Department of Anaesthesiology, University Hospital, Johannes Gutenberg-University, Langenbeckstrasse 1, D-55131 Mainz, Germany
Accepted for publication: May 16, 2000
![]() |
Abstract |
---|
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
---|
Br J Anaesth 2000; 85: 55662
Keywords: anaesthesia, paediatric; publications
![]() |
Introduction |
---|
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
---|
New medical information is communicated through international journals. The number of articles on specific topics such as paediatric anaesthesia, indicates current publication activity in the respective field. In addition to information transfer, peer-reviewed publication activity contributes to the visibility of individual authors within the medical community, and publications in highly ranked journals may promote their professional career as well as the likelihood of receiving funding from various sources.2
Our literature search failed to identify a quantitative evaluation of the spectrum of publications, authors and journals on paediatric anaesthesia. It was therefore the aim of this study to identify: all papers with a focus on anaesthesia in infants and children published over a 6-yr period; the respective journals; the publication activity and the international recognition achieved (according to impact factors) of the authors who were from several countries; and to characterize the publication patterns.
![]() |
Methods |
---|
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
---|
Twelve peer-reviewed serial publications in the field of anaesthesia (Acta Anaesthesiologica Scandinavica [1 volume/ 10 issues per year], Anaesthesia [1/12], Anästhesiologie-Intensivmedizin-Notfallmedizin-Schmerztherapie [1/8 in 19931995, 1/10 in 1996, 1/12 in 19971998], Anesthesia & Analgesia [2/12], Anesthesiology [2/12], British Journal of Anaesthesia [2/12], Canadian Journal of Anaesthesia [1/12], Der Anaesthesist [1/12], European Journal of Anaesthesiology [1/6], Paediatric Anaesthesia [1/6; 1/7 in 1997], Pain [4/12; 5/15 in 19961998], Regional Anesthesia, 1998 renamed Regional Anesthesia and Pain Medicine [1/6]) were evaluated on an article-to-article basis (hand search3 4). The annual number of articles was determined for each journal and the abstracts were searched for the selected key words. If one of the key words was identified, the publication was registered and the first page archived. The annual subject index of every periodical was also cross-checked for all key words to ensure identification of each article on paediatric anaesthesia.
The MedlineTM database was searched by PC (WinSPIRS 2.0, SilverPlatter Information, Boston, USA). Boolean operations were used (variables were the selected key words and year of publication; the above-mentioned 12 periodicals were excluded). The computerized search allowed key word identification in the title, abstract, Medical Subject Headings (MESH), and address of origin. The MedlineTM report was archived for each identified contribution, including the abstract and address of the authors.
Study selection
English abstracts of all initially identified articles were assessed for clinical practice of paediatric anaesthesia. Articles related to other fields of medicine, for example surgery, cardiology, immunology or experimental research, were excluded from further evaluation. Thus, a detailed report on endoscopic findings in children anaesthetized during the procedure was excluded. In contrast, a publication describing certain paediatric anaesthesia techniques during endoscopic procedures was included.
Formal analysis
The final sample was evaluated as to language and country of origin. The origin of publications was determined according to the following algorithm: (i) address of correspondence; (ii) address of the institution; or (iii) nationality of the first author shown in previous publications by the same individual. If more than one address was indicated, the first one was used.
Physical characteristics, ranking and calculations
Numbers (19931998) of infants and children (aged 014 yr) and officially registered anaesthetists (specialists) were calculated and averaged, based on information provided by governments and national specialist societies of selected countries. The numbers of publications per 1 million children (PpmC; potential study population) and publications per 1000 anaesthetists (PptA; potential investigators) were determined by dividing the total number of relevant publications by the respective demographic factor.
It may be assumed that the number of publications together with the respective cumulative impact factor may serve to assess publication activity of a specific journal and of a country/region. Anaesthesia journals referenced in MedlineTM were listed according to the number of articles on paediatric anaesthesia published during the 6-yr study period, and the respective impact factor (Science Citation Index) was averaged from 1993 to 1998.5 The cumulative impact factor for a journal (cIF-journal) resulted from the multiplication of the number of articles therein by the respective impact factor. The cumulative impact factor for a country (cIF-country) was calculated for the seven most active countries/regions (number of articles) by adding the respective cIF-journal values of the national authors. Additionally, the mean impact factor (mIF) for the average publication on paediatric anaesthesia was obtained for each of these countries by dividing cIF-country by the number of publications for each country.
