Can a bibliometric indicator predict the success of an analgesic?

Thirty-year survey of bibliometrics used in the research literature of pain: Analysis, evolution, and pitfalls

During the last decades, the emergence of Bibliometrics and the progress in Pain research have led to a proliferation of bibliometric studies on the medical and scientific literature of pain (B/P). This study charts the evolution of the B/P literature published during the last 30 years. Using various searching techniques, 189 B/P studies published from 1993 to August 2022 were collected for analysis-half were published since 2018. Most of the selected B/P publications use classic bibliometric analysis of Pain in toto, while some focus on specific types of Pain with Headache/Migraine, Low Back Pain, Chronic Pain, and Cancer Pain dominating. Each study is characterized by the origin (geographical, economical, institutional, …) and the medical/scientific context over a specified time span to provide a detailed landscape of the Pain research literature. Some B/P studies have been developed to pinpoint difficulties in appropriately identifying the Pain literature or to highlight some general publishing pitfalls. Having observed that most of the recent B/P studies have integrated newly emergent software visualization tools (SVTs), we found an increase of anomalies and suggest that readers exercise caution when interpreting results in the B/P literature details.

Understanding Drug Repurposing From the Perspective of Biomedical Entities and Their Evolution: Bibliographic Research Using Aspirin

BACKGROUND

Drug development is still a costly and time-consuming process with a low rate of success. Drug repurposing (DR) has attracted significant attention because of its significant advantages over traditional approaches in terms of development time, cost, and safety. Entitymetrics, defined as bibliometric indicators based on biomedical entities (eg, diseases, drugs, and genes) studied in the biomedical literature, make it possible for researchers to measure knowledge evolution and the transfer of drug research.

OBJECTIVE

The purpose of this study was to understand DR from the perspective of biomedical entities (diseases, drugs, and genes) and their evolution.

METHODS

In the work reported in this paper, we extended the bibliometric indicators of biomedical entities mentioned in PubMed to detect potential patterns of biomedical entities in various phases of drug research and investigate the factors driving DR. We used aspirin (acetylsalicylic acid) as the subject of the study since it can be repurposed for many applications. We propose 4 easy, transparent measures based on entitymetrics to investigate DR for aspirin: Popularity Index (P₁), Promising Index (P₂), Prestige Index (P₃), and Collaboration Index (CI).

RESULTS

We found that the maxima of P₁, P₃, and CI are closely associated with the different repurposing phases of aspirin. These metrics enabled us to observe the way in which biomedical entities interacted with the drug during the various phases of DR and to analyze the potential driving factors for DR at the entity level. P₁ and CI were indicative of the dynamic trends of a specific biomedical entity over a long time period, while P₂ was more sensitive to immediate changes. P₃ reflected the early signs of the practical value of biomedical entities and could be valuable for tracking the research frontiers of a drug.

CONCLUSIONS

In-depth studies of side effects and mechanisms, fierce market competition, and advanced life science technologies are driving factors for DR. This study showcases the way in which researchers can examine the evolution of DR using entitymetrics, an approach that can be valuable for enhancing decision making in the field of drug discovery and development.

Academic Interest in Pain: Comparison of Four Specialties With Long-Standing Involvement in Pain Medicine

PURPOSE

One of the most interesting signs of growth in a medical specialty is the addition of pain medicine as a clinical subspecialty to it. The aim of this study was to analyze publication-based academic interest in pain medicine among clinical specialties with long-standing involvement in pain management.

METHODS

We assessed the activity within several specialties in the development of an academic foundation for pain medicine by measuring the frequency of the most common pain topics (1998-2017) in academic journals representing such specialties. The selection of materials for the analysis of publication-based academic interest associated with the development of pain medicine followed a three-step process: (1) Medical specialties, limited to those with accredited fellowship training in pain medicine for more than 20 years - anesthesiology, neurology, physiatry, and psychiatry; (2) Pain topics, based on the degree of topic association with the work of pain clinics - a total of 34 topics; (3) Specialty journals, mostly official journals of societies publishing articles representing all aspects of a specialty - four journals per specialty. Specialty-related academic interest was characterized in two dimensions: its breadth (the number of different topics of interest with distinctly high shares of publications) and its intensity (maximal number of publications on a particular topic).

