Research in orthopaedics from China has thrived over the last decade: a bibliometric analysis of publication activity

Publication Trends in Osteoporosis Treatment: A 20-Year Bibliometric Analysis

BACKGROUND

Osteoporosis prevalence continues to escalate with the growth of the older adult population. In this study, we aimed to investigate the profile of osteoporosis treatment-related research articles published in the past 20 years using bibliometric analysis.

METHODS

We analyzed all osteoporosis treatment-related articles published between 2001 and 2020 in the Web of Science (WoS) database using bibliometric methods. In the Title search section in WoS, we searched the documents using "osteoporosis treatment"-related keywords. We used the VOSviewer software to construct the bibliometric maps of keyword co-occurrences.

RESULTS

Our search yielded 29,738 publications, 21,556 (72.5%) were original articles and 4,529 (15.2%) were review articles and review articles (4,529). We noticed a steady increase in the publication numbers from 2001 to 2020. The overall scientific publication number in WoS increased 3.5-fold, with the five most productive countries being the USA, China, Germany, the United Kingdom, and Japan. The largest contributor was the University of California system. The most productive journals were Osteoporosis International (1,679, 6.4%), Bone (832, 3.2%), and the Journal of Bone and Mineral Research (727, 2.8%). We observed increasing trends in the appearance of denosumab and teriparatide during the last two decades. In our keyword co-occurrence analysis, we constructed four keyword clusters using VOSviewer.

CONCLUSIONS

In this study, we provided a gross overview of the visibility and productivity of research studies in osteoporosis treatment. Substantial changes have occurred in osteoporosis treatment over the last 20 years. The effector mechanism of anti-osteoporosis medications could be future hot spots in osteoporosis research. We believe that our study is a valuable guide for clinicians related to the global outputs of osteoporosis treatment.

Are UK and Ireland trauma and orthopaedic surgeons maintaining their research output?

INTRODUCTION

Healthcare faces growing challenges. With reports of diminishing research output from the UK and Ireland in the leading surgical journals, this study aimed to ascertain whether this trend had been echoed in the trauma and orthopaedic literature.

MATERIALS AND METHODS

Citable research output from the 10 globally leading trauma and orthopaedic journals was analysed from five individual years, over a 20-year period, to ascertain trends in absolute output, geographical mix, and level of evidence.

RESULTS

The overall number of published articles fell by 14.5%. North America saw the greatest decline (-8.0%), followed by Japan (-5.6%) and Europe (-3.3%). The UK and Ireland (+2.9%) and the rest of the world (+13.9%) saw rising output. A decline in lower (levels IV and V) and a rise in higher (levels I, II and III) quality evidence was observed. The UK and Ireland had a greater proportion of higher-quality studies than North America and Japan, but lower than Europe and the rest of the world. The impact factor of the leading journal rose from 4.47 to 7.01.

DISCUSSION

The research landscape has evolved, with leading journals placing greater emphasis on higher-quality evidence. UK and Irish research output remains stable, contributing 14% of the most highly cited publications in 2018, and challenging North America's dominance with a greater proportion of level I and II evidence in the leading journals.

CONCLUSION

With the growing emergence of Europe and the rest of the world, UK and Irish authors must build upon the region's output despite political challenges such as Brexit. Increasing international collaboration will continue to play an important role.

Bibliometric evaluation of orthopaedics and traumatology publications from France: 20-year trends (1998-2017) and international positioning

BACKGROUND

Little is known about the scientific publication output for individual countries and medical specialties. The contribution of French authors to the currently expanding volume of publications on orthopaedics and traumatology (OT) is unclear. Orthopaedics & Traumatology: Surgery & Research (OTSR) is an English-language version of a preexisting French journal that was launched in 2009 to increase the dissemination of research done in France. The objective of this study was to use Web of Science (WoS) data from 1998 to 2017 to determine (i) the contribution of OT publications to the total worldwide volume of scientific publications, (ii) the contribution of OT publications from France to the total worldwide volume of OT publications, and (iii) changes over time in the proportion of OT publications from France with special attention to potential effects of the creation of OTSR.

