The Spectrum of Altmetrics in Neurosurgery: The Top 100 “Trending” Articles in Neurosurgical Journals

Effective Use of Twitter by Orthopaedic Sports Medicine Journals Can Result in Increased Impact Factor

Purpose

To determine whether activity on Twitter was correlated with increasing impact factor (IF) among 6 orthopaedic sports medicine journals.

Methods

Twitonomy software was used to collect account activity for the American Journal of Sports Medicine; Arthroscopy: The Journal of Arthroscopic and Related Surgery; Knee Surgery, Sports Traumatology, Arthroscopy; Journal of Shoulder and Elbow Surgery; Orthopaedic Journal of Sports Medicine; and Sports Health. Data from 2000 to 2020 were collected. Each journal's annual IF score was collected via scijournal.org. A multivariate regression model was used to predict the influence of different Twitter metrics on IF from 2012 to 2019. The journal name, number of tweets, and interaction of the two were used to predict IF. Additionally, Pearson correlation was used to assess correlations between Twitter account metrics and IF.

Results

Over the study period, all IFs increased, with the exception of that for American Journal of Sports Medicine. The effect size between number of tweets and IF was not the same for each journal. For every additional tweet, American Journal of Sports Medicine increased its IF by 0.001 (P = .18). Sports Health and Orthopaedic Journal of Sports Medicine increased their IF by 0.01 (P = .002) and 0.022 (P < .001), respectively. Knee Surgery, Sports Traumatology, Arthroscopy would expect a decrease in its IF by 0.004 (P = .55) and Journal of Shoulder and Elbow Surgery and Arthroscopy would increase its IF by 0.002 (P = .71) and 0.001 (P = .99), but this was not significant. There was a statistically significant positive correlation between annual tweets and IF across all journals.

Conclusions

Markers of Twitter account activity, specifically the number of annual tweets, were predictive of an increase in IF among the orthopedic sports medicine journals included in this study.

Clinical Relevance

The findings of this study may allow orthopaedic sports medicine journals to make more effective, targeted, and productive use of their social media accounts to reach a broader audience, increase their influence, and increase the IF of their journal.

The Top Ranked 101 Articles in Pediatric Surgical Journals from an Altmetric Perspective

INTRODUCTION

 In the era of scientific digitalization, online media platforms gain increasing popularity to accomplish research output awareness. The Altmetric Attention Score AAS weights these online mentions based on a privy algorithm. We aimed to characterize the top 100 articles with the highest (AAS) published in pediatric surgery journals.

MATERIALS AND METHODS

 Publications from six core pediatric surgery journals were retrieved from www.altmetric.com in January 2023 and ranked by their AAS. The top 101 publications were analyzed for their bibliometric measures, study design, and quality as well as online media mentions.

RESULTS

 The top 101 AAS articles were published between 1974 and 2022, preferentially from the United States (64%) and mainly in Journal of Pediatric Surgery (73%), followed by Journal of Pediatric Surgery Case Reports, Pediatric Surgery International, Seminars in Pediatric Surgery, and European Journal of Pediatric Surgery. Their AAS ranged between 21 and 389 (median: 33), with Twitter/X being mostly responsible for online mentions (n = 2,189; 75%). The number of citations in peer-reviewed journals ranged between 0 and 358 (median: 16) and did not correlate to AAS. Retrospective study design (33%) with low evidence level IV (43%) dominated.

CONCLUSION

 The Journal of Pediatric Surgery is the main source of high-profile AAS publications in pediatric surgery. The altmetric popularity of articles is predominantly achieved by their propagation via X, irrespective of the study quality and recognition in the scientific community. Thus, active "twitterism" may play the key role to reach high AAS scores.

Subject matter predicts where top pediatric spine articles are shared: citations vs. social media

STUDY DESIGN

Systematic review. The purpose of this study was to compare the top 25 articles on pediatric spine surgery by number of citations and Altmetric score. All published articles pertaining to pediatric spine surgery from 2010 to 2021 were assessed for: Altmetric scores, Altmetric score breakdown (e.g. Twitter, News), citation counts, and article topics. The top 25 Altmetric articles and top 25 cited articles were identified. Out of the 50 total articles, only 3 (6.0%) overlapped between the two groups. The top Altmetric articles had averages (mean ± SD) of 167 ± 130 Altmetric score and 66 ± 135 citations, while the top citation articles had averages of 22 ± 45 Altmetric score and 196 ± 114 citations. When evaluating article topics, articles on 'back pain' (36% vs. 4%; P  = 0.003) and 'backpacks' (16% vs. 0%; P  = 0.030) were published significantly more in the top Altmetric group, while articles on 'scoliosis' (93% vs. 36%; P  < 0.001) and 'growth friendly surgery' (24% vs. 4%; P  = 0.041) were published significantly more in the top citation group. The total number of citations and online mentions for both groups are presented in Table 2. The biggest differences were the top Altmetric score articles receiving greater percentages of Twitter mentions relative to overall mentions (87% vs. 57%). The most socially popular articles focused on back pain and backpacks, and the most cited articles focused on scoliosis and growth-friendly surgery. Twitter had the most mentions of all social media for both the top cited articles and the top Altmetric articles.

Evaluating Funding for Authors Achieving High Citations vs. Online Popularity

INTRODUCTION

The Altmetric score is a validated tool that measures online attention of scientific studies. A relationship between government/industry funding for authors and their study's citations have been previously demonstrated. It is not known whether funding is related to greater online attention. We hypothesize authors publishing studies achieving greater online attention (higher Altmetric scores) receive greater monetary support from industry while authors publishing studies achieving critical acclaim (more citations) receive greater monetary support from the National Institute of Health (NIH).

METHODS

Top spine surgery studies between 2010 and 2021 were selected based on Altmetric scores and citation number. The Open Payments Database was accessed to evaluate industry financial relationships while the NIH Research Portfolio Online Reporting Tool was accessed to evaluate NIH funding. Payments were compared between groups and analyzed with the Student t-test, analysis of variance, and chi square analysis. Alpha <0.05.

RESULTS

There were 60 and 51 authors with payment data in the top 50 Altmetric and top 50 citation studies, respectively, with eight authors having studies in both groups. Total industry payments between groups were not markedly different. The eight authors with studies in both groups received markedly more industry payments for consulting, travel/lodging, and faculty/speaking fees. Authors with articles in both groups (50%) were significantly more likely to receive NIH support, compared with authors of the top Altmetric articles (5%; P < 0.001) and top citation articles (12%; P < 0.001). Authors receiving NIH support received significantly less industry payments compared with authors not receiving NIH support ($148,544 versus $2,159,526; P < 0.001).

DISCUSSION

These findings reject our hypothesis: no notable differences for industry payments and NIH funding between authors for top Altmetric and citation studies. Authors receiving funding from industry versus the NIH are generally two distinct groups, but there is a small group supported by both. These studies achieve both critical acclaim (citations) and online popularity (Altmetric scores).

DATA AVAILABILITY

Data can be available on reasonable request.

Which Topics Drive Dissemination? Alternative Bibliometrics Analysis of the Highest-Ranking Articles in 3 Infectious Diseases Journals Before COVID-19

Dissemination of research is paramount to improving patient care. Historically, dissemination is reported in conventional bibliometrics. However, with the increased utilization of digital platforms for communication, alternative bibliometrics describe more real-time dissemination of information. This study documents dissemination of publication topics in infectious diseases journals prior to the COVID-19 pandemic.

The bibliometric and altmetric analysis of chronic traumatic encephalopathy research: how great is the impact?

Background

The study of chronic traumatic encephalopathy (CTE) has received great attention from academia and the general public. This study aims to analyze the research productivity on CTE and investigate the most discussed articles in academia and the general public by conducting bibliometric and altmetric analyses.

Methods

Data of articles were obtained from the Web of Science Core Databases and Altmetric Explore. VOSviewer and CiteSpace software were used to analyze and visualize the articles. The correlation between Altmetric attention scores (AAS) and citation counts were assessed by Spearman correlation coefficient.

Results

788 publications of CTE were eventually gathered and analyzed, and 100 articles with highest citation counts (Top-cited) and 100 articles with highest AASs (Top-AAS) were then identified. The keywords density map showed both the general public and the scientists were particularly interested in the risk factors and pathology of CTE, and scientists were interested in the causes and characteristics of neurodegenerative diseases while the public became increasingly concerned about the detection and prevention of CTE. By examining the shared characteristics of the 44 articles (High-High articles) that overlapped between Top-cited and Top-AAS articles, we identified certain traits that may potentially contribute to their high citation rates and high AASs. Besides, significant positive correlations with varied strength between AAS and citation were observed in the 788 articles, Top-cited, Top-AAS and High-High datasets.

