Dixson, University of Illinois, Urbana-Champaign; Leah Durán, University of Arizona; Elizabeth Dutro, University of Colorado, Boulder; Brian Edmiston, The Ohio State University; Patricia Enciso, The Ohio State University; Jeanne Fain, Lipscomb University; Tiffany Flowers, Georgia State University; Brittany Frieson Davis, University of North Texas; Danling Fu, University of Florida; Antero Godina Garcia, Stanford University; James Paul Gee, Arizona State University; Alexandra Georgakopolou, Kings College London; María Paula Ghiso, Teachers College, Columbia University; Susan Goldman, University of Illinois, Chicago; Millie Gort, University of Colorado, Boulder; Steven Graham, Vanderbilt University; Judith Green, University of California, Santa Barbara; David Green, Jr., Howard University; Lydia Haff, Hawaii; Troy Hicks, Central Michigan University; Jim Hoffman, University of North Texas; Huili Hong, Vanderbilt University ; Ana Christina Iddings Da Silva, Vanderbilt University; Vanessa Irvin, University of Hawaii; Hilary Janks, University of Witwatersrand; Korina Jocson, University of Massachusetts Amherst; Lamar Johnson, Michigan State; Latrise Johnson, University of Alabama; Miriam Jorge, University of Missouri-St. Louis; Judith Kalman, Centro de Investigación y Estudios Avanzados; Minjeong Kim, University of Massachusetts, Lowell; Lydiah Kiramba, University of Nebraska; Kafi Kumasi, Wayne State University; Wan Shun Eva Lam, Northwestern University; Kevin Leander, Vanderbilt University; Adam Leftstein, Ben Gurion University of the Negev; Constant Leung, Kings College London; Sarah Levine, Stanford University; Cynthia Lewis, University of California, Santa Cruz; Diana Liu, Columbia University; David Low, California State University, Fresno; Ruth Lowery, University of North Texas; Lian Madsen, University of Copenhagen; Joanne Marciano, Michigan State University; Danny Martinez, University of California, Davis; Ramón Martínez, Stanford University; Wayne Martino, Western University; Stephen May, The University of Auckland; Byeonggon Min, Seoul National University; Nicole Mirra, Rutgers University; Karla Möller, University of Illinois, Urbana-Champaign; Briana Morales, St. Louis, MO; Ernest Morrell, Notre Dame University; Luz Murillo, Texas State University; Vanesa Neves, Universidade Federal de Minas Gerais; George Newell, The Ohio State University; Sue Nichols, University of South Australia; Carmen Helena Guerrero-Nieto, Universidad Distrital Francisco José de Caldas ; Silvia Nogueron-Liu, University of Colorado, Boulder; Allison Wynhoff Olsen, Montana State University; Mariana Pacheco, University of Wisconsin; Kate Pahl, Sheffield University; Deborah Palmer, University of Colorado, Boulder; Uta Papen, Lancaster University; Jenell Igeleke Penn, The Ohio State University; Tonya Perry, University of Alabama, Birmingham; Grace Player, University of Connecticut; David Poveda, Universidad Autónoma de Madrid; Detra Price-Dennis, Columbia University; Ben Rampton, Kings College London; Timothy Rasinski, Kent State University; Iliana Reyes, University of Arizona; Ryan Rish, State University of New York, Buffalo; Rebecca Rogers, University of Missouri St Louis; Deborah Rowe, Vanderbilt University; Jennifer Rowsell, University of Bristol; Lee Rutherford, Westerville, Ohio; Ryan Schey, University of Georgia; Yolanda Sealey-Ruiz, Columbia University; Audra Skukauskaite, University of Central Florida;  Peter Smagorinsky, University of Georgia; Mandy Smith, Columbus, Ohio; Julia Snell, University of Leeds; Tamara Spencer, St. Mary’s College; Massimiliano Spotti, Tilburg University; Laura Sterponi, University of California, Berkeley; Amy Stornaiuolo, University of Pennsylvania; Laura Taylor, Rhodes College; Ebony Elizabeth Thomas, University of Michigan; K.C. 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English dominates scientific research – here’s how we can fix it, and why it matters

Científica del Instituto de Lengua, Literatura y Antropología (ILLA), del Centro de Ciencias Humanas y Sociales (CCHS) del Consejo Superior de Investigaciones Científicas (CSIC), Centro de Ciencias Humanas y Sociales (CCHS - CSIC)

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Elea Giménez Toledo does not receive a salary, nor does she own shares, nor does she receive funding from any company or organisation that might benefit from this article. She is a commissioner of the SEGIB, which implies only unpaid scientific advice to this institution, as part of the scientific activity carried out at the CSIC.

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It is often remarked that Spanish should be more widely spoken or understood in the scientific community given its number of speakers around the world, a figure the Instituto Cervantes places at almost 600 million .

However, millions of speakers do not necessarily grant a language strength in academia. This has to be cultivated on a scientific, political and cultural level, with sustained efforts from many institutions and specialists.

The scientific community should communicate in as many languages as possible

By some estimates, as much as 98% of the world’s scientific research is published in English , while only around 18% of the world’s population speaks it. This makes it essential to publish in other languages if we are to bring scientific research to society at large.

The value of multilingualism in science has been highlighted by numerous high profile organisations, with public declarations and statements on the matter from the European Charter for Researchers , the Helsinki Initiative on Multiligualism , the Unesco Recommendation on Open Science , the OPERAS Multiligualism White Paper , the Latin American Forum on Research Assessment , the COARA Agreement on Reforming Research Assessment , and the Declaration of the 5th Meeting of Minsters and Scientific Authorities of Ibero-American Countries . These organisations all agree on one thing: all languages have value in scientific communication .

As the last of these declarations points out, locally, regionally and nationally relevant research is constantly being published in languages other than English. This research has an economic, social and cultural impact on its surrounding environment, as when scientific knowledge is disseminated it filters through to non-academic professionals, thus creating a broader culture of knowledge sharing.

Greater diversity also enables fluid dialogue among academics who share the same language, or who speak and understand multiple languages. In Ibero-America, for example, Spanish and Portuguese can often be mutually understood by non-native speakers, allowing them to share the scientific stage. The same happens in Spain with the majority of its co-official languages .

Read more: Non-native English speaking scientists work much harder just to keep up, global research reveals

No hierarchies, no categories

Too often, scientific research in any language other than English is automatically seen as second tier, with little consideration for the quality of the work itself.

