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However, we anticipate that in order to create societal impact, societal outputs are a sine qua non.
The study further focuses on societal outputs and use (societal quality) as an addition to scientific outputs and use (scientific quality).
Therefore, we have left scientific and societal impact of research (groups) out of the scope of this study as mentioned before, and discuss the level of societal outputs as a measure for societal quality only.
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The alternative is that large numbers of people will remain without diagnosis or best treatment, with not much hope for change, their unmitigated personal disability burdens translating into lost productivity with reduced societal output reflected in gross domestic product.
In this sense, it differs from simple tax and redistribution schemes that might change the income distribution but do not add to societal output.
This paper elaborates primarily on a quantitative approach to assess societal output and use of research performed by health research groups (societal quality of research).
Another Dutch project focused on the societal output at the level of medical research departments at the Leiden University Medical Center, and defined stakeholder specific indicators of societal impact in the areas of knowledge production, knowledge exchange, knowledge use and earning capacity [ 21].
It is from the 1990s that societal products (outputs) [ 8- 10], societal use (societal references) and societal benefits (changes in society) also came into scope [ 11- 21].
But as long as they do not have explicit societal objectives, activities and outputs in this area are hard to adjust.
We also offer some thoughts as to how to address this gap between training program output and societal need.
We need to address the ongoing discrepancy between societal need and the output of our training programs, a problem that as mentioned earlier is a global one.
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