The Skewed Impact of Highly Cited Articles on Journal Impact Factor

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From mouthpiece of an emerging specialty to voice for high-quality research: the first 100 years of the British Journal of Anaesthesia

The British Journal of Anaesthesia (BJA) celebrates its centenary in 2023, and with it 100 yr of continuous anaesthesia research publication. As an editorially and financially independent journal, the BJA faced a rapidly changing anaesthesia profession, health system, and publishing world without the security of institutional support. In its early days, the Journal was vocal about the challenging conditions faced by anaesthetists before the National Health System was established, and was essential in advocating for the specialty. Although the years after World War II brought improving fortunes for the specialty, the BJA found itself struggling to publish. As the Journal's fortunes began to improve, a new research and healthcare context emerged, radically changing the face of anaesthesia research and practice, to which the Journal needed to adapt. In spite of a range of challenges throughout the years, the BJA has developed into an international, future-focused, well-respected publication. This could not have been achieved without continual transformation, and the willingness to take risks and meet the changing times head on.

How COVID-19 Affected the Journal Impact Factor of High Impact Medical Journals: Bibliometric Analysis

BACKGROUND

Journal impact factor (IF) is the leading method of scholarly assessment in today's research world, influencing where scholars submit their research and where funders distribute their resources. COVID-19, one of the most serious health crises, resulted in an unprecedented surge of publications across all areas of knowledge. An important question is whether COVID-19 affected the gold standard of scholarly assessment.

OBJECTIVE

In this paper, we aimed to comprehensively compare the productivity trends of COVID-19 and non-COVID-19 literature as well as track their evolution and scholarly impact across 3 consecutive calendar years.

METHODS

We took as an example 6 high-impact medical journals (Annals of Internal Medicine [Annals], The British Medical Journal [The BMJ], Journal of the American Medical Association [JAMA], The Lancet, Nature Medicine [NatMed], and The New England Journal of Medicine [NEJM]) and searched the literature using the Web of Science database for manuscripts published between January 1, 2019, and December 31, 2021. To assess the effect of COVID-19 and non-COVID-19 literature in their scholarly impact, we calculated their annual IFs and percentage changes. Thereafter, we estimated the citation probability of COVID-19 and non-COVID-19 publications along with their rates of publication and citation by journal.

RESULTS

A significant increase in IF change for manuscripts including COVID-19 published from 2019 to 2020 (P=.002; Annals: 283%; The BMJ: 199%; JAMA: 208%; The Lancet: 392%; NatMed: 111%; and NEJM: 196%) and to 2021 (P=.007; Annals: 41%; The BMJ: 90%; JAMA: 6%; The Lancet: 22%; NatMed: 53%; and NEJM: 72%) was seen, against non-COVID-19 ones. The likelihood of highly cited publications was significantly increased in COVID-19 manuscripts between 2019 and 2021 (Annals: z=3.4, P<.001; The BMJ: z=4.0, P<.001; JAMA: z=3.8, P<.001; The Lancet: z=3.5, P<.001; NatMed: z=5.2, P<.001; and NEJM: z=4.7, P<.001). The publication and citation rates of COVID-19 publications followed a positive trajectory, as opposed to non-COVID-19. The citation rate for COVID-19 publications peaked by the second quarter of 2020 while that of the publication rate approximately a year later.

CONCLUSIONS

The rapid surge of COVID-19 publications emphasized the capacity of scientific communities to respond against a global health emergency, yet inflated IFs create ambiguity as benchmark tools for assessing scholarly impact. The immediate implication is a loss in value of and trust in journal IFs as metrics of research and scientific rigor perceived by academia and society. Loss of confidence toward procedures employed by highly reputable publishers may incentivize authors to exploit the publication process by monopolizing their research on COVID-19 and encourage them to publish in journals of predatory behavior.

Insights from full-text analyses of the Journal of the American Medical Association and the New England Journal of Medicine

Analysis of the content of medical journals enables us to frame the shifting scientific, material, ethical, and epistemic underpinnings of medicine over time, including today. Leveraging a dataset comprised of nearly half-a-million articles published in the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM) over the past 200 years, we (a) highlight the evolution of medical language, and its manifestations in shifts of usage and meaning, (b) examine traces of the medical profession's changing self-identity over time, reflected in its shifting ethical and epistemic underpinnings, (c) analyze medicine's material underpinnings and how we describe where medicine is practiced, (d) demonstrate how the occurrence of specific disease terms within the journals reflects the changing burden of disease itself over time and the interests and perspectives of authors and editors, and (e) showcase how this dataset can allow us to explore the evolution of modern medical ideas and further our understanding of how modern disease concepts came to be, and of the retained legacies of prior embedded values.