Conclusion

This study is the first to link bibliometric and altmetric analyses for CTE publications, which may provide deeper understanding of the attention of the scientists and the general public pay to the study of CTE, and offer some guidance and inspiration for future CTE in the selection of research topics and directions.

Variation in academic neurosurgery departments' #neurosurgery social media influence

Background

Social media use is increasingly common among academic neurosurgery departments, but its relationship with academic metrics remains underexamined.

Methods

We examine the relationship between American academic neurosurgery departments' number of followers on Twitter, Instagram, and Facebook and the following academic metrics: Doximity Residency rankings, US News & World Report rankings (USNWR) of their affiliated medical schools, and the amount of NIH funding of those schools.

Results

Few departments had disproportionate number of followers. A greater proportion of programs had Twitter accounts (88.9%) than had Instagram (72.2%) or Facebook (51.9%) accounts (p=0.0001). Programs identified as "Influencers" had more departmental NIH funding (p=0.044), more institutional NIH funding (p=0.035), better Doximity residency rankings (p=0.044), and better affiliated medical school rankings (p=0.002). Number of Twitter followers had the strongest correlation with academic metrics, yet only modest correlations were identified to departmental NIH funding (R=0.496, p=0.0001), institutional NIH funding (R=0.387, p=0.0072), Doximity residency rank (R=0.411, p=0.0020), and affiliated medical school ranking (R=0.545,p<0.0001). On multivariable regression, only being affiliated with a medical school in the top quartile on the USNWR rankings, rather than neurosurgery departmental metrics, predicted having more Twitter (OR=5.666, p=0.012) and Instagram (OR=8.33, p=0.009) followers.

Conclusion

American academic neurosurgery departments preferentially use Twitter over Instagram or Facebook. Their Twitter or Instagram presences are associated with better performance on traditional academic metrics. However, these associations are modest, suggesting that other factors contribute to a department's social media influence. A department's affiliated medical school may contribute to the department's social media brand.

Analysis of the 100 most cited articles on ameloblastoma

OBJECTIVES

An increasing number of articles are published each year. The aim of this is to provide a list of the 100 most cited articles on the subject of ameloblastoma.

METHODS

A bibliographic search was performed on Google Scholar (GS), Microsoft Academic (MA), and Dimensions for ameloblastoma. A ranking was created in order of citation density. Graphical representations of keywords and authorship were created with VOSviewer. Statistical analysis was performed and only results with a 95% confidence interval were considered significant.

RESULTS

A helpful list of top 100 articles was developed to help professionals in a variety of ways. Some curiosities are discussed about this scientometric analysis in ameloblastoma articles.

CONCLUSIONS

A useful list of the top 100 most cited articles on ameloblastoma has been provided. Bibliometric and altmetric analysis using Google Scholar, Microsoft Academic, and Dimensions is a free and excellent tool, not only as a citation manager but also as a study reference.

The Altmetric Attention Score Is Associated With Citation Rates and May Reflect Academic Impact in the Total Joint Arthroplasty Literature

Background: Given the increasing interest and potential use of social media for the promotion of orthopedic literature, there is a need to better understand Altmetrics. Purposes: We sought to determine the relationship between the Altmetric Attention Score (AAS) and the number of citations for articles on total joint arthroplasty (TJA) published in orthopedics journals. We also sought to determine the predictors of greater social media attention for these articles. Methods: Articles on TJA published in Bone and Joint Journal (BJJ), Journal of Bone and Joint Surgery (JBJS), Clinical Orthopedics and Related Research (CORR), Journal of Arthroplasty, Journal of Knee Surgery, Hip International, and Acta Orthopaedica in 2016 were extracted (n = 498). One-way analysis of variance with Bonferroni corrections was used to compare AAS and citations across journals. Multivariate regressions were used to determine predictors of social media attention and number of citations. Results: The mean AAS and number of citations were 7.5 (range: 0-289) and 16.7 (range: 0-156), respectively. Significant between-group effects were observed according to journal for AAS and number of citations. Publishing an article in JBJS was the strongest predictor of higher number of citations. Publishing an article in BJJ was the only independent predictor of higher AAS, while publishing an article in JBJS or CORR trended toward statistical significance. A higher AAS was a significant predictor of a higher number of citations. Number of citations and number of study references were positive predictors of greater social media attention on Twitter and Facebook. Conclusions: In articles on TJA published in 7 journals in 2016, a higher AAS was a associated with a higher number of citations. Various bibliometric characteristics were found to be significantly associated with greater social media attention; the most common influences were number of citations and number of references. Researchers in orthopedics can use this information when considering how to assess the impact of their work.

Twitter Use Among Orthopedic Surgery Journals Correlates With Increased Citation Rates

Use of alternative online means of distribution for research is a rapidly evolving area in orthopedics. In this study, we investigate the impact of Twitter on research citation rates and the association between Altmetric Attention Score (AAS) and citation rates across major orthopedic journals. Original research articles published in a selection of 10 journals between January 2018 and December 2018 were analyzed for number and source of tweets, AAS, and number of citations. We determined the relationship between Twitter use of different sources and number of citations across all journals and within each individual journal, any statistical differences in citations and AAS for tweeted vs nontweeted articles, and the correlation between journal impact factor and average number of monthly tweets. We included 2916 articles in our study, at an average of 26 months after publication. The mean AAS was 9.7 (SD, 45.1; range, 0-1125), and mean citation rate was 6.4 (SD, 8.5; range, 0-166). Impact factor was strongly correlated with average monthly tweets (r²=0.77). Tweeted articles received 8.51 citations on average, compared with 2.56 citations for nontweeted articles (P<.05). Tweets sent by the author/department had the highest impact on future citations (P<.01). Tweets by news outlets had a smaller, positive effect on citations (P<.01). Tweets sent by Arthroscopy (P<.01) and Journal of Pediatric Orthopaedics (P<.01) had high impacts compared with other journals. [Orthopedics. 2023;46(1):e38-e44.].

Evaluation of Altmetric Analysis Scores of the Top 100 Articles on Polycystic Ovary Syndrome Published in the Last 10 Years

OBJECTIVE

In the current study, we analyzed the 100 most cited articles with the topic, title, and keywords of polycystic ovary syndrome (PCOS) published in all journals in terms of traditional metrics and the altmetric score (AS).

METHODS

The term "polycystic ovary syndrome (PCOS)" was searched in the Web of Science (WoS) database and filtered for articles published in all journals. Bibliographic data and AS were obtained for 100 highly cited papers from January 2012 to July 2022. Descriptive statistics were reported and correlation analysis between traditional bibliographies and the AS was performed.

RESULTS

The Journal of Clinical Endocrinology & Metabolism, with 14 articles, had the most publications on the Top 100 list. When the studies were classified according to subtypes, 56 papers were original scientific papers with mean AS of 32.5 (15.3-52.7), whereas 44 papers were reviews and meta-analyses with AS of 16.0 (8.6-43.2). The AS was positively correlated with H-index, total WoS citation number of article and Q category. There were no correlations with impact factor (IF), five-year IF, journal impact factor (JIF) percentile and journal citation indicator (JCI) value.

CONCLUSION

Our results suggest that the AS is related with article total WoS citation number, journal Q category, and journal H-index. Effective communication on social media can promote scientific productivity and have a positive impact on society.

Characteristics analysis and evaluation of discourse leading for academic journals: perspectives from multiple integration of altmetrics indicators and evaluation methods

Purpose

Under the background of open science, this paper integrates altmetrics data and combines multiple evaluation methods to analyze and evaluate the indicators' characteristics of discourse leading for academic journals, which is of great significance to enrich and improve the evaluation theory and indicator system of academic journals.

Design/methodology/approach

This paper obtained 795,631 citations and 10.3 million altmetrics indicators data for 126,424 published papers from 151 medicine, general and internal academic journals. In this paper, descriptive statistical analysis and distribution rules of evaluation indicators are first carried out at the macro level. The distribution characteristics of evaluation indicators under different international collaboration conditions are analyzed at the micro level. Second, according to the characteristics and connotation of the evaluation indicators, the evaluation indicator system is constructed. Third, correlation analysis, factor analysis, entropy weight method and TOPSIS method are adopted to evaluate and analyze the discourse leading in medicine, general and internal academic journals by integrating altmetrics. At the same time, this paper verifies the reliability of the evaluation results.