![]() |
Results |
---|
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
---|
|
|
|
|
|
|
|
![]() |
Discussion |
---|
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
---|
Limitations and advantages of the applied method
The limitations of this exercise were that MedlineTM (US National Library of Medicine, 1999) only references 3900 of 165 000 published journals worldwide.6 Furthermore, we excluded book chapters, abstracts, popular science publications or rejected manuscripts, all of which reflect publication activity. The advantages of this restrictive approach were that all included articles underwent peer-review ensuring a specific level of quality, and that subjective or random factors such as accessibility were eliminated making the results reproducible. Furthermore, because only work on clinical paediatric anaesthesia was included in our study, some publications with potentially relevant information may not have been identified.
The selection of key words and the criteria for inclusion or exclusion of the retrieved articles was dependent upon the decision of the investigators. Other search terms or selection criteria might have yielded different data. In addition, as the correspondence address listed may not always have represented the country of origin of all the authors involved, we were unable to quantify foreign contributions to specific papers.
Journals
Approximately 78% of all publications appeared in anaesthesia journals, and 46% of the articles were found in five periodicals (Paediatric Anaesthesia, Anesthesia & Analgesia, Canadian Journal of Anaesthesia, British Journal of Anaesthesia and Anesthesiology). While these journals may be of vital interest to paediatric anaesthetists worldwide, other anaesthesia journals may also be important, because for instance they reflect activities in the country of the respective reader.
Increases in the number of articles on paediatric anaesthesia (24%) were smaller than increases in publications on medical topics as a whole (33%).6 Larger or smaller increases in some journals may be a reflection of editorial board decisions. For example, Anesthesia & Analgesia became the official journal of the American Society of Pediatric Anesthesia in 1996,1 and the number of publications on paediatric anaesthesia increased accordingly. This may have led to fewer publications elsewhere, for instance in the Canadian Journal of Anaesthesia or in Masui. Alternatively, the impact factor of a journal (e.g. Anesthesia & Analgesia, IF=2.471; Table 5) could play an important role in manuscript submission. Some authors, for instance from Japan, may have preferred to submit their manuscripts there, which in turn, resulted in fewer submissions to Japanese journals.
Paediatric Anaesthesia has an important position with 19% of all publications in the field, although the impact factor (0.813) is ranked relatively low. The relevance of the impact factor to estimate importance and quality of scientific output has become the subject of intense debate.715 It has been suggested that the impact factor reflects international recognition or visibility, rather than the quality or importance of certain periodicals or a researchers work.16 Some journals may have an important role independent of their impact factor as they convey specific information for interested specialists.
Publication productivity and international recognition of different countries/regions
The largest proportion of publications on paediatric anaesthesia originated from the USA and the UK, which is in proportion to medical research output in general.6 American and British authors may publish more frequently, due to special mechanisms of fund-raising and career development in their home countries. The high productivity of anaesthetists from the UK and several smaller European countries, Switzerland, Sweden, Denmark, was to be expected as it is similar to the publication pattern in other medical areas.4 1719 Differences in publication productivity between countries have been associated with differences in the respective medical systems and other factors such as language, training and funding.17
Alternatively, work from highly productive countries may have been published preferentially. A strong correlation between the origins of medical journals and the respective authors has previously been observed in related fields, for example anaesthesia, intensive care, emergency medicine and pain management.14 18 19 Apart from the scientific content, which is evaluated through a vigorous peer-review process, it has been suggested that acceptance of manuscripts may be influenced by various co-factors. For example, the probability of having an English language manuscript accepted is greater than the acceptance of a non-English version.20 Furthermore, the majority of authors publishing in highly ranked USA- or UK-based journals write in their native language, originate from countries with a high scientific reputation, and their reviewers may be from the same country. Thus, it has been suggested that work by Anglo-American authors is more likely to be accepted by Anglo-American journals, resulting in a certain publication bias.2124
Some of these factors may exert an additional influence on publication patterns in paediatric anaesthesia. However, our data appear to support the view that anaesthetists from certain countries, in relation to the respective available manpower and/or study population, are more active in communicating new information on paediatric anaesthesia to the scientific community. Together with the higher impact factors of the journals, this results in higher cumulative and mean impact factors for both North American and British publications, and thus in greater international recognition or visibility (i.e. number of publications multiplied by the impact factor).16 The high cumulative and mean impact factors of some European countries/regions, may additionally result from the lack of non-English language anaesthesia journals in these countries, leading the authors to publish elsewhere.