National Consensus on Portal Hypertension Management in Indonesia

Portal hypertension is a clinical syndrome that consists of hypersplenism, ascites, gastroesophageal varices, and encephalopathy. This condition is marked by increased portal pressure gradient and may occur with or without liver cirrhosis. To date, portal hypertension remains as the leading cause of severe complications and death of a patient with chronic liver disease, especially liver cirrhosis. Therefore, thorough understanding about management of portal hypertension is strongly required, especially considering that many complications of portal hypertension require early diagnosis and treatment to improve the prognosis of the patients. Additionally, although hepatic venous pressure gradient (HVPG) measurement has become a gold standard procedure for measuring portal pressure in the last twenty years, utilization of this method in Indonesia has been hindered by reluctance of the patients due to its invasiveness, high cost, and limited availability. This consensus is developed with evidence-based medicine principles to provide a guideline for portal hypertension management for general practitioners, specialists, and consultants, to achieve better clinical outcomes of portal hypertension in Indonesia.  Keywords: portal hypertension, liver cirrhosis, chronic liver disease.

Effectiveness of Bendamustine-Rituximab Compared to R-CHOP/R-CVP as a First-Line Treatment of Indolent Non-Hodgkin's Lymphoma or Mantle-Cell Lymphoma

BACKGROUND

R-CHOP/R-CVP is the only recommended first-line treatment for Non-Hodgkin's Lymphoma (NHL). Limited treatment alternatives often lead to relapse and refractory NHL, which increases disease progressivity and worsens prognosis. Bendamustine-rituximab is being studied for its potential as a superior first-line therapy for indolent NHL and mantle-cell NHL (MCL); however, it is not in the national guidelines. Evidence-based research is needed to demonstrate the effectivity of bendamustine-rituximab compared to R-CHOP/R-CVP for a complete response of indolent NHL and MCL.

METHODS

A literature search was conducted using PubMed, Scopus, EBSCOHost, and Cochrane. Studies consistent with clinical question and eligibility criteria were included and critically appraised using the Oxford Centre for Evidence-Based Medicine (CEBM) tool.

RESULTS

Two randomized controlled trials (RCTs) were included in this study, both concluding that bendamustine-rituximab is superior to R-CHOP/R-CVP with a complete response, with RR values of 0.90 (95% CI 0.80 - 1.01) and 0.86 (95% CI 0.76 - 0.98).

CONCLUSION

Bendamustine-rituximab is more effective than R-CHOP/R-CVP as a first-line treatment of indolent NHL or MCL.

Turning the page on 2021: an eventful year for the British Journal of Anaesthesia

The British Journal of Anaesthesia (BJA) had an eventful 2021, following what was a cataclysmic 2020 for the whole world. Despite the tragic challenges of multiple waves of the COVID-19 pandemic and the unparalleled burdens this created for everyone working in anaesthesia and critical care, the BJA underwent a major transformation during 2021. The BJA strongly supported research and education relevant to the pandemic, and to the broader missions of anaesthesia, critical, and pain medicine. Innovations to the BJA in 2021 included a special section on COVID-19 and the Anaesthetist; a new open access journal in the BJA stable; creation of a new social media editor position; new webinar and author interview series; transition to a new manuscript management system; and a move away from paper to electronic publication.

Psychotherapy for Healthcare Provider During COVID-19 Pandemic: An Evidence Based Clinical Review

BACKGROUND

health workers are one of the groups affected physically as well as psychologically from the pandemic. Recent studies showed many of the health workers reported experiencing anxiety, depression, and insomnia. This study aims to identify psychotherapy as a psychological health intervention, for healthcare workers during the COVID-19 pandemic.

METHODS

an evidence based clinical review of psychotherapy as a psychological health intervention, reported in the literature, which is developed for healthcare workers during the COVID-19 pandemic. The review was conducted following set out for Evidence-based clinical review by searching the following digital libraries: PubMed, ProQuest, Cochrane, and Google Scholar.