HYPOTHESIS

The proportion of OT publications from France increased after 2010-2012, indicating a positive effect of OTSR.

MATERIAL AND METHODS

WoS data were used to identify original studies and review articles written by at least one French author, published between 1998 and 2017, and dealing with OT (defined as orthopaedics and/or traumatology in adult and/or paediatric patients). The worldwide volumes of publications in OT and other specialties were compared. Within worldwide OT publications, the proportion from France was determined. Indicators of impact were evaluated during successive 5-year periods. Finally, the position of OT in worldwide research was assessed and OT journals were analysed.

RESULTS

Among worldwide scientific medical publications, the proportion dealing with OT increased year on year from 1.93% in 1998 to 2.65% in 2017. Among annual publications from France, the proportion dealing with OT rose similarly, from 1.32% to 2.40%. Over the 20-year study period, France moved from the sixth to the ninth position, chiefly due to a large increase in publications from Asia. However, France remained in third position among European countries and increased its OT production 3-fold between 1998 and 2017. The proportion of OT articles from France that ranked among the top 1% most cited articles increased by 65% from 2008-2012 (20 articles) to 2013-2017 (33 articles), and the proportion in the top 10% increased by 31.8% (211 in 2008-2012 and 278 in 2013-2017). This rate of progression was faster than in any of the other western countries. Between 1998-2011 and 2012-2017, the contribution of French OT to publication output showed a 1.56-fold greater increase than did the contribution of OT to the worldwide volume of scientific medical publications.

DISCUSSION

OT publications from France have kept pace with the steady increase seen worldwide over the last 20years. Although the US and UK remain in the lead, and despite the considerable growth in the output of Asian countries, France occupies a prominent position on the international OT scene. The creation of OTSR has elevated the international profile of French OT centres.

LEVEL OF EVIDENCE

IV, retrospective study with no control group.

Publication output of French orthopedic and trauma surgeons: Quantitative and qualitative bibliometric analysis of their scientific production in orthopedics and other medical fields

INTRODUCTION

Bibliometric analysis is being used more and more in orthopedics and traumatology. However, the quantity and quality of publications authored by French orthopedic and trauma surgeons outside their discipline have never been analyzed, nor has the change in the quality of orthopedics publications. This led us to carry out a bibliometric analysis to answer the following questions: 1) How has the quantity of scientific production by French orthopedists changed over the past 10 years? 2) How has the quality of the overall scientific production by French orthopedists changed over the past 10 years?

HYPOTHESIS

From 2008 to 2017, the production of French orthopedists has increased in quantity and quality in orthopedics and other medical fields.

MATERIAL AND METHODS

The analysis was performed by cross-referencing the list of SOFCOT (French Society for Orthopaedic Surgery and Traumatology) members with the French SIGAPS database and the InCites platform. Out of 3979 SOFCOT members, 972 (24%) had authored publications during this period and were included in the analysis. Several indicators were analyzed: number of publications; SIGAPS score (production quality) for the various Web of Science (WoS) categories; number and percentage of publications in the top 1% and top 10% (most highly cited articles worldwide).

RESULTS

The "Orthopedics" discipline was still the most prevalent with 68% of all publications identified. The "Surgery" discipline was stable, and the share of publications had increased in five other disciplines: Sports Sciences, Clinical Neurology, Emergency Medicine, Engineering-Biomedical and Material Science-Biomaterials. Of the 727 journals indexed in PubMed in which at least one author is a French orthopedic or trauma surgeon, 79 journals (11%) had at least 10 articles authored by a French orthopedists, making up 4680/6056 published articles (77%) during the study period. The highest SIGAPS score was in the "Orthopedics" discipline followed by "Surgery", and then by "Sport Sciences" with a large number of publications in the SIGAPS B category. Publications in "Orthopedics" category A and B journals increased 14% during this period. When all disciplines are pooled, the share of publications in SIGAPS A, B and C categories increased by 10% from 2008 to 2017. The largest increase in publications for categories A and B and the top 1% and 10% was in "Sports Sciences".