In conclusion, Paediatric Anaesthesia, Anesthesia & Analgesia, the Canadian Journal of Anaesthesia, the British Journal of Anaesthesia and Anesthesiology are important journals for the paediatric anaesthetist, as they account for 46% of all publications in this field. Publications on paediatric anaesthesia with the greatest international recognition (according to the impact factor) originated from the US and the UK. This may be due to a high publication productivity of authors from the respective countries, and certain co-factors supporting publication in the highly ranked USA- and UK-based periodicals. The lingua franca of scientific publications is English, a factor that cannot be ignored by non-native speakers of English who wish to influence paediatric anaesthesia.
![]() |
Acknowledgement |
---|
![]() |
Footnotes |
---|
![]() |
References |
---|
![]() ![]() ![]() ![]() ![]() ![]() ![]() |
---|
2 Kumararatne M. Why publish? JAMA 1997; 277: 957[ISI][Medline]
3 Jadad AR, McQuay HJ. Searching the literature. Be systematic in your searching. BMJ 1993; 307: 66[ISI][Medline]
4 Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. BMJ 1994; 309: 128691
5 Science Citation Index (SCI) Journal Citation Reports. A bibliometric analysis of science journals in the ISI database. Institute for Scientific Information, Philadelphia, 19931998
6 Kolbitsch Ch, Balogh D, Hauffe H, Löckinger A, Benzer A. National publication output in medical research. Anaesthesiol Intensivmed Notfallmed Schmerzther 1999; 34: 2147
7 Garfield E. How can impact factors be improved? BMJ 1996; 313: 4113
8 Opthof T. Sense and nonsense about the impact factor. Cardiovasc Res 1997; 33: 17[ISI][Medline]
9 Seglen PO. Why the impact factor should not be used for evaluating research. BMJ 1997; 314: 498502[ISI][Medline]
10 Lindner UK, Oehm V. Die Magie des Impact Faktors Enttarnung eines Phänomens. Der Anaesthesist 1997; 46: 12[ISI][Medline]
11 Smith R. Unscientific practice flourishes in science. Impact factors of journals should not be used in research assessment. BMJ 1998; 316: 1036
12 Williams G. Misleading, unscientific, and unjust: the United Kingdoms research assessment exercise. BMJ 1998; 316: 107982
13 Hecht F, Hecht BK, Sandberg AA. The journal impact factor: a misnamed, misleading, misused measure. Cancer Genet Cytogenet 1998; 104: 7781[ISI][Medline]
14 Gallagher EJ, Barnaby DP. Evidence of methodological bias in the derivation of the Science Citation Index impact factor. Ann Emerg Med 1998; 31: 1079[ISI][Medline]
15 Gisvold SE. Citation analysis and journal impact factors is the tail wagging the dog? Acta Anaesthesiol Scand 1999; 43: 9713[ISI][Medline]
16 Favaloro EJ. Medical research in New South Wales 19931996 assessed by Medline publication capture. MJA 1998; 169: 61722[Medline]
17 Boldt J, Maleck W, Koetter KP. Which countries publish in important anesthesia and critical care journals? Anesth Analg 1999; 88: 117580
18 Shahla M, Verhaeghe V, Hedeshi AR, Friedman G, Vincent JL. European participation in major intensive care journals. Intensive Care Med 1995; 21: 710[ISI][Medline]
19 Shahla M, Hedeshi AR, Verhaeghe V, Gomez J, Vincent JL. International participation in major intensive care journals. The smaller the better. Intensive Care Med 1996; 22: 125860[ISI][Medline]
20 Nylenna M, Riis P, Karlsson Y. Multiple blinded reviews of the same two manuscripts. Effects of referee characteristics and publication language. JAMA 1994; 272: 14951[Abstract]
21 Elster AD, Chen MYM. The internationalization of the American Journal of Roentgenology: 19801992. Am J Roentgenol 1994; 162: 51922[Abstract]
22 Link AM. US and non-US submissions. JAMA 1998; 280: 2467
23 Campbell FM. National bias: a comparison of citation practices by health professionals. Bull Med Libr Assoc 1990; 78: 37682[ISI][Medline]
24 Henrissat B. National publication bias [Letter]. Nature 1991; 354: 427[Medline]