RESULTS

According to the number of topics with a distinctly high share of articles per topic (≥ 5%), the rank order of specialties was as follows (of 34 topics): anesthesiology (22), physiatry (20), neurology (10), and psychiatry (0). Regarding comparative intensity of interest, anesthesiology has prevailing interest in 16 topics (especially in postoperative pain and pharmacologic pain treatment), physiatry in 13 topics (especially in physical methods of pain therapy), and neurology in one topic (headache disorders).

CONCLUSION

Publication-based academic interest in pain management was most intensive in two specialties, anesthesiology and physiatry, with anesthesiology being somewhat more multifaceted, especially in the methods of pain treatment.

Problems with Developments of Breakthrough Analgesics: Recent History via Scientometric Analysis

This study evaluated 13 specific topics representing molecular targets for pain during the period 1982-2016. The evaluation was performed by measuring research efforts via a scientometric approach on one hand and by assessing successful outcomes of these efforts, as indicated by the development of FDA-approved analgesics, on the other. A number of new analgesics were developed during this period, some of them with a completely novel mechanism of action. However, the main problems with approved drugs, as well as drug candidates, are relatively low levels of clinical superiority in effectiveness and narrow spectrum of action in different types of pain, compared to opioids or NSAIDs. The most interesting feature of the scientometric analysis of the 13 analgesic discovery topics is the long-lasting growth in the number of articles. The total number of all PubMed articles persistently increased over each of many 5-year periods in every topic even without any success in the development of new analgesics. Scientometric indices of NIH-supported studies are not better at predicting successes in the discovery of new analgesics than indices applied to all publications without regard to the category of support. Thus, even the highly valued NIH-based funding system did not demonstrate a clear advantage for discovery efforts centered on pain-related molecular targets. The evaluated research efforts did not result in breakthrough analgesics that could demonstrably affect the current use of opioids or NSAIDs. Orthodox thinking-both in research and research funding-might be the main reason for the absence of breakthrough analgesics.

Academic Journals Assessed as Springboards for New Developments: A Study of Leading Anesthesia Journals Over Past 50 Years

PURPOSE

The impact of academic journals on scientific activity can be measured using different approaches. The aim of this study was to assess the leading anesthesia journals as springboards for new developments in the field of anesthesia.

METHODS

The selection of the topics for analysis was based on the degree of increase in the number of articles on a topic that was at the center of specialty interest during 1966-2015. The assessment of a journal's response to a new development was made by measuring the number of initial articles on a related topic. Six leading anesthesia journals were assessed collectively and individually as to whether their responses to new developments were prompt and prominent.

RESULTS

The role of the leading specialty journals in presentation of 28 topics related to prominent new developments in anesthesia was found to depend on the nature of topics and the type of articles. Compared with all PubMed journals publishing articles associated with anesthesia in 1966-2015, the six leading anesthesia journals published 43% of drug-related research articles, 30% of technique-related research articles, and 16% of both drug- and technique-related review articles. Regarding initial publications (on new topics), this group of six journals contributed comparably more articles: from 43% to 84% of drug-related research articles, from 30% to 49% of technique-related research articles, from 16% to 33% of drug-related review articles, and from 16% to 25% of technique-related review articles. The approximate doubling of the shares demonstrates the dominance of this group of journals in the swiftness response to new anesthesia developments. The promptness of reaction to new developments in anesthesia of each of the six leading anesthesia journals was assessed (the combination of drug- and technique-related articles) based on the number of articles published among the first (first 5 plus next 30) on all 28 topics. The ranking order of four journals (with the highest number of all 1966-2015 articles) regarding early publications was (from high to low): Anesthesia & Analgesia, British Journal of Anaesthesia, Anesthesiology, and Anaesthesia.

CONCLUSION

This study assesses six leading anesthesia journals for their function as springboards for new developments in anesthesia over the past 50 years. The dominance of leading journals in initial publications on 28 drug-related and technique-related topics was clearly demonstrated. The results also indicate the possibility of using promptness of response to new advances for quantitative assessment of this aspect of a journal's contribution to the specialty.

Recent History of Publication-Based Academic Interest in General Anesthetics

PURPOSE

The aim of this study was to determine how interest in various general anesthetics among the authors of academic publications changed over the past 50 years.