Findings

Six features of discourse leading integrated with altmetrics indicators are obtained. In the era of open science, online academic exchanges are becoming more and more popular. The evaluation activities based on altmetrics have fine-grained and procedural advantages. It is feasible and necessary to integrate altmetrics indicators and combine the advantages of multiple methods to evaluate the academic journals' discourse leading of which are in a diversified academic ecosystem.

Originality/value

This paper uses descriptive statistical analysis to analyze the distribution characteristics and distribution rules of discourse leading indicators of academic journals and to explore the availability of altmetrics indicators and the effectiveness of constructing an evaluation system. Then, combining the advantages of multiple evaluation methods, The author integrates altmetrics indicators to comprehensively evaluate the discourse leading of academic journals and verify the reliability of the evaluation results. This paper aims to provide references for enriching and improving the evaluation theory and indicator system of academic journals.

The Author Impact Factor as a Metric to Evaluate the Impact of Neurosurgical Researchers

OBJECTIVE

The objective of this study was to assess the Author Impact Factor (AIF) as a useful metric and as a complement to the h-index among neurosurgical researchers.

METHODS

The 5-year AIF and h-index were compared among 3 groups of researchers: 1) the 100 most prolific of all time within general neurosurgical journals ("Experienced"), 2) the 100 most prolific during the 2015-2019 period within general neurosurgical journals ("Trending Group"), and 3) the 100 postgraduation year 7 neurosurgical residents with the highest h-index ("Amateur").

RESULTS

The Amateur group had a lower median h-index than the Experienced (6 vs. 55; P < 0.001) and Trending (6 vs. 43; P < 0.001) groups. The highest h-index of the Amateur group (24) was lower than the first quartile of the Experienced (46.25) and Trending (26.00) groups. The Amateur group had a lower median 5-year AIF than the Experienced (2.15 vs. 3.17; P < 0.001) and Trending (2.15 vs. 2.85; P = 0.02) groups. Unlike the h-index, the gap between the 5-year AIF distribution of the Amateur group and other groups was not profound. Although there was a positive correlation between the metrics in the 3 groups, they did not proxy for each other. For instance, while the h-index of some experienced authors that have not published recently was high, their AIFs were zero. Also, some Amateur authors published very impactful articles and had a high 5-year AIF. However, since their number of publications is inevitably low, their h-index were low.

CONCLUSIONS

The AIF provides intuitive and complementary information to the h-index regarding the research output of neurosurgical authors.

High social media attention scores are not reflective of study quality: an altmetrics-based content analysis

Recent literature has demonstrated the associations between social media attention, as measured by altmetric attention score (AAS), and higher citation rates across medical disciplines. Despite increasing use of AAS, an understanding of factors associated with higher AAS and social media attention remains lacking. Furthermore, if this increased attention correlates with a higher methodological quality and lower biases has not been determined. Therefore, the purpose of the current study was to determine the relationship between methodological quality, study biases and the AAS in randomized controlled trials (RCTs). All RCTs from 2016 in the New England Journal of Medicine (NEJM), Journal of the American Medical Society (JAMA), and Lancet were extracted and the (1) AAS; (2) Methodological Bias (JADAD Scale); Study Bias (Cochrane Risk-of-Bias tool for RCTs) recorded. A total of 296 RCTs with a median (range) AAS and citation rate per article of 234.0(7-4079) and 165.0(4-3257), respectively, were included. The AAS was positively associated with citation rate (β 0.19, 95% CI 0.10-0.29; P < 0.001). Methodological bias was not associated with the AAS (β - 36.3, 95% CI - 83.5-10.9; P = 0.131), but was negatively associated with higher citation rates (β - 66.4, 95% CI - 106.0 to - 26.9; P = 0.001). The number of study biases was not associated with the AAS (β 43.7, 95% CI - 6.3-93.7;P = 0.086), but was positively associated with a higher citation rate (β 64.5, 95% CI 22.4-106.6; P = 0.003). The online attention of RCTs in medical journals was not necessarily reflective of high methodological quality and minimal study biases, but was associated with higher citation rates. Researchers and clinicians should critically examine each article despite the amount of online attention an article receives as the AAS does not necessarily reflect article quality.

The Author-Level Metrics Study: An Analysis of the Traditional and Alternative Metrics of Scholarly Impact for Neurosurgical Authors

Background and objective

There is a paucity of information regarding the concordance of traditional metrics across publicly searchable databases and about the correlation between alternative and traditional metrics for neurosurgical authors. In this study, we aimed to assess the congruence between traditional metrics reported across Google Scholar (GS), Scopus (Sc), and ResearchGate (RG). We also aimed to establish the mathematical correlation between traditional metrics and alternative metrics provided by ResearchGate.

Methods

Author names listed on papers published in the Journal of Neurosurgery (JNS) in 2019 were collated. Traditional metrics [number of publications (NP), number of citations (NC), and author H-indices (AHi)] and alternative metrics (RG score, Research Interest score, etc. from RG and the GS i10-index) were also collected from publicly searchable author profiles. The concordance between the traditional metrics across the three databases was assessed using the intraclass correlation coefficient and Bland-Altman (BA) plots. The mathematical relation between the traditional and alternative metrics was analyzed.

Results

The AHi showed excellent agreement across the three databases studied. The level of agreement for NP and NC was good at lower median counts. At higher median counts, we found an increase in disagreement, especially for NP. The RG score, number of followers on RG, and Research Interest score independently predicted NC and AHi with a reasonable degree of accuracy.

Conclusions

A composite author-level matrix with AHi, RG score, Research Interest score, and the number of RG followers could be used to generate an "Impact Matrix" to describe the scholarly and real-world impact of a clinician’s work.

Technique Articles Are More Effective at Increasing Social Media Attention in Comparison With Original Research Articles: An Altmetrics-Based Analysis

Purpose

To compare social media attention and citation rates between technique articles and matched original research articles (ORAs) regarding surgical procedures.

Methods

All technique articles published from August 2019 through July 2020 in the free, electronic versions of Arthroscopy Techniques and JBJS Essential Surgical Techniques were matched by topic to articles in the “Original Research” sections of Arthroscopy, Sports Medicine, and Rehabilitation and JBJS Open Access in a 4:1 ratio within this time frame. The primary outcome was the Altmetric Attention Score (AAS). Secondary outcomes included citations, bibliometrics, and social media metrics. Independent t tests were used to compare primary and secondary outcomes between technique articles and ORAs. A multivariate linear regression analysis was performed to determine the association between article type and social media attention while controlling for confounding bibliometric characteristics.

Results

A total of 285 matched research articles (n = 57, 20.0%) and technique articles (n = 228, 80.0%) were included. The mean AAS among all technique articles was 3.63 ± 10.08 (range, 0-96) whereas the mean AAS among all ORAs was 1.30 ± 3.98 (range, 0-25), representing a statistically significant difference (P = .016). The mean citation rate among all technique articles was not significantly different from that among ORAs (P = .73). Multivariate linear regression analysis showed a statistically significant positive association between AAS and article type, with an additional mean increase in the AAS of 2.91 (95% confidence interval, 0.04-5.77; P = .047) for every technique article compared with an ORA. Furthermore, a significant positive relation was noted between the article origin and the AAS, with an increase in the AAS of 3.00 (95% confidence interval, 0.82-5.17; P = .007) for every article published in North America compared with an article originating from another continent.

Conclusions

Technique articles resulted in significantly greater AASs and social media attention in comparison with open-access ORAs on similar topics. Publications that described technical procedures in a technique journal and studies from North America were positively associated with greater AASs and greater numbers of citations received by articles.

Clinical Relevance

An improved understanding of how much attention is given to technique articles versus matched ORAs by social media may influence the methods authors and journals use for distributing content. The present study suggests that one option to increase the amount of social media attention received for a particular study may be to utilize an accompanying surgical technique video or illustrations as these are easily shareable on social media and offer rapid dissemination of knowledge, similar to that of an infographic. However, physicians who view multimedia within technique articles should be encouraged to review the accompanying articles and the supporting original research as a primary source before making changes in their clinical practice.

Top 50 covid and oral health articles: A 2021 altmetric analysis

Objectives

There is a world of information at our disposal, and it is increasingly difficult to transform this dull amount of data into knowledge. How to be constantly actualized? This study aims to create an altmetric list of the top 50 articles related to COVID-19 and oral health.