This harmful prejudice ignores the work of those involved, especially in the humanities and social sciences. It also profoundly undermines the global academic community’s ability to share knowledge with society.

By defending and preserving multilingualism, the scientific community brings research closer to those who need it. Failing to pursue this aim means that academia cannot develop or expand its audience. We have to work carefully, systematically and consistently in every language available to us.

Read more: Prestigious journals make it hard for scientists who don't speak English to get published. And we all lose out

The logistics of strengthening linguistic diversity in science

Making a language stronger in academia is a complex process. It does not happen spontaneously, and requires careful coordination and planning. Efforts have to come from public and private institutions, the media, and other cultural outlets, as well as from politicians, science diplomacy , and researchers themselves.

Many of these elements have to work in harmony, as demonstrated by the Spanish National Research Council’s work in ES CIENCIA , a project which seeks to unite scientific and and political efforts.

Academic publishing and AI models: a new challenge

The global academic environment is changing as a result the digital transition and new models of open access. Research into publishers of scientific content in other languages will be essential to understanding this shift. One thing is clear though: making scientific content produced in a particular language visible and searchable online is crucial to ensuring its strength.

In the case of academic books, the transition to open access has barely begun , especially in the commercial publishing sector, which releases around 80% of scientific books in Spain. As with online publishing, a clear understanding will make it possible to design policies and models that account for the different ways of disseminating scientific research, including those that communicate locally and in other languages. Greater linguistic diversity in book publishing can also allow us to properly recognise the work done by publishers in sharing research among non-English speakers.

Read more: Removing author fees can help open access journals make research available to everyone

Making publications, datasets, and other non-linguistic research results easy to find is another vital element, which requires both scientific and technical support. The same applies to expanding the corpus of scientific literature in Spanish and other languages, especially since this feeds into generative artificial intelligence models.

If linguistically diverse scientific content is not incorporated into AI systems, they will spread information that is incomplete, biased or misleading: a recent Spanish government report on the state of Spanish and co-official languages points out that 90% of the text currently fed into AI is written in English.

Deep study of terminology is essential

Research into terminology is of the utmost importance in preventing the use of improvised, imprecise language or unintelligible jargon. It can also bring huge benefits for the quality of both human and machine translations, specialised language teaching, and the indexing and organisation of large volumes of documents.

Terminology work in Spanish is being carried out today thanks to the processing of large language corpuses by AI and researchers in the TeresIA project, a joint effort coordinated by the Spanish National Research Council. However, 15 years of ups and downs were needed to to get such a project off the ground in Spanish.

The Basque Country, Catalonia and Galicia, on the other hand, have worked intensively and systematically on their respective languages. They have not only tackled terminology as a public language policy issue, but have also been committed to established terminology projects for a long time.

Multiligualism is a global issue

This need for broader diversity also applies to Ibero-America as a whole, where efforts are being coordinated to promote Spanish and Portuguese in academia, notably by the Ibero-American General Secretariat and the Mexican National Council of Humanities, Sciences and Technologies .

While this is sorely needed, we cannot promote the region’s two most widely spoken languages and also ignore its diversity of indigenous and co-official languages. These are also involved in the production of knowledge, and are a vehicle for the transfer of scientific information, as demonstrated by efforts in Spain.

Each country has its own unique role to play in promoting greater linguistic diversity in scientific communication. If this can be achieved, the strength of Iberian languages – and all languages, for that matter – in academia will not be at the mercy of well intentioned but sporadic efforts. It will, instead, be the result of the scientific community’s commitment to a culture of knowledge sharing.

This article was originally published in Spanish

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• Systematic Review
• Open access
• Published: 26 April 2024

Systematic review on the frequency and quality of reporting patient and public involvement in patient safety research

• Sahar Hammoud   ORCID: orcid.org/0000-0003-4682-9001 1 ,
• Laith Alsabek 1 , 2 ,
• Lisa Rogers 1 &
• Eilish McAuliffe 1  

BMC Health Services Research volume  24 , Article number:  532 ( 2024 ) Cite this article

212 Accesses

Metrics details

In recent years, patient and public involvement (PPI) in research has significantly increased; however, the reporting of PPI remains poor. The Guidance for Reporting Involvement of Patients and the Public (GRIPP2) was developed to enhance the quality and consistency of PPI reporting. The objective of this systematic review is to identify the frequency and quality of PPI reporting in patient safety (PS) research using the GRIPP2 checklist.

Searches were performed in Ovid MEDLINE, EMBASE, PsycINFO, and CINAHL from 2018 to December, 2023. Studies on PPI in PS research were included. We included empirical qualitative, quantitative, mixed methods, and case studies. Only articles published in peer-reviewed journals in English were included. The quality of PPI reporting was assessed using the short form of the (GRIPP2-SF) checklist.

A total of 8561 studies were retrieved from database searches, updates, and reference checks, of which 82 met the eligibility criteria and were included in this review. Major PS topics were related to medication safety, general PS, and fall prevention. Patient representatives, advocates, patient advisory groups, patients, service users, and health consumers were the most involved. The main involvement across the studies was in commenting on or developing research materials. Only 6.1% ( n  = 5) of the studies reported PPI as per the GRIPP2 checklist. Regarding the quality of reporting following the GRIPP2-SF criteria, our findings show sub-optimal reporting mainly due to failures in: critically reflecting on PPI in the study; reporting the aim of PPI in the study; and reporting the extent to which PPI influenced the study overall.

Conclusions

Our review shows a low frequency of PPI reporting in PS research using the GRIPP2 checklist. Furthermore, it reveals a sub-optimal quality in PPI reporting following GRIPP2-SF items. Researchers, funders, publishers, and journals need to promote consistent and transparent PPI reporting following internationally developed reporting guidelines such as the GRIPP2. Evidence-based guidelines for reporting PPI should be encouraged and supported as it helps future researchers to plan and report PPI more effectively.

Trial registration

The review protocol is registered with PROSPERO (CRD42023450715).

Peer Review reports

Patient safety (PS) is defined as “the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum” [ 1 ]. It is estimated that one in 10 patients are harmed in healthcare settings due to unsafe care, resulting in over three million deaths annually [ 2 ]. More than 50% of adverse events are preventable, and half of these events are related to medications [ 3 , 4 ]. There are various types of adverse events that patients can experience such as medication errors, patient falls, healthcare-associated infections, diagnostic errors, pressure ulcers, unsafe surgical procedures, patient misidentification, and others [ 1 ].