DISCUSSION

Over the past 10 years, French orthopedists have continued to increase their scientific production in the orthopedics field and in related fields such as Sport Sciences, Clinical Neurology and Biomedical Engineering. The quality of the scientific production of French orthopedists in their discipline and outside of it has greatly improved, as evidenced by the shift toward SIGAPS A and B journals.

LEVEL OF EVIDENCE

IV, retrospective study without control group.

Worldwide research productivity in the field of full-endoscopic spine surgery: a bibliometric study

PURPOSE

To investigate the quantity and quality of articles in the field of full-endoscopic spine surgery (FESS) from different countries and assess characteristics of worldwide research productivity.

METHODS

Articles published from 1997 to July 23, 2018, were screened using the Web of Science database. All studies were assessed for the following parameters: the number of total publications, h-index, contribution of countries, authors, journals, and institutions.

RESULTS

A total of 408 articles were identified between 1997 and 2018. Between 1997 and 2017, the number of published articles tended to increase by 41 times. The largest number of articles was from China (30.15%), followed by South Korea (28.68%), the USA (13.97%), Germany (9.31%), and Japan (4.90%). The highest h-index was found for articles from South Korea (23), followed by the USA (18), Germany (16), China (11), and Japan (7). The highest number of articles was published in World Neurosurgery (12.50%), followed by Pain Physician (10.29%), Spine (6.62%), European Spine Journal (4.66%), and Journal of Neurosurgery: Spine (4.17%). Wooridul Spine Hospital published the largest number of articles (10.29%), followed by Tongji University (5.88%), University of Witten/Herdecke (5.39%), Brown University (5.15%), and Third Military Medical University (3.43%).

CONCLUSIONS

The number of articles published in the field of FESS has increased rapidly in the past 20 years. In terms of quantity, China is the most contributive country based on the number of publications. High-quality papers as measured by h-index and the large quantity is from South Korea (second only to China). These slides can be retrieved under Electronic Supplementary Material.

A 14-year literature survey on spine-related clinical research output by orthopedic surgeons from mainland China

BACKGROUND

In recent years, China is increasingly playing an active role in various fields of biomedical research. Many bibliometric studies have provided valuable insights to different fields of clinical studies. However, similar evaluation on spine surgery-related clinical research is still limited. We herein aimed to examine the scientific publications by orthopedic spine surgeons from mainland China within a 14-year period.

METHODS

Articles were identified in PubMed using predetermined query terms. Descriptive statistics were calculated, and T tests, Chi-squared tests, and regression analysis were conducted on the number of publications, impact factors (IFs), citations, region of the study, and associated medical subject headings (MeSHs).

RESULTS

A total of 1498 articles were identified and the annual number of publications, citations, and IFs all increased exponentially. The average IF was significantly higher in 2007 to 2013 than 2000 to 2006. Most publications were from Shanghai and Beijing and the 5 most productive administrative regions generated 70% of all publications. Analysis of associated MeSHs suggested research topics became more heterogeneous over the study period.

CONCLUSION

This was the first comprehensive evaluation on the clinical research output by orthopedic spine surgeons from mainland China. The annual number of publications and citations both increased significantly; however, research was highly concentrated in a handful of administrative regions.

Worldwide Research Productivity in the Field of Minimally Invasive Spine Surgery: A 20-year Survey of Publication Activities

MINI: The time trend for the number of minimally invasive spine surgery articles showed a significant increase over time with an average of 93.23 articles per year. Among all related journals, Spine published the largest number of articles in minimally invasive spine surgery research and was the most popular one in the top five countries.

STUDY DESIGN

Bibliometric analysis.

OBJECTIVE

This study aimed to reveal the characteristics of world productivity in the field of minimally invasive spine surgery (MISS) research and to provide a general picture for surgeons and researchers.