Methods

Research of terms COVID-19 and oral health was done using Dimensions app. Results were ranked in altmetric citations and analyzed through Microsoft Excel. Some tables and graphics were created. Graphical illustration of keywords was created using VOSviewer.

Results

Some interesting facts can be seen, like growing interest in dental aerosols, perspectives, and virucidal activity of some mouthwashes.

Conclusions

Altmetric analysis is a helpful manner to scientific updates, supplementing bibliometric analysis. A terrific manner to see trends. The scientific community goes to great lengths to solve problems with dental aerosols, particularly to reduce contamination. Some adjustments to dental office and the use of barriers are recommended.

ALTMETRIC ANALYSIS OF THE MOST-CITED 100 ARTICLES ON THE RETINA PUBLISHED BETWEEN 2010 AND 2020

PURPOSE

Altmetric analysis is a way of assessing the social impact of scientific articles. In this study, we aimed to analyze the 100 most-cited articles on the topic of the retina published in ophthalmology journals in traditional metrics and altmetrics.

METHODS

The term "retina" was searched in the Web of Science database, and articles published in ophthalmology journals were filtered out. A total of 100 highly cited articles from 2010 to 2020 were evaluated for bibliographic data and altmetrics. First, descriptive statistics and then correlation analysis between traditional bibliographies and altmetrics were performed.

RESULTS

According to the Web of Science search, the number of citations of the articles listed in the top 100 list ranged from 809 to 137. The altmetric scores of the articles listed in the top 100 list ranged from 0 to 1,340. There was no statistically significant correlation between the altmetric scores and the number of citations, but there was a statistically weak correlation between the altmetric scores and the average citations per year, H index, impact factor, and number of years since publication.

CONCLUSION

Altmetrics is not sufficient to determine the scientific value of articles and can be affected by many factors, unlike traditional bibliometrics. However, being a good communicator in social media can support scientific productivity and create social impact.

The 100 Most Mentioned Glaucoma Articles Online With Highest Altmetric Attention Scores

PRCIS

Characteristics of the most mentioned glaucoma articles on the internet were analyzed, allowing a better understanding of the dissemination of glaucoma research to the general public.

PURPOSE

The aim was to determine the 100 most mentioned articles on the internet in the field of glaucoma and analyze their characteristics.

MATERIALS AND METHODS

We identified the top 100 glaucoma articles with the highest Altmetric Attention Score (AAS), an automatically calculated metric for monitoring social media. Each article was evaluated for several characteristics including year of publication, title, journal name, journal impact factor (IF), article topic, article type, affiliation, and online mentions (news, blog, policy, Twitter, Facebook, etc.). Correlation analysis was conducted for AAS with these characteristics.

RESULTS

The selected 100 articles came from 44 journals with more than half (56%) published in ophthalmology-specific journals. There was no significant correlation between IF and number of articles in a specific journal or AAS (P>0.1), but the number of articles in the top 100 was higher for ophthalmology journals with a higher IF (P<0.05). Original study was the most common study type (87%), of which clinical observation study was the most common subgroup (40%). Epidemiology/risk factor and basic science were the most common article topics (each 24%), followed by medical treatment (13%). Article topics regarding medical treatment had a significantly greater AAS than other topics (P<0.05). Of the top 5 articles, more than half (60%) were related to "Lifestyle choice" topics.

CONCLUSIONS

There was no association between journal IF and AAS, consistent with previous studies. 90% of journals that had articles in the top 100 had a Twitter page. "Lifestyle choice" activities and other modifiable risk factors attracted significant online attention regarding glaucoma studies, with two of the top three most mentioned articles related to dietary intake. The present study thus provides a better understanding of online engagement with glaucoma research and the dissemination of this research to the general public.

Current state of social media utilization in neurosurgery amongst European Association of Neurosurgical Societies (EANS) member countries

Background

Social Media (SoMe) is becoming increasingly used in the medical community, and its use has been related with academic productivity. However, utilization of SoMe in the European neurosurgical community has not been assessed systematically.

Methods

An online search was undertaken to discover SoMe accounts of (1) national and related neurosurgical societies listed on the EANS website, (2) neurosurgical journals present on EANS website, (3) neurosurgery centers within EANS member countries, as listed on their website. SoMe accounts of Facebook, Twitter, YouTube, and Instagram were searched for journals and societies, and Twitter, Instagram, and Facebook for neurosurgery departments. The number of likes/followers/subscribers was recorded.

Results

Five (31%) neurosurgery journals had a SoMe presence. The highest number of followers, likes, and tweets was found for JNNP, and Journal of Neurological Surgery Part B had the most subscribers and video views. SoMe usage was identified for 11 national (28.2%) and 2 multi-national neurosurgical societies. From these, the French Society of Neurosurgery had the largest number of Facebook followers (> 2800) and Likes (> 2700), the Society of British Neurological Surgeons had the largest number of Twitter followers (> 2850), whereas EANS overall had the most followers on Twitter > 5100 and Facebook > 5450. A total of 87 SoMe neurosurgery center accounts were found on either Facebook, Instagram or Twitter, for 64 of 1000 centers (6.4%) in 22 of 40 different countries (55%). Of these 67% (n = 43/64) arose from 6 countries (England, Germany, Italy, Romania, Turkey, Ukraine). There were more Facebook accounts (n = 42) than Instagram accounts (n = 23) or Twitter accounts (n = 22).

Conclusion

SoMe use amongst neurosurgical societies and departments in Europe is very limited. From our perspective, explanations are lacking for the correlated numbers to the market shares of SoMe in the respective countries. Further research, including a survey, to follow up on this important topic should be undertaken among EANS members.

Infographics Are More Effective at Increasing Social Media Attention in Comparison With Original Research Articles: An Altmetrics-Based Analysis

PURPOSE

To compare social media attention and citation rates between infographics (visual abstracts) and original research articles.

METHODS

All infographics in 2019 from electronic versions of Arthroscopy were matched by topic to articles in the "Original Research" section of the journal in a 4:1 ratio within the same year. The primary outcome was the Altmetric Attention Score (AAS), a cumulative measure of social media attention from various platforms such as Twitter and Facebook. Secondary outcomes included citation rates, article characteristics, and number of shares on social media platforms. Independent t tests and χ² analyses were used to compare primary and secondary outcomes between infographics and control articles. Multivariate linear regression analysis was performed to determine the association between article type and social media attention while controlling for bibliometric characteristics.

RESULTS

A total of 60 matched research articles (n = 48, 80.0%) and infographics (n = 12, 20.0%) published in 2019 in Arthroscopy were included. The mean AAS among all infographics was 29.75 ± 32.84 (range, 3-118), whereas the mean AAS among all control research articles was 5.75 ± 8.90 (range, 0-41), representing a statistically significant difference (P < .001). Infographics had significantly more Twitter mentions (100% vs 70.8%, P < .001) and Facebook mentions (75% vs. 6.2%, P < .001) compared with original articles. Multivariate linear regression analysis demonstrated a statistically significant and positive association between AAS and article type, with an additional mean increase in the AAS of 33.7 (95% confidence interval 11.6-50.6; P = .003) for every infographic article compared with an original research article. The mean citation rate among all infographics was 2.4 ± 2.4 (range, 0-7), whereas the mean citation rate among all control research articles was 2.2 ± 4.0 (range, 0-27), which was not a significant difference (P = .69).

CONCLUSIONS

Infographics resulted in significantly greater AAS and social media attention in comparison with original research articles of similar topics. We recommend the routine creation of infographics by journals to increase the social media attention that their research and chosen topics of interest receive. However, viewers of infographics should read them out of interest but turn their attention toward the original article or a source of more detailed information before making changes in clinical decision-making or practice, as they can be oversimplified.

CLINICAL RELEVANCE

Infographics are an increasingly used by journals as a form of depicting research findings from select studies. By producing infographics, journals may increase the amount of social media attention received for a particular study or topic of interest.

The Use of Twitter by Medical Journals: Systematic Review of the Literature

BACKGROUND

Medical journals use Twitter to engage and disseminate their research articles and implement a range of strategies to maximize reach and impact.

OBJECTIVE

This study aims to systematically review the literature to synthesize and describe the different Twitter strategies used by medical journals and their effectiveness on journal impact and readership metrics.

METHODS

A systematic search of the literature before February 2020 in four electronic databases (PubMed, Web of Science, Scopus, and ScienceDirect) was conducted. Articles were reviewed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines.