Over the last few decades, the approach of PS management has shifted toward actively involving patients and their families in managing PS. This innovative approach has surpassed the traditional model where healthcare providers were the sole managers of PS [ 5 ]. Recent research has shown that patients have a vital role in promoting their safety and decreasing the occurrence of adverse events [ 6 ]. Hence, there is a growing recognition of patient and family involvement as a promising method to enhance PS [ 7 ]. This approach includes involving patients in PS policy development, research, and shared decision making [ 1 ].

In the last decade, research involving patients and the public has significantly increased. In the United Kingdom (U.K), the National Institute for Health Research (NIHR) has played a critical role in providing strategic and infrastructure support to integrate Public and Patient Involvement (PPI) throughout publicly funded research [ 8 ]. This has established a context where PPI is recognised as an essential element in research [ 9 ]. In Ireland, the national government agency responsible for the management and delivery of all public health and social services; the National Health Service Executive (HSE) emphasise the importance of PPI in research and provide guidance for researchers on how to involve patients and public in all parts of the research cycle and knowledge translation process [ 10 ]. Similar initiatives are also developing among other European countries, North America, and Australia. However, despite this significant expansion of PPI research, the reporting of PPI in research articles continues to be sub-optimal, inconsistent, and lacks essential information on the context, process, and impact of PPI [ 9 ]. To address this problem, the Guidance for Reporting Involvement of Patients and the Public (GRIPP) was developed in 2011 following the EQUATOR methodology to enhance the quality, consistency, and transparency of PPI reporting. Additionally, to provide guidance for researchers, patients, and the public to advance the quality of the international PPI evidence-base [ 11 ]. The first GRIPP checklist was a significant start in producing higher-quality PPI reporting; however, it was developed following a systematic review, and did not include any input from the international PPI research community. Given the importance of reaching consensus in generating current reporting guidelines, a second version of the GRIPP checklist (GRIPP2) was developed to tackle this problem by involving the international PPI community in its development [ 9 ]. There are two versions of the GRIPP2 checklist, a long form (GRIPP2-LF) for studies with PPI as the primary focus, and a short form (GRIPP2-SF) for studies with PPI as secondary or tertiary focus.

Since the publication of the GRIPP2 checklist, several systematic reviews have been conducted to assess the quality of PPI reporting on various topics. For instance, Bergin et al. in their review to investigate the nature and impact of PPI in cancer research, reported a sub-optimal quality of PPI reporting using the GRIPP2-SF, mainly due to failure to address PPI challenges [ 12 ]. Similarly, Owyang et al. in their systematic review to assess the prevalence, extent, and quality of PPI in orthopaedic practice, described a poor PPI reporting following the GRIPP2-SF checklist criteria [ 13 ]. While a few systematic reviews have been conducted to assess theories, strategies, types of interventions, and barriers and enablers of PPI in PS [ 5 , 14 , 15 , 16 ], no previous review has assessed the quality of PPI reporting in PS research. Thus, our systematic review aims to address this knowledge gap. The objective of this review is to identify the frequency PPI reporting in PS research using the GRIPP2 checklist from 2018 (the year after GRIPP2 was published) and the quality of reporting following the GRIPP2-SF. The GRIPP2 checklist was chosen as the benchmark as it is the first international, evidence-based, community consensus informed guideline for the reporting of PPI in research and more specifically in health and social care research [ 9 ]. Additionally, it is the most recent report-focused framework and the most recommended by several leading journals [ 17 ].

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to plan and report this review [ 18 ]. The review protocol was published on PROSPERO the International Database of Prospectively Registered Systematic Reviews in August 2023 (CRD42023450715).

Search strategy

For this review, we used the PICo framework to define the key elements in our research. These included articles on patients and public (P-Population) involvement (I- phenomenon of Interest) in PS (C-context). Details are presented in Table  1 . Four databases were searched including Ovid MEDLINE, EMBASE, PsycINFO, and CINAHL to identify papers on PPI in PS research. A systematic search strategy was initially developed using MEDLINE. MeSH terms and keywords relevant to specific categories (e.g., patient safety) were combined using the “OR” Boolean term (i.e. patient safety OR adverse event OR medical error OR surgical error) and categories were then combined using the “AND” Boolean term. (i.e. “patient and public involvement” AND “patient safety”). The search strategy was adapted for the other three databases. Full search strategies are provided in Supplementary file 1 . The search was conducted on July 27th, 2023, and was limited to papers published from 2018. As the GRIPP2 tool was published in 2017, this limit ensured the retrieval of relevant studies. An alert system was set on the four databases to receive all new published studies until December 2023, prior to the final analysis. The search was conducted without restrictions on study type, research design, and language. To reduce selection bias, hand searching was carried out on the reference lists of all the eligible articles in the later stages of the review. This was done by the first author. The search strategy was developed by the first author and confirmed by the research team and a Librarian. The database search was conducted by the first author.

Inclusion and exclusion criteria

Studies on PPI in PS research with a focus on health/healthcare were included in this review. We defined PPI as active involvement which is in line with the NIHR INVOLVE definition as “research being carried out ‘with’ or ‘by’ members of the public rather than ‘to’, ‘about’ or ‘for’ them” [ 19 ]. This includes any PPI including, being a co-applicant on a research project or grant application, identifying research priorities, being a member of an advisory or steering group, participating in developing research materials or giving feedback on them, conducting interviews with study participants, participating in recruitment, data collection, data analysis, drafting manuscripts and/or dissemination of results. Accordingly, we excluded studies where patients or the public were only involved as research participants.

We defined patients and public to include patients, relatives, carers, caregivers and community, which is also in line with the NIHR PPI involvement in National Health Service [ 19 ].

Patient safety included topics on medication safety, adverse events, communication, safety culture, diagnostic errors, and others. A full list of the used terms for PPI and PS is provided in Supplementary file 1 . Regarding the research type and design, we included empirical qualitative, quantitative, mixed methods, and case studies. Only articles published in peer-reviewed journals and in English were included.

Any article that did not meet the inclusion criteria was excluded. Studies not reporting outcomes were excluded. Furthermore, review papers, conference abstracts, letters to editor, commentary, viewpoints, and short communications were excluded. Finally, papers published prior to 2018 were excluded.