SUMMARY OF BACKGROUND DATA

Significant growth has been observed in the field of MISS research in recent years. However, bibliometric studies concerning the quantity and quality of articles published in MISS journals are scarce.

METHODS

All the data concerning MISS in this study originate from the Web of Science (Thomson Reuters, New York, NY) without restrictions. All selected literates were evaluated in the following aspects: publication year, publication journals, author, times cited, Web of Science category, countries/territories.

RESULTS

A total number of 2051 articles were published worldwide. The articles published during 2000 to 2015 are more than 11.28 times when compared to those published before 2000. The United States published the largest number of articles (855/2051, 41.7%), followed by Germany (245/2051, 11.9%), South Korea (160/2051, 7.8%), China (147/2051, 7.2%), and Japan (108/2051, 5.2%) and had the highest total citations (16,626). Additionally, the United States had the highest average citations per article (12.14), followed by Japan (11.98), Germany (11.19), South Korea (11.04), and China (10.95). High-income countries published 98.73% of articles, upper-middle-income countries published 0.24% of articles, and middle-income countries published 1.03% of articles.

CONCLUSION

The time trend for the number of MISS articles showed a significant increase over time with an average of 93.23 articles per year. The United States was the most productive country and had the highest average citations per article. Among related journals, Spine published the largest number of articles in MISS research and was the most popular one in the top five countries.

LEVEL OF EVIDENCE

5.

Orthopedics research output from China, USA, UK, Japan, Germany and France: A 10-year survey of the literature

BACKGROUND

In the past decade, researchers have made great progress in the field of Orthopedics. However, the research status of different countries is unclear. To summarize the number of published articles, we assessed the cumulative impact factors in top orthopedic journals. The aims of the study were to measure: 1) the quality and quantity of publications in orthopedics-related journals from China and other five counties, 2) the trend of the number of publications in orthopedics-related journals.

METHODS

The related journals were selected based on the 2014 scientific citation index (SCI) and articles were searched based on the PubMed database. To assess the quantity and quality of research output, the number of publications including clinical trials, randomized controlled trials, meta-analyses, case reports, reviews, citations, impact factors, number of articles in the top 10 journals and most popular journals were recorded.

RESULTS

A total of 143,138 orthopedics articles were published from 2005 to 2014. The USA accounts for 24.9% (35,763/143,138) of the publications, followed by UK (7878/143,138 (5.5%)), Japan (7133/143,138 (5.0%)), Germany (5942/143,138 (4.2%)), China (4143/143,138 (2.9%)) and France (2748/143,138 (1.9%)). The ranking for accumulated impact factors as follows: USA, UK, Japan, Germany, France and China. The mean impact factor's order is USA, China, Germany, Japan, France, UK, and interestingly the mean impact factors in Japan is similar to the Germany in 2005-2014. The USA had the highest percentage of articles in the top 10 journals, while China owns the least. The USA had the highest number of average citations, while Japan had lowest number of average citations.

CONCLUSIONS

According to this study, we can conclude that the USA has had been leading the orthopedics research in the past 10 years. Although China still falls behind, it has made considerable progress in the orthopedics research, not only in quantity but also quality.

LEVEL OF EVIDENCE

IV.

A bibliometric analysis of exertional heat stroke research in Web of Science

BACKGROUND

Exertional heat stroke is a fatal condition and remains a health problem. This paper evaluates the publication trend regarding exertional heat stroke research between 1996 and 2015 using a bibliometric method.

METHOD

Articles regarding exertional heat stroke research published between 1996 and December 2015 were searched for in the SCI-EXPANDED database of Web of Science. The search results were analyzed with regard to publication year; publication quantity regarding countries/regions, and authors; citation frequency; and journal distribution. CiteSpace (v3.6) was used for a document co-citation visualization analysis.

RESULTS

In total, 289 publications on heat stroke were located. After selection, 209 original articles conducted across 28 countries/regions and published in 83 journals were included in the analysis. The USA, Isreal, and France were the most common locations for exertional heat stroke studies. The CiteSpace visualization cluster analysis showed that exertional heat stroke-related mortality and protective measures were constant concerns of research.