RESULTS

The search identified 44 original research studies that evaluated Twitter strategies implemented by medical journals and analyzed the relationship between Twitter metrics and alternative and citation-based metrics. The key findings suggest that promoting publications on Twitter improves citation-based and alternative metrics for academic medical journals. Moreover, implementing different Twitter strategies maximizes the amount of attention that publications and journals receive. The four key Twitter strategies implemented by many medical journals are tweeting the title and link of the article, infographics, podcasts, and hosting monthly internet-based journal clubs. Each strategy was successful in promoting the publications. However, different metrics were used to measure success.

CONCLUSIONS

Four key Twitter strategies are implemented by medical journals: tweeting the title and link of the article, infographics, podcasts, and hosting monthly internet-based journal clubs. In this review, each strategy was successful in promoting publications but used different metrics to measure success. Thus, it is difficult to conclude which strategy is most effective. In addition, the four strategies have different costs and effects on dissemination and readership. We recommend that journals and researchers incorporate a combination of Twitter strategies to maximize research impact and capture audiences with a variety of learning methods.

Guidelines for optimal utilization of social media for brain tumor stakeholders

OBJECTIVE

Effective use of social media (SM) by medical professionals is vital for better connections with patients and dissemination of evidence-based information. A study of SM utilization by different stakeholders in the brain tumor community may help determine guidelines for optimal use.

METHODS

Facebook, Twitter, and YouTube were searched by using the term "Brain Tumor." Platform-specific metrics were determined, including audience size, as a measure of popularity, and mean annual increase in audience size, as a measure of performance on SM. Accounts were categorized on the basis of apparent ownership and content, with as many as two qualitative themes assigned to each account. Correlations of content themes and posting behavior with popularity and performance metrics were assessed by using the Pearson's test.

RESULTS

Facebook (67 pages and 304,581 likes) was predominantly used by organizations (64% of pages). Top themes on Facebook, Twitter, and YouTube were charity and fundraising (67% of pages), education and research (72% of accounts), and experience sharing and support seeking (48% of videos, 60% of views, and 82% of user engagement), respectively. On Facebook, only the presence of other concurrent platforms influenced a page's performance (rho = 0.59) and popularity (rho = 0.61) (p < 0.05). On Twitter, the number of monthly tweets (rho = 0.66) and media utilization (rho = 0.78) were significantly correlated with increased popularity and performance (both p < 0.05). Personal YouTube videos (30% of videos and 61% of views) with the theme of experience sharing and support seeking had the highest level of engagement (60% of views, 70% of comments, and 87% of likes).

CONCLUSIONS

Popularity and prevalence of qualitative themes differ among SM platforms. Thus, optimal audience engagement on each platform can be achieved with thematic considerations. Such considerations, along with optimal SM behavior such as media utilization and multiplatform presence, may help increase content popularity and thus increase community access to neurooncology content provided by medical professionals.

#Neurosurgery: A Temporal and Content Analysis of Academic Neurosurgery on Twitter

BACKGROUND

Social media has become ubiquitous in modern medicine. Academic neurosurgery has increased adoption to promote individual and departmental accomplishments, engage with patients, and foster collaboration. We sought to quantitatively evaluate the adoption of one of the most used social media platforms, Twitter, within academic neurosurgery.

METHODS

A quantitative and qualitative analysis of Twitter use across 118 academic neurosurgery departments with residency programs in the United States was performed in March 2019 and March 2021. We collated Twitter handles, Doximity residency ranking (a peer-determined ranking system), geographic location, and Twitter demographics (tweets, followers, likes, and tweet content) from before and after the coronavirus disease 2019 (COVID-19) pandemic. Tweet content was characterized by reviewers over a predetermined 6-month period. Linear regression and parametric/nonparametric tests were used for analysis.

RESULTS

Departmental accounts grew 3.7 accounts per year between 2009 and 2019 (R² = 0.96), but 43 accounts (130%) were added between 2019 (n = 33) and 2021 (n = 76). This growth, coinciding with the COVID-19 pandemic, changed the model from linear to exponential growth (R² = 0.97). The highest-ranking programs based on Doximity were significantly more likely to have an account (P < 0.001) and have more followers (P < 0.0001). Tweet content analysis revealed prioritization of faculty/resident activity (mean 49.9%) throughout the quartiles.

CONCLUSIONS

We demonstrate rapid uptake in Twitter use among U.S. academic neurosurgical departments, accelerated by COVID-19. With the impact of COVID-19, it is clear that there will be continued rapid adoption of this platform within neurosurgery, and future studies should explore the outcomes of peer collaboration, patient engagement, and dissemination of medical information.

Orthognathic Surgery: A Bibliometric Analysis of the Top 100 Cited Articles

PURPOSE

An increasing number of articles on orthognathic surgery are published every year. This paper aims to provide a list of the top 100 cited articles on orthognathic surgery to help any professional level with interest in this topic and to map the trends of orthognathic surgery publications over time.

METHODS

A bibliographic search (retrospective study) following STROBE guidelines was performed on Google Scholar (GS) and Dimensions with the term "orthognathic surgery" in the title, abstract, and keywords. The number of citations, citations per year, authors, and publication year were evaluated. A ranking was created in GS citations order with the top 100 cited articles and variables discussed individually. A graphical illustration of keywords was created using VOSviewer. These steps are fundamental in creating this list and relating it to all published articles on the topic.

RESULTS

A helpful list of the top 100 articles was developed to help professionals in entirely different manners. Virtual planning and complications in orthognathic surgery were the most cited topics, with a 95% confidence interval (P < .05). Some curiosities are discussed, such as increasing interest in surgery first and the relation between airway/obstructive sleep apnea and orthognathic surgery.

CONCLUSIONS

Bibliometric and altmetric analysis for free using Google Scholar and Dimensions is laborious but possible. Bibliometrics is a powerful tool to become actualized at any health professional level, from students to academics; and could save considerable effort and time for parties interested in the topic. Appropriate keywords are a crucial step to wider article dissemination.

Examining the correlation between Altmetric Attention Score and citation count in the gynecologic oncology literature: Does it have an impact?

•

The AAS is a useful tool to predict future citation counts for oncology publications in gynecologic oncology.

•

A hybrid metric using impact factor and AAS may help to predict academic influence on a broader scale.

•

In addition to impact factor, AAS may be used by journals to enhance interest in subscriptions.

•

AAS may be another metric used to assess the quality of publications.

We sought to determine the correlation between Altmetric Attention Score and traditional bibliometrics in the gynecologic oncology literature. We identified the 10 most-cited gynecologic oncology articles from 5 major gynecology journals and 10 major “oncology” journals that publish on gynecologic oncology during 2014, 2016, and 2018. Article citation count and Altmetric Attention Score (AAS), as well as journal impact factor (IF) and date of Twitter account development were recorded. Pearson's correlation coefficient was used to describe the relationship between AAS, tweets, IF, and citation count. While the median citation counts significantly decreased for the top-cited gynecologic oncology articles from 2014 to 2018 (p < 0.001), the corresponding median AAS continuously increased during this period (p = 0.008). For articles published in 2014 and 2018, there was a strong positive relationship between the median citation count and the median AAS (2014: r = 0.92; 2018: r = 0.97), as well as between the IF (r = 0.78 and r = 0.89, respectively); these correlations were moderate to weak in 2016 (r = 0.5 and r = 0.41, respectively). There was a continuously increasing strong positive correlation from 2014 to 2018 between journal IF and median AAS (2014: r = 0.75; 2016: r = 0.82; 2018: r = 0.92). Gynecologic oncology articles published in higher impact journals are associated with increased social media visibility and attention. Our data support the idea that early online attention scores, like the AAS, might be useful for predicting future citation counts for oncology publications in general and gynecologic oncology specifically.

Orthopaedic Randomized Controlled Trials Published in General Medical Journals Are Associated With Higher Altmetric Attention Scores and Social Media Attention Than Nonorthopaedic Randomized Controlled Trials

PURPOSE

To (1) compare the Altmetric Attention Score (AAS) and citation rates between orthopaedic and nonorthopaedic randomized controlled trials (RCTs) from 5 high-impact medical journals and (2) identify general characteristics of these articles associated with greater exposure on social media platforms.

METHODS

Articles published in The New England Journal of Medicine (NEJM), Lancet, The Journal of the American Medical Association (JAMA), Annals of Internal Medicine, and Archives of Internal Medicine between January 2011 and December 2016 were analyzed. These journals were selected based on retaining high impact factors with rigorous publication standards and availability of the AAS for their publications. The queried time frame was chosen to balance the inception of the AAS with an optimal period for citation accrual. A total of 14 article characteristics, in addition to number of Tweets, Facebook shares, news mentions, and the AAS, were extracted. Inclusion criteria were orthopaedic RCTs reporting on outcomes after surgical intervention. Linear regression was used to assess the relationship between publication characteristics and the AAS and social media attention.