Study selection

The selection of eligible studies was done by the first and the second authors independently, starting with title and abstracts screening to eliminate papers that failed to meet our inclusion criteria. Then, full text screening was conducted to decide on the final included papers in this review. Covidence, an online data management system supported the review process, ensuring reviewers were blinded to each other’s decisions. Disagreements between reviewers were discussed first, in cases where the disagreement was not resolved, the fourth author was consulted.

Data extraction and analysis

A data extraction sheet was developed using excel then piloted, discussed with the research team and modified as appropriate. The following data were extracted: citation and year of publication, objective of the study, country, PS topic, design, setting, PPI participants, PPI stages (identifying research priorities, being a member of an advisory or steering group, etc.…), frequency of PPI reporting as per the GRIPP2 checklist, and the availability of a plain language summary. Additionally, data against the five items of GRIPP2-SF (aim of PPI in the study, methods used for PPI, outcomes of PPI including the results and the extent to which PPI influenced the study overall, and reflections on PPI) were extracted. To avoid multiple publication bias and missing outcomes, data extraction was done by the first and the second authors independently and then compared. Disagreements between reviewers were first discussed, and then resolved by the third and fourth authors if needed.

Quality assessment

The quality of PPI reporting was assessed using GRIPP2-SF developed by Staniszewska et al. [ 9 ] as it is developed to improve the quality, consistency, and reporting of PPI in social and healthcare research. Additionally the GRIPP2-SF is suitable for all studies regardless of whether PPI is the primary, secondary, or tertiary focus, whereas the GRIPP2-LF is not suitable for studies where PPI serves as a secondary or tertiary focus. The checklist includes five items (mentioned above) that authors should include in their studies. It is important to mention that Staniszewska et al. noted that “while GRIPP2-SF aims to guide consistent reporting, it is not possible to be prescriptive about the exact content of each item, as the current evidence-base is not advanced enough to make this possible” ([ 9 ] p5). For that reason, we had to develop criteria for scoring the five reporting items. We used three scoring as Yes, No, and partial for each of the five items of the GRIPP2-SF. Yes, was given when authors presented PPI information on the item clearly in the paper. No, when no information was provided, and partial when the information partially met the item requirement. For example, as per GRIPP2-SF authors should provide a clear description of the methods used for PPI in the study. In the example given by Staniszewska et al., information on patient/public partners and how many of them were provided, as well as the stages of the study they were involved in (i.e. refining the focus of the research questions, developing the search strategy, interpreting results). Thus, in our evaluation of the included studies, we gave a yes if information on PPI participants (i.e. patient partners, community partners, or family members etc..) and how many of them were involved was provided, and information on the stages or actions of their involvement in the study was provided. However, we gave a “partial” if information was not fully provided (i.e. information on patient/public partners and how many were involved in the study without describing in what stages or actions they were involved, and vice versa), and a “No” if no information was presented at all.

The quality of PPI reporting was done by the first and the second authors independently and then compared. Disagreements between reviewers were first discussed, and then resolved by the third and fourth author when needed.

Assessing the quality or risk of bias of the included studies was omitted, as the focus in this review was on appraising the quality of PPI reporting rather than assessing the quality of each research article.

Data synthesis

After data extraction, a table summarising the included studies was developed. Studies were compared according to the main outcomes of the review; frequency of PPI reporting following the GRIPP2 checklist and the quality of reporting as per GRIPP2-SF five items, and the availability of a plain language summary.

Search results and study selection

The database searches yielded a total of 8491 studies. First, 2496 were removed as duplicates. Then, after title and abstract screening, 5785 articles were excluded leaving 210 articles eligible for the full text review. After a careful examination, 68 of these studies were included in this review. A further 38 studies were identified from the alert system that was set on the four databases and 32 studies from the reference check of the included studies. Of these 70 articles, 56 were further excluded and 14 were added to the previous 68 included studies. Thus, 82 studies met the inclusion criteria and were included in this review. A summary of the database search results and the study selection process are presented in Fig.  1 .

PRISMA flow diagram of the study selection process. The PRISMA flow diagram details the review search results and selection process

Overview of included studies

Details of the study characteristics including first author and year of publication, objective, country, study design, setting, PS topic, PPI participants and involvement stages are presented in Supplementary file 2 . The majority of the studies were conducted in the U.K ( n  = 24) and the United States of America ( n  = 18), with the remaining 39 conducted in other high income countries, the exception being one study in Haiti. A range of study designs were identified, the most common being qualitative ( n  = 31), mixed methods ( n  = 13), interventional ( n  = 5), and quality improvement projects ( n  = 4). Most PS topics concerned medication safety ( n  = 17), PS in general (e.g., developing a PS survey or PS management application) ( n  = 14), fall prevention ( n  = 13), communication ( n  = 11), and adverse events ( n  = 10), with the remaining PS topics listed in Supplementary file 2 .

Patient representatives, advocates, and patient advisory groups ( n  = 33) and patients, service users, and health consumers ( n  = 32) were the main groups involved. The remaining, included community members/ organisations. Concerning PPI stages, the main involvement across the studies was in commenting on or developing research materials ( n  = 74) including, patient leaflets, interventional tools, mobile applications, and survey instruments. Following this stage, involvement in data analysis, drafting manuscripts, and disseminating results ( n  = 30), and being a member of a project advisory or steering group ( n  = 18) were the most common PPI evident in included studies. Whereas the least involvement was in identifying research priorities ( n  = 5), and being a co-applicant on a research project or grant application ( n  = 6).

Regarding plain language summary, only one out of the 82 studies (1.22%) provided a plain language summary in their paper [ 20 ].

Frequency and quality of PPI reporting

The frequency of PPI reporting following the GRIPP2 checklist was 6.1%, where only five of the 82 included studies reported PPI in their papers following the GRIPP2 checklist. The quality of PPI reporting in those studies is presented in Table  2 . Of these five studies, one study (20%) did not report the aim of PPI in the study and one (20%) did not comment on the extent to which PPI influenced the study overall.

The quality of PPI reporting of the remaining 77 studies is presented in Table  3 . The aim of PPI in the study was reported in 62.3% of articles ( n  = 48), while 3.9% ( n  = 3) partially reported this. A clear description of the methods used for PPI in the study was reported in 79.2% of papers ( n  = 61) and partially in 20.8% ( n  = 16). Concerning the outcomes, 81.8% of papers ( n  = 63) reported the results of PPI in the study, while 10.4% ( n  = 8) partially did. Of the 77 studies, 68.8% ( n  = 53) reported the extent to which PPI influenced the study overall and 3.9% ( n  = 3) partially reported this. Finally, 57.1% ( n  = 44) of papers critically reflected on the things that went well and those that did not and 2.6% ( n  = 2) partially reflected on this.