CONCLUSIONS

Research related to exertional heat stroke has been continuous concerned. USA is still the leading country in this field.

Fifty top-cited fracture articles from China: a systematic review and bibliometric analysis

Background

With more than 50,000 orthopaedic surgeons, China is having an increasing impact on fracture surgery research. However, the most influential Chinese articles on fracture surgery have not been determined. This study aimed to characterise the most-cited articles on fracture surgery by Chinese authors to provide insight into the fracture research in China.

Methods

The Web of Science was used to search for citations of fracture surgery articles that originated in China. The 50 most-cited articles were identified. The title, number of citations, year of publication, journal, article type, level of evidence, city, institution, and authors were recorded and evaluated.

Results

The 50 top-cited papers were published between 1984 and 2012. The most prolific decade began in the year 2000. These articles received 28 to 209 citations (mean 52), were written in English, and published in 12 journals. Injury was the most popular journal, with the largest number of articles (11) on the top 50 list. The region with the largest number of published articles was Hong Kong (20), followed by Kaohsiung (8), Shanghai (8), and Taipei (7). Most were clinical studies (39), while the remaining studies were basic science articles (11). The hip was the most common topic in the clinical studies. The most popular level of evidence was IV.

Conclusions

This list of the top 50 publications identifies the most influential Chinese fracture surgery articles for the global community. This study presents insight into the historical contributions of Chinese researchers and the fracture surgery trends in China.

Growing Trend of China's Contribution to Global Diabetes Research: A Systematic Literature Review

China, as a rapidly developing country with the largest population in the world, is playing an increasingly important role in diabetes research. There are >10,000 diabetes doctors who care for a large population of diabetic patients. The quantity and quality of research on diabetes from 3 major regions of China, including Mainland China (ML), Taiwan (TW), and Hong Kong (HK), is unknown. We aimed to analyze the contributions of each of these 3 regions to diabetes research.Articles on diabetes originating from ML, TW, and HK that were published from 2005 to 2014 were retrieved from the Web of Science. The quantity of articles, citations, article types, and articles published in high-impact journals were analyzed.A total of 9302 articles were retrieved from the 3 regions of China. There were 6775 from ML, 1993 from TW, and 534 from HK, with an increasing trend in publications from 2005 to 2014. After 2006, the number of publications from ML exceeded TW and HK. The largest total number of citations (48,296) was from ML. The highest mean citations, however, were from HK (15.90). PLoS One was the most popular journal in all 3 regions. The greatest number of RCTs, clinical trials, meta-analyses, and articles published in high-impact journals were from ML.There has been a significant increase in the number of articles published on diabetes research from China during the past 10 years. Most of the articles were published by authors in ML, and an increasing trend began in 2006. HK had the highest quality research output in terms of mean citations per article.

Trends in scientific publications of Indian spine surgeons over 14 years (2000-2013)

BACKGROUND

The number and quality of scientific publications reflects the standards of scientific research in a country. However, the contribution of Indian spine surgeons toward global publications is unknown. The goal is to study the publications of Indian spine surgeons between 2000 and 2013.

MATERIALS AND METHODS

A literature search of the publications by Indian spine surgeons was performed using MEDLINE. The search terms used were India and several spine-related terminologies. The main information of the selected papers including the year of publication, scientific journal, type of pathology studied, Neurosurgical or Orthopedic Department where the study was done, type of study, and the type of article was analyzed.

RESULTS

A total of 4459 articles were identified using MEDLINE and after exclusion, 507 articles were analyzed. A growth of 440% in the number of publications was observed in the period between 2009 and 2013, during which 60.15% of the articles were published. Clinical studies (n = 492; 97.04) were the most common types of articles, followed by experimental studies and other types. The Neurosurgery department published the majority of the articles (58.2%). The three most common pathologies studied were spinal tumors (17.35%), surgical technique (15.4%), and spinal infection (15.2%).

