Fifty Most Cited Articles for Femoroacetabular Impingement and Hip Arthroscopy

Top 50 Most-Cited Studies about Osteochondritis Dissecans

Purpose

To determine the 50 most frequently cited studies on osteochondritis dissecans (OCD) and to conduct a bibliometric analysis of these studies.

Methods

We performed a search within the Clarivate Web of Science database, identifying articles published before December 2022 that encompass topics related to OCD. The search was conducted using the keywords "Osteochondritis Dissecans OR Osteochondritis OR Dissecans."Search results were then filtered using predetermined guidelines and criteria, and the 50 most-cited articles were selected for analysis. Extracted data included title, journal, design, main topic, joint, citations, year, country of origin, and level of evidence.

Results

The search yielded 3,865 articles. The 50 most-cited articles were published between 1957 and 2018, with the greatest proportion published from 2000 to 2009 (60%). The most frequently studied topic was treatment (68%), followed by etiology (14%) and imaging (8%). The majority of articles had Level IV evidence (36%) and the largest proportion focused on the knee joint (36%), followed by the ankle (32%), and elbow (6%). The mean citation count per article was 287 (range: 157-1,050), with the most-cited articles primarily published from 2000 to 2003. The leading country of origin was the United States, accounting for 19 publications.

Conclusions

Most of the top 50 most-cited articles regarding OCD are about treatment, and the knee is the most-studied joint. The majority of the articles were Level IV evidence and were published in the United States between 2000 and 2009.

Clinical Relevance

The top 50 most-cited studies list will provide researchers, medical students, residents, and fellows with a foundational list of the most important and influential academic contributions regarding osteochondritis dissecans (OCD).

Rate of continued conservative management versus progression to surgery at minimum one year follow-up in patients with pre-arthritic hip pain

INTRODUCTION

Extensive literature has described surgical outcomes for pre-arthritic hip pain, but the proportion of patients who progress to surgery remains unknown.

OBJECTIVE

To determine the proportion of patients who present to a tertiary referral center for pre-arthritic hip pain and progress to surgery at minimum one year follow-up.

DESIGN

Retrospective cohort study.

SETTING

Single tertiary care academic medical center.

PATIENTS

Thirteen to 40-year-olds who presented for initial evaluation to a conservative or surgical orthopedic specialist and were diagnosed with pre-arthritic hip pain (n=713 patients, 830 hips).

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

The primary outcome was the rate of progression to surgery at minimum one year follow-up for the entire cohort. Predictors of progression to surgery were determined for the entire cohort and for radiographically defined subgroups using multiple logistic regression. Candidate predictors included baseline demographic, radiographic, clinical diagnosis, and patient-reported outcome measures.

RESULTS

In a cohort with mean age 25.4 (SD 8.1) years, 72.7% female, and mean follow-up 2.6 (range 1.0-4.8) years, 429/830 hips (51.7% [95% CI 48.2%-55.1%]) progressed to surgery. Predictors of surgical progression in the entire cohort included younger age (OR 0.95/year [95% CI 0.93-0.98]), pain duration longer than six months (OR 1.87-2.03, p≤.027), worse physical function (OR 0.96/Patient-Reported Outcomes Measurement Information System (PROMIS) point [0.92-0.99]), and a clinical diagnosis of femoroacetabular impingement (FAI) (OR 3.47 [2.05-5.89]), acetabular dysplasia (OR 2.75 [1.73-4.35]), and/or labral tear (OR 10.71 [6.98-16.47]). Radiographic dysplasia (lateral center edge angle<20⁰ ) increased the likelihood of surgery in all subgroups (OR 2.05-8.47, p≤.008). Increasing maximum α angle increased the likelihood of surgery in patients with severe cam FAI (α>63⁰ ) (OR 1.03/degree [1.00-1.06]).

CONCLUSION

Almost half of patients with pre-arthritic hip pain did not progress to surgery at minimum one year follow-up. A trial of conservative management is likely worthwhile in most patients. This article is protected by copyright. All rights reserved.

Femoroacetabular Impingement and Labral Tear: From the Most Highly Cited Articles to Research Interests

Objective

To highlight the characteristics of the most highly cited articles and propose the research interests over the past decades in the field of femoroacetabular impingement (FAI) and labral tear.