Summary of main findings

This systematic review assessed the frequency of reporting PPI in PS research using the GRIPP2 checklist and quality of reporting using the GRIPP2-SF. In total, 82 studies were included in this review. Major PS topics were related to medication safety, general PS, and fall prevention. Patient representatives, advocates, patient advisory groups, patients, service users, and health consumers were the most involved. The main involvement across the studies was in commenting on or developing research materials such as educational and interventional tools, survey instruments, and applications while the least was in identifying research priorities and being a co-applicant on a research project or grant application. Thus, significant effort is still needed to involve patients and the public in the earlier stages of the research process given the fundamental impact of PS on their lives.

Overall completeness and applicability of evidence

A low frequency of reporting PPI in PS research following the GRIPP2 guidelines was revealed in this review, where only five of the 82 studies included mentioned that PPI was reported as per the GRIPP2 checklist. This is despite it being the most recent report-focused framework and the most recommended by several leading journals [ 17 ]. This was not surprising as similar results were reported in recent reviews in other healthcare topics. For instance, Musbahi et al. in their systematic review on PPI reporting in bariatric research reported that none of the 90 papers identified in their review mentioned or utilised the GRIPP2 checklist [ 102 ]. Similarly, a study on PPI in orthodontic research found that none of the 363 included articles reported PPI against the GRIPP2 checklist [ 103 ].

In relation to the quality of reporting following the GRIPP2-SF criteria, our findings show sub-optimal reporting within the 77 studies that did not use GRIPP2 as a guide/checklist to report their PPI. Similarly, Bergin et al. in their systematic review to investigate the nature and impact of PPI in cancer research concluded that substandard reporting was evident [ 12 ]. In our review, this was mainly due to failure to meet three criteria. First, the lowest percentage of reporting (57.1%, n  = 44) was related to critical reflection on PPI in the study (i.e., what went well and what did not). In total, 31 studies (42.9%) did not provide any information on this, and two studies were scored as partial. The first study mentioned that only involving one patient was a limitation [ 27 ] and the other stated that including three patients in the design of the tool was a strength [ 83 ]. Both studies did not critically comment or reflect on these points so that future researchers are able to avoid such problems and enhance PPI opportunities. For instance, providing the reasons/challenges behind the exclusive inclusion of a single patient and explaining how this limits the study findings and conclusion would help future researchers to address these challenges. Likewise, commenting on why incorporating three patients in the design of the study tool could be seen as a strength would have been beneficial. This could be, fostering diverse perspectives and generating novel ideas for developing the tool. Similar to our findings, Bergin et al. in their systematic review reported that 40% of the studies failed to meet this criterion [ 12 ].

Second, only 48 out of 77 articles (62.3%) reported the aim of PPI in their study, which is unlike the results of Bergin et al. where most of the studies (93.1%) in their review met this criterion [ 12 ]. Of the 29 studies which did not meet this criterion in our review, few mentioned in their objective developing a consensus-based instrument [ 41 ], reaching a consensus on the patient-reported outcomes [ 32 ], obtaining international consensus on a set of core outcome measures [ 98 ], and facilitating a multi-stakeholder dialogue [ 71 ] yet, without indicating anything in relation to patients, patient representatives, community members, or any other PPI participants. Thus, the lack of reporting the aim of PPI was clearly evident in this review. Reporting the aim of PPI in the study is crucial for promoting transparency, methodological rigor, reproducibility, and impact assessment of the PPI.

Third, 68.8% ( n  = 53) of the studies reported the extent to which PPI influenced the study overall including positive and negative effects if any. This was again similar to the findings of Bergin et al., where 38% of the studies did not meet this criterion mainly due to a failure to address PPI challenges in their respective studies [ 12 ]. Additionally, Owyang et al. in their review on the extent, and quality of PPI in orthopaedic practice, also described a poor reporting of PPI impact on research [ 13 ]. As per the GRIPP2 guidelines, both positive and negative effects of PPI on the study should be reported when applicable. Providing such information is essential as it enhances future research on PPI in terms of both practice and reporting.

Reporting a clear description of the methods used for PPI in the study was acceptable, with 79.2% of the papers meeting this criterion. Most studies provided information in the methods section of their papers on the PPI participants, their number, stages of their involvement and how they were involved. Providing clear information on the methods used for PPI is vital to give the reader a clear understanding of the steps taken to involve patients, and for other researchers to replicate these methods in future research. Additionally, reporting the results of PPI in the study was also acceptable with 81.8% of the papers reporting the outcomes of PPI in the results section. Reporting the results of PPI is important for enhancing methodological transparency, providing a more accurate interpretation for the study findings, contributing to the overall accountability and credibility of the research, and informing decision making.

Out of the 82 studies included in this review, only one study provided a plain language summary. We understand that PS research or health and medical research in general is difficult for patients and the public to understand given their diverse health literacy and educational backgrounds. However, if we expect patients and the public to be involved in research then, it is crucial to translate this research that has a huge impact on their lives into an easily accessible format. Failing to translate the benefits that such research may have on patient and public lives may result in them underestimating the value of this research and losing interest in being involved in the planning or implementation of future research [ 103 ]. Thus, providing a plain language summary for research is one way to tackle this problem. To our knowledge, only a few health and social care journals (i.e. Cochrane and BMC Research Involvement and Engagement) necessitate a plain language summary as a submission requirement. Having this as a requirement for submission is crucial in bringing the importance of this issue to researchers’ attention.

Research from recent years suggests that poor PPI reporting in articles relates to a lack of submission requirements for PPI reporting in journals and difficulties with word limits for submitted manuscripts [ 13 ]. Price et al. assessed the frequency of PPI reporting in published papers before and after the introduction of PPI reporting obligations by the British Medical Journal (BMJ) [ 104 ]. The authors identified an increase in PPI reporting in papers published by BMJ from 0.5% to 11% between the periods of 2013–2014 and 2015–2016. The study findings demonstrate the impact of journal guidelines in shaping higher quality research outputs [ 13 ]. In our review, we found a low frequency of PPI reporting in PS research using the GRIPP2 checklist, alongside sub-optimal quality of reporting following GRIPP2-SF. This could potentially be attributed to the absence of submission requirements for PPI reporting in journals following the GRIPP2 checklist, as well as challenges posed by word limits.