CONCLUSION

The current study shows that publications in the field of spine surgery have been increasing in the last few years, although it is less. Further efforts such as research training of spine surgeons, inducing collaborations and formulation of multicenter projects and periodically allocating adequate funds are key factors to improve the scientific publications from India.

Scientific publications in nursing journals from Mainland China, Taiwan, and Hong Kong: a 10-year survey of the literature

Background: China has witnessed remarkable progress in scientific performance in recent years. However, the quantity and quality of nursing publications from three major regions (Mainland China, Taiwan, and Hong Kong) have not been reported. This study aimed to investigate the characteristics of scientific research productivity from Mainland China, Taiwan, and Hong Kong in the field of nursing. Methods: Articles published in the 110 nursing journals originating from Mainland China, Taiwan, and Hong Kong between 2005 and 2014 were retrieved from the Web of Science. The total number of articles published, the impact factor, and the citation count were analyzed. Results: There were 2,439 publications between 2005 and 2014 from China, including 438 from Mainland China, 1,506 from Taiwan, and 495 from Hong Kong. There was a significant increase in publications for these three regions (p < 0.05), especially for Mainland China, with a 59.50-fold increase experienced. From 2011, the number of publications from Mainland China exceeded that from Hong Kong. Taiwan had the highest total journal impact factor (2,142.81), followed by Hong Kong (720.39) and Mainland China (583.94). The mean journal impact factor from Hong Kong (1.46) was higher than that from Taiwan (1.42) and Mainland China (1.33). Taiwan had the highest total citation count (8,392), followed by Hong Kong (3,785) and Mainland China (1,493). The mean citation count from Hong Kong (7.65) was higher than that from Taiwan (5.57) and Mainland China (3.41). The Journal of Clinical Nursing was the most popular journal in the three regions. Discussion: Chinese contributions to the field of nursing have significantly increased in the past ten years, particularly from Mainland China. Taiwan is the most productive region in China. Hong Kong had the highest-quality research output, according to mean journal impact factor and mean citation count.

The 50 Most-cited Articles in Orthopaedic Surgery From Mainland China

BACKGROUND

Citation analysis has been widely used to evaluate the impact of articles in medical and surgical specialties. Although China is the most populous country in the world, and although more than 50,000 orthopaedic surgeons practice there, to our knowledge no formal citation analysis of Chinese orthopaedic articles has been performed.

QUESTIONS/PURPOSES

We identified the 50 most-cited orthopaedic articles from mainland China and evaluated these articles in terms of their language of publication, source journals, and topics.

METHODS

Science Citation Index Expanded was searched in July 31, 2014 for citations of articles published in 70 selected journals since the inception of the database. The 50 most-cited orthopaedic articles originating in mainland China were identified. Basic information, including title, authors, year of publication, article type, journal in which the work was published, city, institution, number of citations, decade published, and topic or subspecialty of the research were recorded.

RESULTS

The number of citations for the top 50 papers ranged from 181 to 31 (mean, 52). These articles were published between 1981 and 2010. The decade of 2000 to 2009 was the most prolific, with 36 of the top 50 articles published during this time. All articles were written in English and they were published in a total of 16 journals. The journal Spine published the largest number of articles (12), followed by Clinical Orthopaedics and Related Research (®) (seven). The journal Lancet had the highest impact factor (39.207 for 2013) among any of the journals that published articles we identified. The top 50 articles originated mainly from Beijing (16) and Shanghai (12), with basic research being the focus of the majority (27 of 50; 54%); the remaining were clinical studies. Bone was the most-investigated topic in basic research; the spine was the most-common topic among the identified clinical studies.

CONCLUSIONS

The 50 most-cited articles that we identified should be considered influential, although a large gap remains between mainland China and the global orthopaedic community in terms of citations per article. Nevertheless, insofar as the most-recent decade of our survey generated the most articles in this top-50 list, we would characterize mainland China's effect on musculoskeletal research as increasing, and as funding increases to programs in mainland China, we anticipate this trend will continue in the future.