RESULTS

A total of 9 orthopaedic and 59 nonorthopaedic RCTs were included. The mean AASs were significantly different (574 ± 565.7 versus 256.9 ± 222.3, P = .003), whereas citation rate was not (192.2 ± 117.1 versus 382.3 ± 560.3, P = .317). Orthopaedic RCTs had a significantly greater number of mentions on Twitter and Facebook (P < .001). A higher AAS significantly associated with a greater number of citations (β = 0.75, P = .019) for orthopaedic RCTs. The mean AAS of orthopaedic RCTs favoring nonoperative management (809.6 ± 676.3) was greater than those favoring operative treatment (292.0 ± 248.9) but was not statistically significant (P = .361).

CONCLUSION

Orthopaedic RCTs published in 5 high-impact general medical journals had a significantly greater mean AAS relative to nonorthopaedic RCTs, with no differences in citation rates. Additionally, there was a strong association between the AAS and citation rate of orthopaedic RCTs. Orthopaedic RCTs had greater social media exposure on both Twitter and Facebook.

CLINICAL RELEVANCE

Orthopaedic surgeons, researchers, and providers who publish RCTs in high-impact medical journals can anticipate extensive social media attention for their articles relative to other nonorthopaedic RCTs in the same journals. Social media attention may be related to operative versus nonoperative management topics. This study provides further evidence for the increasing use of the AAS and its association with citation accrual.

The Most Widely Disseminated COVID-19-Related Scientific Publications in Online Media: A Bibliometric Analysis of the Top 100 Articles with the Highest Altmetric Attention Scores

The novel coronavirus disease 2019 (COVID-19) is a global pandemic. This study's aim was to identify and characterize the top 100 COVID-19-related scientific publications, which had received the highest Altmetric Attention Scores (AASs). Hence, we searched Altmetric Explorer using search terms such as "COVID" or "COVID-19" or "Coronavirus" or "SARS-CoV-2" or "nCoV" and then selected the top 100 articles with the highest AASs. For each article identified, we extracted the following information: the overall AAS, publishing journal, journal impact factor (IF), date of publication, language, country of origin, document type, main topic, and accessibility. The top 100 articles most frequently were published in journals with high (>10.0) IF (n = 67), were published between March and July 2020 (n = 67), were written in English (n = 100), originated in the United States (n = 45), were original articles (n = 59), dealt with treatment and clinical manifestations (n = 33), and had open access (n = 98). Our study provides important information pertaining to the dissemination of scientific knowledge about COVID-19 in online media.

Social Media in Neurosurgery: A Systematic Review

OBJECTIVE

Social media has been used increasingly in neurosurgery by individuals. We aimed to identify demographics and preferences of social media use, describe the scope of social media use, and characterize its utility.

METHODS

A systematic review was conducted using PubMed, Embase, and Scopus databases. Titles and abstracts from articles identified in the search were read and selected for full-text review. Studies meeting prespecified inclusion criteria were reviewed in full and analyzed for relevant data.

RESULTS

Of 431 resultant articles, 29 were included. Patients and caregivers most commonly used Facebook and Twitter, whereas nearly 50% of neurosurgeons used LinkedIn and Doximity. Patient and caregiver users of social media tended to be <35 years old. Content of posts varied from requesting/providing information (∼40%) to seeking emotional support/forming connections (∼30%). A total of 20.6% of videos were irrelevant to clinical neurosurgery. Factual accuracy of most videos was poor to inadequate. Social media use was associated with greater academic impact for neurosurgical departments and journals. Posts with photos and videos and weekend posts generated 1.2-2 times greater engagement.

CONCLUSIONS

Patients and caregivers who use social media are typically younger than 35 years old and commonly use Facebook or Twitter. Neurosurgeons prefer Doximity and LinkedIn. Social media yields information regarding common symptoms and uncovers novel symptoms. Videos are poor-to-inadequate quality and often irrelevant to clinical neurosurgery. Optimizing social media use will augment the exchange of ideas regarding clinical practice and research and empower patients and caregivers.

Characteristics of the Most Cited, Most Downloaded, and Most Mentioned Articles in General Medical Journals: A Comparative Bibliometric Analysis

We compared the characteristics of the most cited, most downloaded, and most mentioned (the highest Altmetric Attention Score) articles published in general medical journals. We identified the 640 most frequently cited, 662 most frequently downloaded, and 652 most mentioned articles from 48 general medical journals. A comparison was made of the following characteristics of articles in the most cited, most downloaded, and most mentioned articles: medical specialty, publication type, country of origin, year of publication, and accessibility. There was only a 2.5% overlap in these three groups. Original articles were the more frequent among the most mentioned articles, whereas reviews, case reports, and guidelines/consensus statements were more frequent among the most downloaded articles. The most cited articles were more frequently published in 2010 and before, whereas the most downloaded articles were published in 2017−2018. The most mentioned articles were more frequently open-access articles, compared to the most downloaded articles. The most cited were more frequently older, the most downloaded were more frequently recent and educational, and the most mentioned were more frequently original and open-access articles. The results of our study may provide insights into various measures of article impact.

If I tweet will you cite later? Follow-up on the effect of social media exposure on article downloads and citations

OBJECTIVES

We previously reported that random assignment of scientific articles to a social media exposure intervention did not have an effect on article downloads and citations. In this paper, we investigate whether longer observation time after exposure to a social media intervention has altered the previously reported results.

METHODS

For articles published in the International Journal of Public Health between December 2012 and December 2014, we updated article download and citation data for a minimum of 24-month follow-up. We re-analysed the effect of social media exposure on article downloads and citations.

RESULTS

There was no difference between intervention and control group in terms of downloads (p = 0.72) and citations (p= 0.30) for all papers and when we stratified by open access status.

CONCLUSIONS

Longer observation time did not increase the relative differences in the numbers of downloads and citations between papers in the social media intervention group and papers in the control group. Traditional impact metrics based on citations, such as impact factor, may not capture the added value of social media for scientific publications.

Top-cited articles versus top Altmetric articles in nuclear medicine: a comparative bibliometric analysis

BACKGROUND

The impact of any scientific article has traditionally been measured by the number of citations received. More recently, alternative metrics (altmetrics) reflect the digital dissemination of knowledge across the online mediasphere.

PURPOSE

To evaluate and compare the characteristics of top-cited articles with those of top Altmetric articles related to nuclear medicine (NM).

MATERIAL AND METHODS

We performed a search of the Web of Science and Altmetric databases using 114 search terms to identify the 50 top-cited and 50 top Altmetric articles, respectively, in the field of NM. We then compared the following characteristics of the selected articles: publication type; journal category; country of origin; year of publication; topic; imaging modality; and accessibility. Chi-square tests were performed for statistical analysis.

RESULTS

There were no overlaps between the 50 top-cited and 50 top Altmetric articles. In general, compared to the leading Altmetric articles in this field, the cited articles were: more frequently review works published in NM and radiology journals (76% vs. 13%, P = 0.000); published in or before 2005 (84% vs. 0%, P = 0.000); the majority were related to oncology (56% vs. 44%, P = 0.000); and originated from the Netherlands (12% vs. 0%, P = 0.000). Compared to the top-cited articles, the leading Altmetric articles were: more frequently original articles published in other clinical field journals (54% vs. 0%, P = 0.000); primarily published between 2016 and 2018 (70% vs. 0%, P = 0.000); focused on neurology (50% vs. 22%, P = 0.000); and originated from the UK (18% vs. 2%, P = 0.000).

CONCLUSION

Citation counts and Altmetric scores represent unique perspectives for evaluating the impact of NM research.

The Top 100 Spine Surgery Articles on Social Media: An Altmetric Study

STUDY DESIGN

Literature review.

OBJECTIVE

To discern which social media outlets contribute most to spine surgery literature dissemination and to investigate how popular articles compare to articles with most citations.

SUMMARY OF BACKGROUND DATA

Scientific literature is increasingly disseminated through social media. The Altmetric Attention Score (AAS) is defined as an automated, weighted score calculation from counts of all online attention received by various research outputs. Increasing AAS values indicate more online attention. For example, the overall top 100 Altmetric spine surgery peer-reviewed articles since 2010 had an AAS range from 78 to 1537. Among all spine surgery literature reviewed since 2010, the mean AAS was 5.3 with a median of 1.0.