Methods

The ISI Web of Science database (Clarivate Analytics, New York, the United States) was utilized for the identification of articles on 15 December 2020. FAI and labral tear‐related articles (1138 articles) were retrieved, of which the 100 most‐cited articles (top 100) were identified. Subsequent analysis included citation density (citations/article age), authorship, institution, journal, geographic distribution, level of evidence, and theme.

Results

The number of citations per article ranged from 66 to 1189 with a mean of 163.31. The majority of articles were published in the United States (all articles/top 100 = 655/57) and Switzerland (85/22). University of Bern (n = 10) was the most prolific institution. The journal with the most of articles was Arthroscopy: The Journal of Arthroscopic and Related Surgery. The most prolific coauthor (all articles) or first authors (top 100) was Domb (n = 109) and Philippon (n = 6), respectively. The evidence with the most articles is level IV (n = 41). The top three most popular topics of research article were outcomes of surgery (n = 23), imaging diagnosis (n = 18), and comparison of surgery (n = 8). The top four most prevalent themes of review were labral tears (n = 3), FAI (n = 3), comparison of surgery imaging diagnosis, and outcomes of surgery (both n = 2). Six keywords with the newest average publication year, including FAI syndrome (average publication year = 2019.50), patient‐reported outcomes (2019.43), femoroplasty (2018.60), clinical outcomes (2018.17), borderline dysplasia (2018.00), and capsule (2018.00). Five keywords with the highest average citations, including outcome (average citations = 88.50), alpha angle (58.00), complications (55.86), revision hip arthroscopy (49.00), and systematic review (46.14).

Conclusions

Outcomes research is the most popular research interest and patient‐reported outcome instruments might be further and widely used in the emerging articles in the near future. The field of FAI and labral tear has shown an obvious trend of development and is steadily evolving. It could be predicted that there will be an increasing number of publications in the following years, with the United States and Switzerland maintaining leadership in this field.

The top 50 most cited articles on olecranon fractures: a bibliometric analysis

PURPOSE

Citation analysis has been used to determine the impact of an article in a medical specialty. The purpose of this study was to identify the 50 most cited articles on olecranon fracture outcomes, indications, techniques, procedural descriptions, and complications and analyse their characteristics.

METHODS

The Web of Science database was used to search for publications related to olecranon fractures. The top 50 most cited articles that met the inclusion criteria were recorded and reviewed in terms of journal and year of publication, country of origin, type of study, and level of evidence.

RESULTS

The top 50 articles were cited a total of 2165 times and the year of publication ranged from 1957 to 2014. Of the 50 articles identified, 43 were case series correlating with a Level IV evidence designation. The top 50 articles were published in 20 different medical journals and originated from 18 different countries.

CONCLUSION

The majority of the articles analysed were uncontrolled case series that reported outcomes and complications surrounding the operative treatment of olecranon fractures. The top 50 most influential articles pertaining to olecranon fractures provides physicians and residency programs with a high-yield list of publications to reference on the topic.

There Is Limited and Inconsistent Reporting of Postoperative Rehabilitation for Femoroacetabular Impingement Syndrome: A Scoping Review of 169 Studies

OBJECTIVE

To evaluate the reporting of rehabilitation guidelines in studies of postoperative outcomes of patients with femoroacetabular impingement (FAI) syndrome and/or labral tear.

DESIGN

Scoping review.

LITERATURE SEARCH

A computer-assisted literature search was conducted of the MEDLINE, CINAHL, and Embase databases on June 17, 2018. Using key words related to FAI syndrome/labral tear and both open and arthroscopic surgical outcomes, we identified 169 studies that included 16 675 patients. Separate authors calculated and verified the prevalence of reported outcomes.

STUDY SELECTION CRITERIA

We included intervention and observational studies that were prospective or retrospective in design. Studies must have included patients with a primary diagnosis of FAI syndrome and/or labral tear.

DATA SYNTHESIS

We calculated the mean ± SD prevalence for continuous variables, where possible.

RESULTS

Hip arthroscopy was the primary surgical procedure (76% of studies). The mean ± SD age of participants was 34.8 ± 9.2 years and the mean ± SD follow-up time was 27 ± 15.3 months. Of the 169 included studies, 74 (44%) discussed phases of rehabilitation, 49 (29%) reported details on goals between phases, 1 in 3 described details on rehabilitation progression, and fewer than 1 in 10 reported sufficient detail to replicate the rehabilitation protocol. Weight-bearing and range-of-motion restrictions were poorly reported and variable in duration.