METHODS

Publication-based academic interest were analyzed using specific scientometric indices: popularity index (PI), top journal selectivity index (TJSI), and index of change (IC). Terms used for searches were the names of drugs belonging to two pharmacological classes of general anesthetics - inhaled and intravenous. Only those that had a PI value > 2.0 during at least one of the 10 five-year periods, from 1967 to 2016, were selected.

RESULTS

The PI, an index of comparative popularity, reflects a consistent decline in academic interest over time in both classes of general anesthetics. Over the past 25 years, the PI of inhaled anesthetics decreased by 52 %, and that of intravenous anesthetics fell by 32%. At the same time, the PI of anesthesia management increased by 167%. Among individual anesthetics, the most impressive change was a profound decline in halothane's PI, from 22.9 in 1972-1976 to 0.5 in 2012-2016. The interest in halothane was gradually supplanted by that in new agents, initially by enflurane, followed by isoflurane and finally, sevoflurane. The next meaningful change was the gradual rise in sevoflurane's PI to surpass that of isoflurane. The most dramatic change among the PIs of intravenous anesthetics was associated with the introduction of propofol: an increase from 1.8 to its maximum of 13.6.

CONCLUSIONS

The study revealed a constant decline over time in academic interest in the pharmacological basis of general anesthesia relative to all fields of anesthesia combined.

What Can Big Data on Academic Interest Reveal about a Drug? Reflections in Three Major US Databases

The different stages of the life cycle of a drug - 'prenatal' stage, birth of a drug, rapid growth, maturity and stability, decline, and status before 'death' - are reflected in the three following databases: journal articles (PubMed-www.ncbi.nlm.nih.gov/pubmed); patents (US Patent Office-http://partfl1.uspto.gov/netahtml/PTO/search-adv.htlm); and approved drugs (FDA - www.accessdata.fda.gov/scripts/cder/drugsatfda/index/cfm). These databases are huge, from authoritative sources, correctly classified, and they properly link different datasets. Analysis of such data can uncover hidden patterns important for the assessment of drug status and may also yield some predictions regarding its future prospects. Drug-related, publication-based academic bibliographic records are especially numerous and support the development of various scientometric indices. In combination with information from other types of databases, they can outline various trends in pharmacology. Scientometric indices can be classified into those indicating a change in the status of a drug, and those assessing the chances for success, or even drug discontinuation. Here, we present big data analytics on publication-based academic interest in two segments: (i) description of scientometric indices and (ii) their applications for the assessment of the status of a drug.

Publication-Based Academic Interest in Drugs and Techniques for Treatment of Postoperative Pain, 1975-2015

PURPOSE

The aim of this study was to determine how drugs and their administration techniques, introduced over the past 40 years and still popular now, influenced publication-based academic interest in the treatment of postoperative pain.

METHODS

Specific scientometric indices-popularity index (PI), top journal selectivity index (TJSI), and index of change (IC)-were used. Of the 61 terms searched, only those that had a PI value ≥1.0 during the 2011-2015 period were selected. They include eight drugs-bupivacaine, fentanyl, ropivacaine, acetaminophen, tramadol, remifentanil, and dexamethasone-and five techniques-patient-controlled analgesia, epidural opioids, ultrasound-guided nerve blocks, continuous nerve blocks, and transversus abdominis plane block (presented according to their decreasing PI value in each category).

RESULTS

Four of these drugs or techniques with the highest PI in 2011-2015 also held top positions even 20 years earlier: in 1991-1995, the PI for bupivacaine was 9.1; fentanyl, 6.6; patient-controlled analgesia, 10.4; and epidural opioids, 6.8. Since that time, their PI values slowly decreased, for the first three items by approximately 50% and much more than that (85%) with epidural opioids. Nevertheless, to this day, they continue to hold the highest degree of publication-based academic interest. The TJSI can be regarded as an index of expectations at the time of articles publication. With bupivacaine, fentanyl, patient-controlled analgesia, and epidural opioids, the TJSI exceeded the specific high threshold of 10.0 for a very long time. The TJSIs of acetaminophen, ketamine, and dexamethasone were increased with the advent of new expectations regarding the treatment of postoperative pain using these old agents.

CONCLUSIONS

Two important developments related to ultrasound-guided nerve block and continuous nerve block demonstrated only a moderate degree of academic interest. In conclusion, even today, the greatest publication-based academic interest related to postoperative pain is associated with drugs and techniques introduced 40-50 years ago.