Strengths and limitations

This systematic review presents an overview on the frequency of PPI reporting in PS research using the GRIPP2 checklist, as well as an evaluation of the quality of reporting following the GRIPP2-SF. As the first review to focus on PS research, it provides useful knowledge on the status of PPI reporting in this field, and the extent to which researchers are adopting and adhering to PPI reporting guidelines. Despite these strengths, our review has some limitations that should be mentioned. First, only English language papers were included in this review due to being the main language of the researchers. Thus, there is a possibility that relevant articles on PPI in PS research may have been omitted. Another limitation is related to our search which was limited to papers published starting 2018 as the GRIPP2 guidelines were published in 2017. Thus it is probable that the protocols of some of these studies were developed earlier than the publication of the GRIPP2 checklist, meaning that PPI reporting following GRIPP2 was not common practice and thus not adopted by these studies. This might limit the conclusions we can draw from this review. Finally, the use of GRIPP2 to assess the quality of PPI reporting might be a limitation as usability testing has not yet been conducted to understand how the checklist works in practice with various types of research designs. However, the GRIPP2 is the first international, evidence-based, community consensus informed guideline for the reporting of PPI in health and social care research. Reflections and comments from researchers using the GRIPP2 will help improve its use in future studies.

Implications for research and practice

Lack of PPI reporting not only affects the quality of research but also implies that others cannot learn from previous research experience. Additionally, without consistent and transparent reporting it is difficult to evaluate the impact of various PPI in research [ 9 ]: “if it is not reported it cannot be assessed” ([ 105 ] p19). Enhanced PPI reporting will result in a wider range and richer high-quality evidence-based PPI research, leading to a better understanding of PPI use and effectiveness [ 103 ]. GRIPP2 reporting guidelines were developed to provide guidance for researchers, patients, and the public to enhance the quality of PPI reporting and improve the quality of the international PPI evidence-base. The guidance can be used prospectively to plan PPI or retrospectively to guide the structure or PPI reporting in research [ 9 ]. To enhance PPI reporting, we recommend the following;

Publishers and journals

First, we encourage publishers and journals to require researchers to report PPI following the GRIPP2 checklist. Utilising the short or the long version should depend on the primary focus of the study (i.e., if PPI is within the primary focus of the research then the GRIPP2-LF is recommended). Second, we recommend that journals and editorial members advise reviewers to evaluate PPI reporting within research articles following the GRIPP2 tool and make suggestions accordingly. Finally, we encourage journals to add a plain language summary as a submission requirement to increase research dissemination and improve the accessibility of research for patients and the public.

Researchers

Though there is greater evidence of PPI in research, it is still primarily the researchers that are setting the research agenda and deciding on the research questions to be addressed. Thus, significant effort is still needed to involve patients and the public in the earlier stages of the research process given the fundamental impact of PS on their lives. To enhance future PPI reporting, perhaps adding a criterion following the GRIPP2 tool to existing EQUATOR checklists for reporting research papers such as STROBE, PRISMA, CONSORT, may support higher quality research. Additionally, currently, there is no detailed explanation paper for the GRIPP2 where each criterion is explained in detail with examples. Addressing this gap would be of great benefit to guide the structure of PPI reporting and to explore the applicability of each criterion in relation to different stages of PPI in research. For instance, having a detailed explanation for each criterion across different research studies having various PPI stages would be of high value to improve future PPI reporting given the growing interest in PPI research in recent years and the relatively small PPI evidence base in health and medical research.

Funding bodies can also enhance PPI reporting by adding a requirement for researchers to report PPI following the GRIPP2 checklist. In Ireland, the National HSE has already initiated this by requiring all PPI in HSE research in Ireland to be reported following the GRIPP2 guidelines [ 10 ].

This study represents the first systematic review on the frequency and quality of PPI reporting in PS research using the GRIPP2 checklist. Most PS topics were related to medication safety, general PS, and fall prevention. The main involvement across the studies was in commenting on or developing research materials. Thus, efforts are still needed to involve patients and the public across all aspects of the research process, especially earlier stages of the research cycle. The frequency of PPI reporting following the GRIPP2 guidelines was low, and the quality of reporting following the GRIPP2-SF criteria was sub-optimal. The lowest percentages of reporting were on critically reflecting on PPI in the study so future research can learn from this experience and work to improve it, reporting the aim of the PPI in the study, and reporting the extent to which PPI influenced the study overall including positive and negative effects. Researchers, funders, publishers, journals, editorial members and reviewers have a responsibility to promote consistent and transparent PPI reporting following internationally developed reporting guidelines such as the GRIPP2. Evidence-based guidelines for reporting PPI should be supported to help future researchers plan and report PPI more effectively, which may ultimately improve the quality and relevance of research.

Availability of data and materials

All data generated or analysed during this study are included in this published article and its Supplementary information files.

Abbreviations

• Patient safety

United Kingdom

National Institute for Health Research

Public and Patient Involvement

Health Service Executive

Guidance for Reporting Involvement of Patients and the Public

Second version of the GRIPP checklist

Long form of GRIPP2

Short form of GRIPP2

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

The International Database of Prospectively Registered Systematic Reviews

British Medical Journal

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This research is funded as part of the Collective Leadership and Safety Cultures (Co-Lead) research programme which is funded by the Irish Health Research Board, grant reference number RL-2015–1588 and the Health Service Executive. The funders had no role in the study conceptualisation, design, data collection, analysis, decision to publish, or preparation of the manuscript.

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Hammoud, S., Alsabek, L., Rogers, L. et al. Systematic review on the frequency and quality of reporting patient and public involvement in patient safety research. BMC Health Serv Res 24 , 532 (2024). https://doi.org/10.1186/s12913-024-11021-z

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A Peek Inside the Brains of ‘Super-Agers’

New research explores why some octogenarians have exceptional memories.

By Dana G. Smith

When it comes to aging, we tend to assume that cognition gets worse as we get older. Our thoughts may slow down or become confused, or we may start to forget things, like the name of our high school English teacher or what we meant to buy at the grocery store.

But that’s not the case for everyone.