CONCLUSION

Surgical outcome studies do not provide sufficient detail or consistency for practicing clinicians to replicate a postoperative rehabilitation protocol for patients with FAI syndrome/labral tear. J Orthop Sports Phys Ther 2020;50(5):252-258. doi:10.2519/jospt.2020.9189.

The Top 50 Most Influential Articles in Hip Arthroscopy

PURPOSE

To identify the 50 most frequently cited publications related to hip arthroscopy.

METHODS

The Clarivate Analytics Web of Knowledge database was used to search for publications relating to hip arthroscopy. The top 50 most cited articles that met the inclusion criteria were recorded and reviewed for various metrics.

RESULTS

The top 50 publications were cited a total of 8,306 times, with an average of 437.2 total citations per year. Of the 50 articles identified, 44 had been published since 2000. Case series, expert opinion articles, and review articles were the most common study types.

CONCLUSIONS

The majority of the most influential articles on hip arthroscopy are case series and expert opinions; however, as hip arthroscopy continues to become more widely performed, higher-level articles should supplant some of the articles included in this analysis. As indications for hip arthroscopy have expanded, so has its body of literature, with the vast majority of articles identified in our study having been published since 2000. Elucidating the 50 most cited articles in hip arthroscopy will allow practicing physicians a quick reference to the highest-yield articles and will allow residency programs to guide their education on the topic.

CLINICAL RELEVANCE

The top 50 list provides residents, fellows, and researchers with a comprehensive list of the major academic contributions to hip arthroscopy.

The impact of the 30 most cited articles on hip arthroscopy: what is the subject matter?

The purpose of this study was to identify the 30 most cited articles on hip arthroscopy and discuss their influence on recent surgical treatment. Due to advancements in hip arthroscopy, there is a widening spectrum of diagnostic and treatment indications. The purpose of this study was to identify the 30 most cited articles on hip arthroscopy and discuss their influence on contemporary surgical treatment. The Thomson Reuters Web of Science was used to identify the 30 most cited studies on hip arthroscopy between 1900 and 2018. These 30 articles generated 6152 citations with an average of 205.07 citations per item. Number of citations ranged from 146 to 461. Twenty-five out of the 30 papers were clinical cohort studies with a level of evidence between III and IV, encompassing 4348 patients. Four studies were reviewed (one including a technical note) and one a case report. We were able to identify the 30 most cited articles in the field of hip arthroscopy. Most articles were reported in high-impact journals, but reported small sample sizes in a retrospective setting. Prospective multi-arm cohort trials or randomized clinical trials represent opportunities for future studies.

THE 50 MOST CITED ARTICLES IN THE BRAZILIAN MEDICAL LITERATURE ON KNEE SURGERY

OBJECTIVE

To provide an analysis of the 50 most cited articles on knee surgery in the Brazilian medical literature.

METHODS

This is a study of systematic review and meta-analysis, level of evidence 3. It was carried out through search in the SCOPUS database to identify scientific articles published in the Brazilian medical literature. Eighty-six Brazilian journals were analyzed, and articles with ten or more citations and which had the word "joelho" or "knee" in the title, abstract or keywords were selected.

RESULTS

All articles were published as of the year 2000 in 14 journals. The Journal Clinics presented the largest number of publications, followed by Acta Ortopédica Brasileira. The main focus of the studies was on anatomy and biomechanics, mainly from Brazilian authors. Most of the authors were Brazilian, from Brazilian and public research institutions.

CONCLUSION

Biometric analysis has been gaining ground in recent years, but its interpretation must consider various aspects related to the paramount analytical importance.

The Upsurge in Research and Publication on Articular Cartilage Repair in the Last 10 Years