RESULTS

six publications were selected. The identified psychotherapy used as a mental or psychological intervention for healthcare workers during COVID-19 consists of supportive psychotherapy, psychoeducation, social support, and music therapy. Overall, it shows that psychotherapy, especially supportive psychotherapy, can reduce anxiety, depression, and insomnia.

CONCLUSION

the physiological condition of health workers needs to get attention during the COVID-19 pandemic. Although there is no standard of therapy yet, psychotherapy could be an option as it is proven to be able to reduce anxiety, depression, and insomnia.

Content Analysis of Electronic Nicotine Delivery System Publications in Core Clinical Journals from 2012 to 2018

There is no consensus if electronic nicotine delivery systems (ENDS) should be used to reduce harm among the smoking population. Physicians, who represent a trusted source of health communication, are exposed to a range of often conflicting ENDS information and this information may be relayed to patients looking to quit smoking. Previous studies have examined ENDS content of various sources of media but there is a lack of knowledge about ENDS content in medical journals. We analyzed 421 ENDS publications printed between 2012 and 2018 from PubMed's Core Clinical Journal list. Publications were analyzed based on publication type, journal type, study design, geographic focus, theme, terminology, outcomes, and positive/negative statements. The number of ENDS publications grew since 2012, and peaked in 2015. Across all years, negative statements about ENDS outnumbered positive statements, though this difference decreased over time. Over time, negative statements about "toxins and carcinogens" were made less frequently, while negative statements about "gateway effects" and "youth appeal" became more prevalent. UK journals had fewer negative statements relative to US journals. Only 12.6% of publications included guidance for healthcare professionals about ENDS. As published ENDS topics change over time, physicians' communications with patients may be impacted.

Generalizability of findings from systematic reviews and meta-analyses in the Leading General Medical Journals

OBJECTIVE

To assess how items relevant for the assessment of the generalizability of findings from randomized controlled trials were recorded in systematic reviews published in leading general medical journals.

METHODS

All systematic reviews and meta-analyses published in the Annals of Internal Medicine, BMJ, JAMA (The Journal of the American Medical Association) and Lancet from 1 January 2016 to 28 February 2019 were searched via PubMed. Reporting of the characteristics of randomized controlled trials in the systematic reviews was documented by the benchmarking method.

RESULTS

A total of 115 systematic reviews were found. Of these, 71% included pharmacological interventions, 35% included other conservative treatments, 13% included surgical interventions, and 0% included rehabilitation interventions. None of the systematic reviews assessed patient selection, 35% reported disorder-specific clinical features, 25 % reported comorbid conditions, and 21% reported patients' behavioural factors in randomized controlled trials. Functioning, environmental factors and inequity-related factors were recorded in 3%, 0% and 9%, respectively, of the systematic reviews; and adherence to interventions, crossovers, and co-interventions in 7%, 0% and 2%, respectively; follow-up percentages in 8%; and adequacy of statistical analyses in 3%.

CONCLUSION

In all systematic reviews the recording of characteristics of patients, adherence to interventions, follow-up, and statistical analyses in the RCTs was insufficient. The data did not allow assessment of the clinical homogeneity of the randomized controlled trials, or provide justification for meta-analysis, or allow generalizability of the findings.

National Health Priorities under the Kim Jong Un regime in Democratic People's Republic of Korea (DPRK), 2012-2018

The National Health Priorities (NHP) 2016–2020 is the healthcare policy which was most recently announced to the international community by the Democratic People’s Republic of Korea (DPRK). However, understanding DPRK’s internal and practical perspectives and priorities in the healthcare sector is difficult. Hence, there is a need to analyse domestic documents. One such document is the Sa-seol—a kind of editorial in the first issue of the each quarterly medical journal published in DPRK. We analyse the content of 56 Sa-seol published in eight medical journals during the Kim Jong Un regime (2012–2018), and then classified them in terms of their relevance to each of 12 items presented in NHP 2016–2020. Sa-seol mentioned a total of 612 medical and health issues which could be classified into 12 items based on NHP 2016–2020. We divided the items into three categories of concern in the NHP by summarising the total number of mentions: the areas of the most, medium and least concern. The areas of most concern (development of medical science and technology) are not directly related to the present improvement of health and rather, seem to focus on more future development. The areas of medium concern focused on disease control, health systems and social determinants of health. The areas of the least concern were emergency or disaster response and reproductive health services. This study suggests a two-track approach for healthcare cooperation with DPRK:, a well-balanced approach between ‘present’ and ‘future’ needs.