METHODS

We performed an Altmetric database search of nine spine surgery journals from January 2010 to October 2019. Mean AAS was summarized alongside metrics including citation count and impact factor. We assessed correlations between AAS and online sources, readers, and citations. Journals were grouped by impact factor, and analysis-of-variance compared mean AAS. The 100 highest AAS articles were compared to the most cited.

RESULTS

13,601 articles were included. The mean AAS was 5.3, with Twitter contributing the most. The three highest associations were news (P < 0.001), Twitter (P < 0.001), and Facebook (P < 0.001). There was no significant association between impact factor and AAS. Compared with the most cited articles, the top 100 AAS articles had significantly more article types, more prospective studies, fewer retrospective studies, fewer reviews, and fewer systematic reviews (P < 0.001 for all). Spine contributed the most articles in both top 100 sets.

CONCLUSION

Our evaluation revealed Twitter, newsfeeds, and Facebook were the most significant social media outlets. Compared to articles with the most citations, the most popular articles are prospective and encompass broader study designs. Social media plays an integral role in dissemination, both within spine literature and the public sphere.

LEVEL OF EVIDENCE

3.

Predictors of High-Impact Articles in The Annals of Thoracic Surgery

BACKGROUND

Altmetric scores are increasingly used as nontraditional metrics of scholarly impact that capture article social media attention. This study aims to characterize articles from The Annals of Thoracic Surgery that achieved the greatest online reach over a longitudinal period.

METHODS

The 50 articles with the highest Altmetric scores published in The Annals of Thoracic Surgery for 2013, 2015, and 2017 were identified. Spearman rank correlation coefficient was used to assess the correlation of Altmetric scores with citations. Independent predictors of Altmetric scores (25 or greater) were identified through univariable and multivariable logistic regression analysis.

RESULTS

Over time, article Altmetric scores increased significantly (2013, 11.9; 2015, 24.8; and 2017, 75.3; P < .001); with more authors on Twitter in recent years to disseminate scholarly work (2013, 10%; 2015, 20%; and 2017, 42%; P < .001). Recent articles attracted greater attention from news outlets (2013, 1.02; 2015, 2.36; and 2017, 7.48; P < .001) and tweets (2013, 1.84; 2015, 6.68; and 2017, 27.8; P < .001), reaching a larger readership through Twitter (2013, 4210; 2015, 19,300; and 2017, 66,800; P < .001). Log-transformed Altmetric scores were correlated with log-transformed citations for articles published in 2017 (r_s = 0.40; P = .02). On multivariable analysis, tweets (odds ratio = 1.27; 95% confidence interval, 1.01-1.61; P = .044) and mentions by news outlets (odds ratio = 30.49; 95% confidence interval, 4.03-230.16; P = .001) were predictive of high Altmetric scores.

CONCLUSIONS

This longitudinal analysis demonstrates that social media attention related to top performing articles has increased in recent years. Social media is an effective tool to increase article reach and knowledge translation, with Altmetric scores that correlated with citations.

Online Impact and Presence of a Specialized Social Media Team for the Journal of Neurosurgery: Descriptive Analysis

Background

Social media use continues to gain momentum in academic neurosurgery. To increase journal impact and broaden engagement, many scholarly publications have turned to social media to disseminate research. The Journal of Neurosurgery Publishing Group (JNSPG) established a dedicated, specialized social media team (SMT) in November 2016 to provide targeted improvement in digital outreach.

Objective

The goal of this study was to examine the impact of the JNSPG SMT as measured by increased engagement.

Methods

We analyzed various metrics, including impressions, engagements, retweets, likes, profile clicks, and URL clicks, from consecutive social media posts from the JNSPG’s Twitter and Facebook platforms between February 1, 2015 and February 28, 2019. Standard descriptive statistics were utilized.

Results

Between February 2015 and October 2016, when a specialized SMT was created, 170 tweets (8.1 tweets/month) were posted compared to 3220 tweets (115.0 tweets/month) between November 2016 and February 2019. All metrics significantly increased, including the impressions per tweet (mean 1646.3, SD 934.9 vs mean 4605.6, SD 65,546.5; P=.01), engagements per tweet (mean 35.2, SD 40.6 vs mean 198.2, SD 1037.2; P<.001), retweets (mean 2.5, SD 2.8 vs mean 10.5, SD 15.3; P<.001), likes (mean 2.5, SD 4.0 vs mean 18.0, SD 37.9; P<.001), profile clicks (mean 1.5, SD 2.0 vs mean 5.2, SD 43.3; P<.001), and URL clicks (mean 13.1, SD 14.9 vs mean 38.3, SD 67.9; P<.001). Tweets that were posted on the weekend compared to weekdays had significantly more retweets (mean 9.2, SD 9.8 vs mean 13.4, SD 25.6; P<.001), likes (mean 15.3, SD 17.9 vs mean 23.7, SD 70.4; P=.001), and URL clicks (mean 33.4, SD 40.5 vs mean 49.5, SD 117.3; P<.001). Between November 2015 and October 2016, 49 Facebook posts (2.3 posts/month) were sent compared to 2282 posts (81.5 posts/month) sent between November 2016 and February 2019. All Facebook metrics significantly increased, including impressions (mean 5475.9, SD 5483.0 vs mean 8506.1, SD 13,113.9; P<.001), engagements (mean 119.3, SD 194.8 vs mean 283.8, SD 733.8; P<.001), and reach (mean 2266.6, SD 2388.3 vs mean 5344.1, SD 8399.2; P<.001). Weekend Facebook posts had significantly more impressions per post (mean 7967.9, SD 9901.0 vs mean 9737.8, SD 19,013.4; P=.03) and a higher total reach (mean 4975.8, SD 6309.8 vs mean 6108.2, SD 12,219.7; P=.03) than weekday posts.

Conclusions

Social media has been established as a crucial tool for the propagation of neurosurgical research and education. Implementation of the JNSPG specialized SMT had a demonstrable impact on increasing the online visibility of social media content.

Relationship between persuasive metadiscoursal devices in research article abstracts and their attention on social media

Research article abstracts often convince readers that the article is worth reading. Therefore, they rely not only on the quality of arguments or novelty of findings to persuade readers but also linguistic markers in the form of metadiscourse to assert a position on an issue, increase readability of a text, engage readers, and avoid objection to the writer’s interpretations, thereby enhancing the credibility of the text. Given that research article abstracts are often published online and their newsworthiness would affect whether they would be ultimately read, Altmetric.com, which emerged in 2010, can help quantify the popularity of research article abstracts by counting views on social media and other platforms such as news and policy documents. Yet a study on how metadiscoursal devices are used to persuade readers, and how they are correlated with Altmetric Attention Score (AAS) provided by Altmetric.com, merits attention. In our study, we examined 241 abstracts from 50 top journals in 12 disciplines with the highest AAS from 2014–2018 and performed a quantitative analysis of the interactive and interactional metadiscourse markers exhibited in the abstracts. Overall, we found a positive correlation between the use of metadiscourse and AAS. Furthermore, we noticed that each discipline used distinct metadiscourse markers in abstracts with high AAS, which contributed to its respective discipline-specific conventions. It has been previously shown that the use of an array of interactive and interactional metadiscourse renders the abstract more worthy of attention. Being knowledgeable of rhetorical choices in relation to metadiscoursal devices will enable writers to construct more persuasive abstracts by making informed judgments about the appropriate use of metadiscourse to draw the attention of readers in their respective disciplines.

What Is the Predictive Ability and Academic Impact of the Altmetrics Score and Social Media Attention?

BACKGROUND

Citation rate and journal impact factor have traditionally been used to assess research impact; however, these may fail to represent impact beyond the sphere of academics. Given that social media is now used to disseminate research, alternative web-based metrics (altmetrics) were recently developed to better understand research impact on social media. However, the relationship between altmetrics and traditional bibliometrics in orthopaedic literature is poorly understood.

PURPOSE

To (1) assess the extent that altmetrics correlate with traditional bibliometrics and (2) identify publication characteristics that predict greater altmetrics scores.

STUDY DESIGN

Cross-sectional study.