This study aims to study the publication trends in articular cartilage repair (ACR) techniques, over the last 10 years. A literature search was performed on the PubMed, Web of Science, and SCOPUS databases. We used suitable keywords and Boolean operators (articular cartilage injury AND "marrow stimulation OR microfracture (MFx)," "osteochondral autograft," "osteochondral allograft" and "autologous chondrocyte implantation (ACI)," "scaffold"), on January 1, 2019. Trends in publication on these topics were analyzed, focusing on publications over the last 10 years, type of research, authors, institution, and country. There was an increasing trend in publications related to ACR. A search on PubMed revealed 698, 225, 293, 857, and 982 documents on searching for "articular cartilage" AND "marrow stimulation OR microfracture," "osteochondral autograft," "osteochondral allograft," "ACI," and "scaffold," respectively. Similar searches revealed 1154, 219, 330, 1727, and 2742 documents on Web of science and 934, 301, 383, 944, and 2026 on SCOPUS, respectively, in the same order of topics. Overall, most papers were published from the United States and European countries, and Cole BJ was the most published author. There was an increasing trend in the number of publications as well as citations, with international collaboration among researchers. It implies that this field is growing rapidly. The authors from globally recognized and leading clinical institutions in the developed world contributed maximally to these publications. Most of these papers were published in high-impact arthroscopy subspecialty journals. Level of evidence: Level IV.

Fifty Most-cited Articles on Lateral Epicondylitis of the Elbow

Introduction:

Citation number can be used as a marker of a scientific article's influence. This study sought to determine and characterize the most-cited investigations on lateral epicondylitis and identify the most influential studies pertaining to this pathology.

Methods:

The Institute for Scientific Information Web of Science database was queried for articles investigating lateral epicondylitis, and the 50 most-cited articles were selected. For each article, number of citations, citation density, journal, publication year, country of origin, language, article type, article subtype, and level of evidence were recorded.

Results:

Citation numbers ranged from 72 to 332 (mean, 127.4), and densities ranged from 1.6 to 34.0 (mean, 9.4). Articles were published across 26 different journals. Most articles (41) were clinical, with randomized controlled trials (29.3%) being the most commonly cited articles.

Discussion:

Compared with previous investigations looking at citation density within orthopaedics, the most commonly cited clinical articles on lateral epicondylitis had a high percentage of level I or II evidence (39.0%). This compilation of the literature can aid in establishing reading curriculums for trainees in both orthopaedic residencies and fellowships. This is a Level V study.

Manuscript Submission Patterns of Authors Publishing in Orthopaedic Sports Medicine Journals

Background

Previous studies have examined the most cited articles in orthopaedic sports medicine research and the journals in which they were published.

Purpose

To analyze the manuscript submission patterns of authors who published manuscripts in various orthopaedic sports medicine journals.

Study Design

Cross-sectional study.

Methods

All articles published in the March 2017 and April 2017 issues of Arthroscopy, the American Journal of Sports Medicine (AJSM), Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA), and the Orthopaedic Journal of Sports Medicine (OJSM) were searched. In addition, the past 50 sports medicine-related articles published in the Journal of Bone and Joint Surgery (JBJS) dating back from April 2017 to May 2015 were searched. The corresponding author of each article was asked whether the publishing journal was the first journal of submission. If the article was previously submitted elsewhere, authors were asked which other journals, the dates of submission, and the order of submission. The proportion of articles that were initially submitted to each journal, the mean number of submissions prior to publication, and the mean duration from initial submission to date of publication were calculated for each journal.

Results

A total of 298 articles were included in this study, and 221 (74%) corresponding authors responded to the survey. The mean number of submissions before acceptance was 1.05 for AJSM, 1.18 for JBJS, 1.20 for KSSTA, 1.38 for Arthroscopy, and 2.19 for OJSM. The percentage of articles that were submitted to their accepting journal first (ie, not previously submitted elsewhere) was 95% for AJSM, 85% for JBJS, 82% for KSSTA, 68% for Arthroscopy, and 13% for OJSM.

Conclusion

Among the orthopaedic sports medicine journals included in this study, articles published in AJSM have the highest percentage of first submissions.

The Top 50 most-cited articles on Total Ankle Arthroplasty: A bibliometric analysis

Total Ankle Arthroplasty (TAA) is a relatively new and evolving field in Foot and Ankle surgery. We conducted a citation analysis to identify the characteristics of the top 50 most cited articles on total ankle arthroplasty. Using the Web of Science database and the search strategy total ankle arthroplasty OR total ankle replacement, we identified 2445 articles. After filtering for relevant articles, the top 50 cited articles on total ankle arthroplasty were retrieved for descriptive and statistical analysis. The publication years ranged from 1979 to 2013. USA was the most productive country in terms of research output, followed by the UK. Though citation analysis has its flaws, this is a comprehensive list of the top 50 articles significantly impacting literature on total ankle arthroplasty. Based on our study, we conclude that there is marked deficiency of high level articles with respect to the number of citations and future researches need to cater to this question to produce high quality studies.