Altmetric Analysis of Contemporary Iranian Medical Journals

Background:

Altmetrics is a newly emerging scholarly tool measuring online attention surrounding scientific research outputs. With respect to increasing demand of disseminating research findings on the World Wide Web, this study aims to analyze the altmetric statues of Iranian medical journals.

Methods:

On February 27, 2019, the list of Iranian medical journals extracted from http://journals.research.ac.ir/ and consequently altmetric data token out from Altmetric database (Altmetric LLP, London, UK). The science mapping done via keyword co-occurrence, co-citation and co-authorship, network analysis using the VOSviewer. The Pearson coefficient was then employed for the correlation analysis using R.

Results:

Among a total of 104 journals, 7518 articles were mentioned in Altmetric data resources (Mean: 72.28, Confidence Level (95.0%): 16.8), total mentions were 27577 (Mean: 265.16, Confidence Level (95.0%): 79.9). Considering the total mentions of articles, International Journal of Preventive Medicine achieved the first rank, followed by Journal of Research in Medical Sciences and Iranian Journal of Public Health. Notably, Twitter was the most popular altmetric resource followed by Facebook and news outlets. Tweets were generally from the United States and United Kingdom. Among top 5% popular Iranian medical articles multiple sclerosis, cancer, and anxiety was hot topics.

Conclusions:

Iranian biomedical journal editors and research scientists needs to be more dynamic in World Wide Web using social media, post-publication peer review tools, Stack Exchange (Q and A) sites, research highlight tools, Wikipedia, and etc. In spite, more attention to the concept of evidence-based policymaking, by Iranian government along with the health policymakers seems necessary.

Scientometric characterization of Medwave's scientific production 2010-2014

INTRODUCTION

The use of bibliometric indicators for the evaluation of science allows an analysis of scientific production both from a quantitative and qualitative point of view.

OBJECTIVE

To characterize the scientific production of Medwave during the period 2010 to 2014 in terms of visibility and productivity.

METHODS

A bibliometric study was carried out. Variables analyzed were offered by the “Publish or Perish” program working with the Google Scholar database. The number of articles published were related to the number of authors involved in each research work. The articles cited, number of citations, authors and year were reported. Indicators were obtained by placing in name of the journal and its International Standard Serial Number (ISSN) in the navigation box of Publish or Perish.

RESULTS

There were 481 articles published with 220 citations; at a rate of more than 36 citations per year and 20 citations per author and year. An index h = 5 and index g = 6 were achieved. There was an average of two authors per article. Only five articles had more citations than the total they provided.

CONCLUSIONS

The scientometric indicators found place the journal in a favorable position relative to other medical journals of the region, in terms of visibility and productivity. There was a low rate of cooperation since articles with individual authors prevailed. A low number of articles contributed to the productivity of the journal despite having significant number of citations.

Characteristics and Patterns of Rare Malignancies Published in Rare Tumors

Rare Tumors is an international peer-reviewed medical journal established in 2009. The journal is focused on rare cancers and aims to expand upon current knowledge on their presentation, diagnosis, management, and outcomes. We reviewed the 335 case reports published from 2009 to 2015. We found great diversity in both the country of origin as well as specialty of first authors. Outside of the United States (US) and European Union (EU), there were 20 countries with contributions to the journal. Similarly, there was representation from twelve medical specialties with first authorship of reports. Rare Tumors continues to encourage involvement from physicians across the globe and from all medical disciplines.

Academic Debate: Publications Which Promote Political Agendas Have no Place in Scientific and Medical Journals, and Academics Should Refrain from Publishing in Such Journals

This paper presents the full debate held on October 1, 2014, which focused on the following resolution: "Publications which promote political agendas have no place in scientific and medical journals, and academics should refrain from publishing in such journals." The debate moderator was Professor Shimon Glick. Taking the pro stance was Professor A. Mark Clarfield; the con stance was held by Professor Rael D. Strous. Following the first part of the debate, Dr Richard Horton, Editor-in-Chief of The Lancet, gave his thoughts on the topic. This was followed by the opportunity for rebuttal by Professors Clarfield and Strous. The debate was summarized and closed by Professor Glick. This paper provides a slightly edited text of the debate, for ease of reading.