For a little over a decade, scientists have been studying a subset of people they call “super-agers.” These individuals are age 80 and up, but they have the memory ability of a person 20 to 30 years younger.

Most research on aging and memory focuses on the other side of the equation — people who develop dementia in their later years. But, “if we’re constantly talking about what’s going wrong in aging, it’s not capturing the full spectrum of what’s happening in the older adult population,” said Emily Rogalski, a professor of neurology at the University of Chicago, who published one of the first studies on super-agers in 2012.

A paper published Monday in the Journal of Neuroscience helps shed light on what’s so special about the brains of super-agers. The biggest takeaway, in combination with a companion study that came out last year on the same group of individuals, is that their brains have less atrophy than their peers’ do.

The research was conducted on 119 octogenarians from Spain: 64 super-agers and 55 older adults with normal memory abilities for their age. The participants completed multiple tests assessing their memory, motor and verbal skills; underwent brain scans and blood draws; and answered questions about their lifestyle and behaviors.

The scientists found that the super-agers had more volume in areas of the brain important for memory, most notably the hippocampus and entorhinal cortex. They also had better preserved connectivity between regions in the front of the brain that are involved in cognition. Both the super-agers and the control group showed minimal signs of Alzheimer’s disease in their brains.

“By having two groups that have low levels of Alzheimer’s markers, but striking cognitive differences and striking differences in their brain, then we’re really speaking to a resistance to age-related decline,” said Dr. Bryan Strange, a professor of clinical neuroscience at the Polytechnic University of Madrid, who led the studies.

These findings are backed up by Dr. Rogalski’s research , initially conducted when she was at Northwestern University, which showed that super-agers’ brains looked more like 50- or 60-year-olds’ brains than their 80-year-old peers. When followed over several years, the super-agers’ brains atrophied at a slower rate than average.

No precise numbers exist on how many super-agers there are among us, but Dr. Rogalski said they’re “relatively rare,” noting that “far less than 10 percent” of the people she sees end up meeting the criteria.

But when you meet a super-ager, you know it, Dr. Strange said. “They are really quite energetic people, you can see. Motivated, on the ball, elderly individuals.”

Experts don’t know how someone becomes a super-ager, though there were a few differences in health and lifestyle behaviors between the two groups in the Spanish study. Most notably, the super-agers had slightly better physical health, both in terms of blood pressure and glucose metabolism, and they performed better on a test of mobility . The super-agers didn’t report doing more exercise at their current age than the typical older adults, but they were more active in middle age. They also reported better mental health .

But overall, Dr. Strange said, there were a lot of similarities between the super-agers and the regular agers. “There are a lot of things that are not particularly striking about them,” he said. And, he added, “we see some surprising omissions, things that you would expect to be associated with super-agers that weren’t really there.” For example, there were no differences between the groups in terms of their diets, the amount of sleep they got, their professional backgrounds or their alcohol and tobacco use.

The behaviors of some of the Chicago super-agers were similarly a surprise. Some exercised regularly, but some never had; some stuck to a Mediterranean diet, others subsisted off TV dinners; and a few of them still smoked cigarettes. However, one consistency among the group was that they tended to have strong social relationships , Dr. Rogalski said.

“In an ideal world, you’d find out that, like, all the super-agers, you know, ate six tomatoes every day and that was the key,” said Tessa Harrison, an assistant project scientist at the University of California, Berkeley, who collaborated with Dr. Rogalski on the first Chicago super-ager study.

Instead, Dr. Harrison continued, super-agers probably have “some sort of lucky predisposition or some resistance mechanism in the brain that’s on the molecular level that we don’t understand yet,” possibly related to their genes.

While there isn’t a recipe for becoming a super-ager, scientists do know that, in general , eating healthily, staying physically active, getting enough sleep and maintaining social connections are important for healthy brain aging.

Dana G. Smith is a Times reporter covering personal health, particularly aging and brain health. More about Dana G. Smith

A Guide to Aging Well

Looking to grow old gracefully we can help..

The “car key conversation,” when it’s time for an aging driver to hit the brakes, can be painful for families to navigate . Experts say there are ways to have it with empathy and care.

Calorie restriction and intermittent fasting both increase longevity in animals, aging experts say. Here’s what that means for you .

Researchers are investigating how our biology changes as we grow older — and whether there are ways to stop it .

You need more than strength to age well — you also need power. Here’s how to measure how much power you have  and here’s how to increase yours .

Ignore the hyperbaric chambers and infrared light: These are the evidence-backed secrets to aging well .

Your body’s need for fuel shifts as you get older. Your eating habits should shift , too.

People who think positively about getting older often live longer, healthier lives. These tips can help you reconsider your perspective .

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• 29 April 2024

How reliable is this research? Tool flags papers discussed on PubPeer

• Dalmeet Singh Chawla

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RedacTek’s tool alerts users to PubPeer discussions, and indicates when a study, or the papers that it cites, has been retracted. Credit: deepblue4you/Getty

A free online tool released earlier this month alerts researchers if a paper cites studies that are mentioned on the website PubPeer , a forum scientists often use to raise integrity concerns surrounding published papers.

Studies are usually flagged on PubPeer when readers have suspicions, for example about image manipulation , plagiarism , data fabrication or artificial intelligence (AI)-generated text . PubPeer already offers its own browser plug-in that alerts users if a study that they are reading has been posted on the site. The new tool, a plug-in released on 13 April by RedacTek , based in Oakland, California, goes further — it searches through reference lists for papers that have been flagged. The software pulls information from many sources, including PubPeer’s database; data from the digital-infrastructure organization Crossref, which assigns digital object identifiers to articles; and OpenAlex , a free index of hundreds of millions of scientific documents.

It’s important to track mentions of referenced articles on PubPeer, says Jodi Schneider, an information scientist at the University of Illinois Urbana-Champaign, who has tried out the RedacTek plug-in. “Not every single reference that’s in the bibliography matters, but some of them do,” she adds. “When you see a large number of problems in somebody’s bibliography, that just calls everything into question.”

The aim of the tool is to flag potential problems with studies to researchers early on, to reduce the circulation of poor-quality science, says RedacTek founder Rick Meyler, who is based in Emeryville, California. Future versions might also use AI to automatically clarify whether the PubPeer comments on a paper are positive or negative, he adds.