The top 10 arthroplasty articles published in last 10 years by Indian authors

Joint replacement surgery is becoming increasingly popular globally and recently,​in India. The phenomenon of medical tourism has also contributed to increasing number of arthroplasty surgeries being done every year in our country. The surgeons who work in this highly specialized field of orthopedic surgery, have been publishing their research work in reputed journals. In this paper, we have discussed the most cited Indian papers in the field of arthroplasty. It was observed that publications in high impact and reputed journals attract more citations and therefore it is recommended that the 'good' scientific research work should preferably be submitted to these journals to create greater impact and awareness about ones' research.

Top 50 cited journal articles on overhead throwing athletes: a bibliographic analysis

Background

The frequency of citations for a journal article is a reflection of its academic impact. The purpose of this study was to identify and characterize the top 50 cited journal articles related to overhead throwing athletes in the published literature.

Methods

The Web of Science database was searched on January 18, 2016, using the terms "throwing athlete," "baseball," and "pitcher" to identify the top 50 cited articles related to overhead throwing athletes using the all-database function. The type of study, country of origin, publishing journal, and year published were reviewed for each article.

Results

The top 50 articles identified were cited between 95 and 471 times and were published in 13 journals between 1969 and 2011. Most of the articles were small case series or nonsystematic literature reviews. The shoulder was the most common body region studied in the top 50 articles (33 of 50 [66%]). Among original studies (n = 43), there was a good representation of surgical management of shoulder and elbow pathology in overhead athletes (9 of 43 [20.9%]); however, most of the articles reported on shoulder and elbow kinematics (19 of 43 [44.2%]) and pathoanatomy (15 of 43 [34.9%]).

Conclusion

The greater prevalence of nonsurgical articles may reflect a continued effort to better understand the different pathologies specific to overhead throwing athletes. An understanding of the variable content and quality of frequently cited articles on overhead throwing athletes may serve as a stepping stone for future studies to advance the diagnosis and management of complex elbow and shoulder injuries in these high functional individuals.

The 100 most-cited articles on aortic dissection

Background

To identify and characterize the most frequently cited articles that have been published on aortic dissection.

Methods

A list of the 100 most frequently cited publications (T100) about aortic dissection was generated by performing a searching of the Science Citation Index--Expanded using “aortic dissection” as the search term. Basic information about the articles was recorded, including number of citations, journal title, journal impact factor, time since publication, first author’s country, topic/subspecialty of the research, and publication type.

Results

We finally included 180 articles on aortic dissection, from which we identified the 100 most frequently cited articles (T100). The most frequently cited article received 1079 citations, while the least frequently cited article received 68 (mean140.5 citations per article). The T100 originated from 19 countries, with more than half of them originating from the USA (n = 97). The T100 articles were published from 1955 to 2013, with 79% published during the period 1990–2009. In addition, there were 40 different journals with Circulation having the most citations (n = 38). Regarding the article type, there were 21 basic and 140 clinical research articles, one meta-analysis, and 18 review articles. Reviews had the highest mean number of citations (mean 235.5 citations per article).

Conclusions

Our study provides a historical perspective on the progress of dissection research, and helps to identify the quality of the work, the discoveries made, and the trends steering the studies.

Electronic supplementary material

The online version of this article (doi:10.1186/s12872-016-0426-9) contains supplementary material, which is available to authorized users.

Authorship in the field of femoroacetabular impingement: an analysis of journal publications

PURPOSE

This review provides a bibliometric analysis of the contributors to the field of FAI research.

METHODS

A comprehensive search of three databases (MEDLINE, EMBASE, and PubMed) was performed to identify all clinical research articles on the topic of FAI (from inception to 2015). Cadaveric and animal studies were excluded. Study characteristics including authors, residing country of corresponding author, and journal were abstracted from the respective databases.

RESULTS

In total, 1073 articles were included in this review. There were a total of 5471 different authors who contributed to the field of FAI research, 28.3 % of whom were only published in one article. The top 20 authors were associated with over half of all publications, and research studies were typically performed in their countries of residence. The greatest proportion of FAI-related articles was published in the Journal of Arthroscopy and Clinical Orthopaedics and Related Research.