METHODS

Articles published in The American Journal of Sports Medicine (AJSM), The Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, and Knee Surgery, Sports Traumatology, Arthroscopy between January 2016 and December 2016 were analyzed. Among the extracted publication characteristics were journal, number of authors, geographic region of origin, highest degree of first author, study subject and design, sample size, conflicts of interest, and level of evidence; number of references, institutions, citations, tweets, Facebook mentions, and news mentions; and Altmetric Attention Score (AAS). Multivariate regressions were used to determine (1) publication characteristics predictive of AAS and social media attention (mentions on Twitter, Facebook, and the news) and (2) the relationship between AAS and citation rate.

RESULTS

A total of 496 published articles were included, with a mean AAS of 8.6 (SD, 31.7; range, 0-501) and a mean citation rate of 15.0 (SD, 16.1; range, 0-178). Articles in AJSM (β = 19.9; P < .001), publications from North America (β = 8.5; P = .033), and studies concerning measure validation/reliability (β = 25.5; P = .004) were independently associated with higher AAS. Greater AAS score significantly predicted a greater citation rate (β = 0.16; P < .0001). The citation rate was an independent predictor of greater social media attention on Twitter, Facebook, and the news (odds ratio range, 1.02-1.03; P < .05 all).

CONCLUSION

AAS had a significant positive association with citation rates of articles in 5 high-impact orthopaedic journals. Articles in AJSM, studies concerning measure validation and reliability, and publications from North America were positively associated with greater AAS. A greater number of citations was consistently associated with publication attention received on social media platforms.

Chronic traumatic encephalopathy research viewed in the public domain: What makes headlines?

Objective: To determine chronic traumatic encephalopathy (CTE)-related publication characteristics associated with higher Altmetric scores.Methods: A systematic review of the CTE literature was conducted using PubMed. Publications were coded for: journal impact factor (JIF); publication type (primary versus non-primary data collection); discussion of American football; contact sport-CTE association conclusion (yes versus no/neutral); and Altmetric score. Multivariable ordinal logistic regression identified predictors of higher Altmetric scores.Results: Most of the 270 CTE-related publications did not include primary data collection (60%). The median Altmetric score was 12 (range = 0-3745). Higher Altmetric scores were associated with primary data collection [Odds ratio (OR)_Adjusted = 2.29; 95% confidence interval (CI) = 1.35-3.89] and discussing American football (OR_Adjusted = 2.11; 95%CI = 1.24-3.59). Among publications concluding contact sport-CTE associations, higher Altmetric scores were associated with higher JIF (3-point-JIF-increase OR_Adjusted = 2.11; 95%CI = 1.24-3.59); however, the association of higher Altmetric scores with higher JIF was not found among neutral publications or those concluding no contact sport-CTE associations (3-point-JIF-increase OR_Adjusted = 1.07; 95%CI = 0.94-1.22).Conclusions: Most CTE-related publications (60%) did not involve primary data collection. Publication characteristics such as higher JIF and concluding contact sport-CTE associations were associated with higher Altmetric scores. It is important for the academic community to consider strategies to counter publication and promotion bias in the presentation of CTE literature.

Surgeon motivation, and obstacles to the implementation of minimally invasive spinal surgery techniques

Background

This study aimed to analyze the motivators and obstacles to the implementation of minimally invasive spinal surgery techniques (MISST) by spinal surgeons. Motivators and detractors may impact the availability of MISST to patients and drive spine surgeons' clinical decision-making in the treatment of common degenerative conditions of the lumbar spine.

Methods

The authors solicited responses to an online survey sent to spine surgeons by email, and chat groups in social media networks including Facebook, WeChat, WhatsApp, and Linkedin. Descriptive statistics were employed to count the responses and compared to the surgeon's training. Kappa statistics and linear regression analysis of agreement were performed.

Results

A total of 430 surgeons accessed the survey. The completion rate was 67.4%. A total of 292 surveys were submitted by 99 neurosurgeons (33.9%), 170 orthopaedic surgeons (58.2%), and 23 surgeons of other postgraduate training (7.9%). Personal interest (82.5%) and patient demand (48.6%) were the primary motivators for MISST implementation. High equipment (48.3%) and disposables (29.1%) cost were relevant obstacles to MISST implementation. Local workshops (47.6%) and meetings in small groups (31.8%) were listed as the primary knowledge sources. Only 12% of surgeons were fellowship trained, but 46.3% of surgeons employed MISST in over 25% of their cases.

Conclusions

The rate of implementation of MISST reported by spine surgeons was found to be high but impeded by the high cost of equipment and disposables. The primary motivators for spine surgeons' desire to implement were personal interest and patient demand.

Lumbar vacuum disc, vertical instability, standalone endoscopic interbody fusion, and other treatments: an opinion based survey among minimally invasive spinal surgeons

Background

A diseased lumbar intervertebral vacuum disc void of any structurally intact tissue may be vertically unstable. A primary standalone endoscopic decompression and interbody fusion surgery in the treatment of vertical instability in patients with a vacuum disc may be a more reliable treatment than decompression alone.

Methods

The authors solicited responses to an online survey sent to spine surgeons by email, and chat groups on social media networks, including Facebook, WeChat, WhatsApp, and Linkedin. Descriptive and correlative statistics were employed to count the responses and compare the surgeon's responses recorded on a Likert scale from 1 (disagree) to 10 (agree) or in multiple-choice questions. Surgeons were asked about their familiarity with the concept of vacuum disc and vertical instability and how they would treat such patients. Kappa statistics and linear regression analysis of agreement of incoming responses were performed.

Results

A total of 1,165 surgeons accessed the survey. The completion rate was 22.78. The majority surgeons were very familiar with the concept of a "vacuum disc" as a sign of end-stage lumbar degenerative disc disease and a collapsing lumbar motion segment (182/273; 66.7%; Likert score 6.53). The majority of surgeons also thought that vertical instability precedes anterolateral lumbar instability (187/273; 68.5%; Likert score 6.64) and that a vacuum disc may cause vertical instability with symptomatic dynamic foraminal & lateral recess stenosis (222/273; 81%; Likert score 7.48), mechanical back pain (201/273; 73.1%; Likert score 7.48), and may cause sciatica-type low back and leg pain (179/273; 66.3%; Likert score 6.59). The majority of surgeons indicated that vacuum phenomenon on radiographic studies is associated with vertical instability and collapse resulting in dynamic foraminal and lateral recess stenosis and should be treated surgically (199/266; 73.7%; 7 missing responses; Likert score 6.86). Preferred treatments were decompression alone without fusion (P<0.014). There was consensus in support of fusion by TLIF or PLIF with a Likert score of 6.68 (184/266; 69.2%; 7 missing responses). There was no consensus on standalone fusion.

Conclusions

Vacuum phenomenon on radiographic studies is associated with a vertical instability and collapse, resulting in dynamic foraminal and lateral recess stenosis that should be treated surgically. Preferred surgical treatments were decompression alone, decompression with interbody fusion using just bone graft, and fusion employing TLIF or PLIF. Further research into the clinical significance of lumbar vacuum disc, vertical instability and its most appropriate surgical treatments if any is necessary.

Is Asia truly a hotspot of contemporary minimally invasive and endoscopic spinal surgery?

Background

The purpose of this study was to analyze the training in relation to practice patterns of surgeons in Asia who perform lumbar endoscopic spinal surgery in comparison to surgeons the world over. The authors solicited responses to an online survey sent to spine surgeons.

Methods

Pearson Chi-Square measures, Kappa statistics, and linear regression analysis of agreement or disagreement were performed by analyzing the distribution of variances of responses in relation to surgeons' training using statistical package SPSS Version 25.0.

Results

A total of 430 surgeons accessed the survey. The completion rate was 67.4%. Analyzing the responses of 292 surveys submitted by 97 neurosurgeons (33.2%), 161 orthopaedic surgeons (55.1%), and 34 surgeons of other postgraduate training (11.6%) showed that only 14.0% (41/292) of surgeons had completed a fellowship. Ninety-one of the 292 respondents were from Asian countries/regions. A statistically significantly higher percentage of Asian surgeons (96.7%) compared to non-Asian surgeons (81.6%) indicated that they perform modern minimally invasive (MIS) and endoscopic spinal (ES) surgery (P=0.001). Spinal endoscopy was employed by 70.3% of Asian versus 55.2% of non-Asian surgeons (P=0.015). Endoscopic decompression techniques requiring advanced training was employed nearly twice as high by the Asian surgeons than by non-Asian.

Conclusions

Training requirements for MIS and ES surgery and implementation of privileges vary in different parts of the world. While industry-sponsored weekend cadaver workshops have remained the mainstay of training aspiring endoscopic spinal surgeons in North America and Europe leaving many of them to become autodidacts.