Third-generation retractions

As well as flagging PubPeer discussions, the plug-in alerts users if a study, or a paper that it cites, has been retracted. There are existing tools that alert academics about retracted citations ; some can do this during the writing process, so that researchers are aware of the publication status of studies when constructing bibliographies. But with the new tool, users can opt in to receive notifications about further ‘generations’ of retractions — alerts cover not only the study that they are reading, but also the papers it cites, articles cited by those references and even papers cited by the secondary references.

The software also calculates a ‘retraction association value’ for studies, a metric that measures the extent to which the paper is associated with science that has been withdrawn from the literature. As well as informing individual researchers, the plug-in could help scholarly publishers to keep tabs on their own journals, Meyler says, because it allows users to filter by publication.

In its ‘paper scorecard’, the tool also flags any papers in the three generations of referenced studies in which more than 25% of papers in the bibliography are self-citations — references by authors to their previous works.

Future versions could highlight whether papers cited retracted studies before or after the retraction was issued, notes Meyler, or whether mentions of such studies acknowledge the retraction. That would be useful, says Schneider, who co-authored a 2020 analysis that found that as little as 4% of citations to retracted studies note that the referenced paper has been retracted 1 .

Meyler says that RedacTek is currently in talks with the scholarly-services firm Cabell’s International in Beaumont, Texas, which maintains pay-to-view lists of suspected predatory journals . These publish articles without running proper quality checks for issues such as plagiarism, but still collect authors’ fees. The plan is to use these lists to improve the tool so that it can also automatically flag any cited papers that are published in such journals.

doi: https://doi.org/10.1038/d41586-024-01247-6

Schneider, J., Ye, D., Hill, A. M. & Whitehorn, A. S. Scientometrics 125 , 2877–2913 (2020).

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Francis Fan Lee, former professor and interdisciplinary speech processing inventor, dies

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Francis Fan Lee ’50, SM ’51, PhD ’66, a former professor of MIT’s Department of Electrical Engineering and Computer Science, died on Jan. 12. He was approximately 97.

Born in 1927 in Nanjing, China, to professors Li Rumian and Zhou Huizhan, Lee learned English from his father, a faculty member in the Department of English at the University of Wuhan. Lee’s mastery of the language led to an interpreter position at the U.S. Office of Strategic Services, and eventually a passport and permission from the Chinese government to study in the United States. 

Lee left China via steamship in 1948 to pursue his undergraduate education at MIT. He earned his bachelor’s and master’s degrees in electrical engineering in 1950 and 1951, respectively, before going into industry. Around this time, he became reacquainted with a friend he’d known in China, who had since emigrated; he married Teresa Jen Lee, and the two welcomed children Franklin, Elizabeth, Gloria, and Roberta over the next decade. 

During his 10-year industrial career, Lee distinguished himself in roles at Ultrasonic (where he worked on instrument type servomechanisms, circuit design, and a missile simulator), RCA Camden (where he worked on an experimental time-shared digital processor for department store point-of-sale interactions), and UNIVAC Corp. (where he held a variety of roles, culminating in a stint in Philadelphia, planning next-generation computing systems.)

Lee returned to MIT to earn his PhD in 1966, after which he joined the then-Department of Electrical Engineering as an associate professor with tenure, affiliated with the Research Laboratory of Electronics (RLE). There, he pursued the subject of his doctoral research: the development of a machine that would read printed text out loud — a tremendously ambitious and complex goal for the time.

Work on the “RLE reading machine,” as it was called, was inherently interdisciplinary, and Lee drew upon the influences of multiple contemporaries, including linguists Morris Halle and Noam Chomsky, and  engineer Kenneth Stevens , whose quantal theory of speech production and recognition broke down human speech into discrete, and limited, combinations of sound. One of Lee’s greatest contributions to the machine, which he co-built with  Donald Troxel , was a clever and efficient storage system that used root words, prefixes, and suffixes to make the real-time synthesis of half-a-million English words possible, while only requiring about 32,000 words’ worth of storage. The solution was emblematic of Lee’s creative approach to solving complex research problems, an approach which earned him respect and admiration from his colleagues and contemporaries.

In reflection of Lee’s remarkable accomplishments in both industry and building the reading machine, he was promoted to full professor in 1969, just three years after he earned his PhD. Many awards and other recognition followed, including the IEEE Fellowship in 1971 and the Audio Engineering Society Best Paper Award in 1972. Additionally, Lee occupied several important roles within the department, including over a decade spent as the undergraduate advisor. He consistently supported and advocated for more funding to go to ongoing professional education for faculty members, especially those who were no longer junior faculty, identifying ongoing development as an important, but often-overlooked, priority.

Lee’s research work continued to straddle both novel inquiry and practical, commercial application — in 1969, together with Charles Bagnaschi, he founded American Data Sciences, later changing the company’s name to Lexicon Inc. The company specialized in producing devices that expanded on Lee’s work in digital signal compression and expansion: for example, the first commercially available speech compressor and pitch shifter, which was marketed as an educational tool for blind students and those with speech processing disorders. The device, called Varispeech, allowed students to speed up written material without losing pitch — much as modern audiobook listeners speed up their chapters to absorb books at their preferred rate. Later innovations of Lee’s included the Time Compressor Model 1200, which added a film and video component to the speeding-up process, allowing television producers to subtly speed up a movie, sitcom, or advertisement to precisely fill a limited time slot without having to resort to making cuts. For this work, he received an Emmy Award for technical contributions to editing.

In the mid-to-late 1980s, Lee’s influential academic career was brought to a close by a series of deeply personal tragedies, including the 1984 murder of his daughter Roberta, and the subsequent and sudden deaths of his wife, Theresa, and his son, Franklin. Reeling from his losses, Lee ultimately decided to take an early retirement, dedicating his energy to healing. For the next two decades, he would explore the world extensively, a nomadic second chapter that included multiple road trips across the United States in a Volkswagen camper van. He eventually settled in California, where he met his last wife, Ellen, and where his lively intellectual life persisted despite diagnoses of deafness and dementia; as his family recalled, he enjoyed playing games of Scrabble until his final weeks. 

He is survived by his wife Ellen Li; his daughters Elizabeth Lee (David Goya) and Gloria Lee (Matthew Lynaugh); his grandsons Alex, Benjamin, Mason, and Sam; his sister Li Zhong (Lei Tongshen); and family friend Angelique Agbigay. His family have asked that gifts honoring Francis Fan Lee’s life be directed to the  Hertz Foundation . 

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