The question arises from my experience as an author, editor and expert reviewer of biomedical journals, through the identification of bias from the language of publication, the group recognized in a scientific field or discipline authors, the number of citations related publication and even the type of journal where the works are published,
Therefore I also wonder if there's a more complete and reliable way to assess the quality, not only for productivity or number of published articles and citations obtained, but the effect they have on the ground of reality, such contributions; ie Impact on Qualitative Therapeutic Effectiveness, Quality of Life, Troubleshooting Health, Prevention Disorders, Healing or other damage limitation