CONCLUSIONS

The number of authors contributing to FAI research is increasing, suggesting not only increasing prevalence of FAI treatment among orthopaedic surgeons but also increasing interest among hip arthroscopists in furthering understanding regarding the diagnosis and management of the condition. The number of publications produced by the top 20 authors (and their affiliated countries: USA, Switzerland, Canada, and the UK) is expected to contribute to a majority of future publications. Current trends suggest that the quality of evidence will continue to improve in the near future, as large-scale, collaborative studies are currently underway.

LEVEL OF EVIDENCE

Retrospective study, Level IV.

The Top 10 Most Cited Indian Articles in Arthroscopy in Last 10 Years

The interest in the field of arthroscopy is increasing globally and exponentially in the recent past, including in India. Clinicians interested in this area of super specialization have started publishing their research work in reputed journals in this field. The publication from Indian authors is contributed equally by both the teaching government institutions and nonteaching private hospital specialists. The contributions by the Indian teaching institutes have predominantly Indian authors only, whereas those from the private sectors usually have an association with the foreign authors in their research and publications. The publications with higher hierarchy and level of evidence (1 and 2) are associated with greater citations. In addition, the publications in high-impact, reputed journals attract more citations and therefore it is recommended that the "good" scientific research work should preferably be submitted to these journals to create greater impact and awareness about ones' research and publication.

The 50 Most Cited Articles in Rotator Cuff Repair Research

Analysis of the number of citations within a given specialty provides information on the classic publications of that specialty. The goals of this study were to identify the 50 most cited articles on rotator cuff repair and to analyze various characteristics of these articles. The ISI Web of Science (Thomson Reuters, Philadelphia, Pennsylvania) was used to conduct a search for the term rotator cuff repair. The 50 most cited articles were retrieved, and the following objective characteristics of each article were recorded: number of times cited, citation density, journal, country of origin, and language. The following subjective characteristics of each article were also recorded: article type (clinical vs basic science), article subtype, and level of evidence for clinical articles. Of the 50 most cited articles on rotator cuff repair, the number of citations ranged from 138 to 677 (mean, 232±133 citations) and citation density ranged from 3.8 to 53.5 citations per year (mean, 16.9±9.2 citations per year). The articles were published between 1974 and 2011, with most of the articles published in the 2000s (29 articles), followed by the 1990s (16 articles). The articles originated from 8 countries, with the United States accounting for 30 articles (60%). Overall, 66% of the articles were clinical and 34% were basic science. The most common article subtype was the clinical case series (48%). Of the 33 clinical articles, 24 (73%) were level IV. Among the 50 most cited articles on rotator cuff repair, the case series was the most common article subtype, showing the effect that publication of preliminary outcomes and new surgical techniques has had on surgeons performing rotator cuff repair. [Orthopedics. 2016; 39(6):e1045-e1051.].

The 100 most influential publications in paracetamol poisoning treatment: a bibliometric analysis of human studies

BACKGROUND

Analysis of the most influential publications within paracetamol poisoning treatment can be helpful in recognizing main and novel treatment issues within the field of toxicology. The current study was performed to recognize and describe the most highly cited articles related to paracetamol poisoning treatment.

METHODS

The 100 most highly cited articles in paracetamol poisoning treatment were identified from the Scopus database in November 2015. All eligible articles were read for basic information, including total number of citations, average citations per year, authors' names, journal name, impact factors, document types and countries of authors of publications.

RESULTS

The median number of citations was 75 (interquartile range 56-137). These publications were published between 1974 and 2013. The average number of years since publication was 17.6 years, and 45 of the publications were from the 2000s. A significant, modest positive correlation was found between years since publication and the number of citations among the top 100 cited articles (r = 0.316; p = 0.001). A total of 55 journals published these 100 most cited articles. Nine documents were published in Clinical Toxicology, whereas eight documents were published in Annals of Emergency Medicine. Citations per year since publication for the top 100 most-cited articles ranged from 1.5 to 42.6 and had a mean of 8.5 citations per year and a median of 5.9 with an interquartile range of 3.75-10.35. In relation to the origin of the research publications, they were from 8 countries. The USA had the largest number of articles, 47, followed by the UK and Australia with 38 and nine articles respectively.

CONCLUSIONS

This study is the first bibliometric assessment of the top 100 cited articles in toxicology literature. Interest in paracetamol poisoning as a serious clinical problem continues to grow. Research published in high-impact journals and from high income countries is most likely to be cited in published paracetamol research.