General Surgery Journals Research Articles

Does Social Media have an Impact Factor?

Introduction: Social media is now an everyday part of modern life including medicine. There are an increasing number of healthcare professionals and institutions using social media in their clinical and academic practice1. One study alone in 2011 showed 90% of doctors used social media personally and 65% professionally2. Twitter provides a platform for signposting users to the most current and useful material and provide scope for alternative metrics. Historically, a healthcare professional would use the journal impact factor (JIF) of a journal to select the most appropriate to subscribe to and read, however in today's digital society, Twitter provides the ability to see updates across a range of journals and for the clinician to select what is most relevant for them. We therefore performed an observational study to assess whether there was a correlation between Twitter follower numbers (TFN) and JIF. Methods: A search of 10 popular general medicine, general surgery, vascular surgery and interventional radiology journals was performed, namely: Nature, The New England Journal of Medicine, The Lancet, The British Medical Journal (BMJ), The British Journal of Surgery, Circulation, European Journal of Vascular and Endovascular Surgery, Journal of Vascular Surgery (JVS), Journal of Vascular Interventional Radiology and CardioVascular and Interventional Radiology (CVIR). The 2017 JIF stated on their website as of 4th April 2019 was recorded. Of these 7 cited 2017 Journal Citation Reports3 as the source. The JVS and CVIR both stated a JIF that matched 2017 Journal Citation Reports3 but did not cite the source on website. The BMJ had a published 2017 JIF (23.562) that did not match the Journal Citation Reports (23.259)3 [Table 1]. A search of the journals on Twitter was made and the number of followers as of 15:15 GMT on 5th April was noted. Bivariate regression analysis of the TFN as a function of the JIF was undertaken using Minitab 18 statistical software. For the purpose of the analyses the JIF as per the journal website was used, as the minor variations indicated would be likely to have any major impact on the outcomes. Results: There was a visible impression that the higher the JIF the higher the TFN [Table 1]. However, there was low correlation between the JIF and number of followers (adjusted R-sq= 20.76%, p=.104; Graph 1), with occasional low JIF journals also having a large number of followers as noted in the graph outliers. Conclusion: Whilst journals with high JIF clearly had higher TFN, we could find no causal link to suggest that social media following was indeed impacted upon by the impact factor directly. This is likely due to confounding factors particularly the fact that the number of followers will be from a varied background and much higher than that of the number of actual directly contributing authors who are also journal followers, which then via individual and subsequently journal citation impact may possibly have a more direct correlation, but that is outside of the scope of the current analysis.Table 1Journal Impact Factors and Twitter followingGraph 1Scatterplot: correlation between TFN.and JIF.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Disclosure: Nothing to disclose

Review of "Editorial (Spring) Board? Gender Composition in High-Impact General Surgery Journals Over 20 Years" by Harris CA, Banerjee T, Cramer M, et al in Ann Surg 269: 582-588, 2019.

Journal of Craniofacial Surgery 30(5):p 1612-1613, July/August 2019. | DOI: 10.1097/SCS.0000000000005550

The Top 100: A Review of the Most Cited Articles in Surgery

IntroductionWe performed a study of the top 100 most cited articles in the five general surgery journals with the highest impact according to Journal Citation Report. MethodsWe selected the five journals with the highest impact in 2015: Annals of Surgery, British Journal of Surgery, JAMA Surgery, Surgery, and Journal of the American College of Surgeons. In January 2017, using the Web of Science application, we performed a search of all articles published by these journals and identified the 100 most cited articles (top 100). We evaluated the number of citations, year of publication, type of article, country and hospital of the article, area of interest and number of authors. ResultsThe median number of citations per top 100 paper was 490. Twenty percent of the top 100 papers have been published since 2000. Overall, 70% are original papers, 8% randomized control trials, 11% reviews, 1% meta-analyses and 11% other subtypes. There are 13% proceedings papers. Sixty-one percent are from the US. The most frequently discussed topic is hepato-pancreato-biliary surgery (33%). ConclusionsThe top 100 most cited articles tend to be original articles describing studies carried out in the US, reporting significant surgical breakthroughs. Hepato-pancreato-biliary surgery is the most common subject area. Annals of Surgery had twice as many citations as the other journals studied. The archetypal article of the Top15 most cited is an original paper published in the twentieth century, with an average of 2000 citations.

Editorial (Spring) Board? Gender Composition in High-impact General Surgery Journals Over 20 Years.

To quantify gender composition of 10 high-impact general surgery journals, delineate how board composition has changed over time, and evaluate qualification metrics by gender. Underrepresentation of women on editorial boards may contribute to the gender-based achievement gap in surgery. We performed a cross-sectional analysis of the editorial board gender composition among 10 high-impact general surgery journals in 1997, 2007, and 2017. Univariate and multivariate regression analyses were used to assess differences in editors' H-indices, academic rank, and number of advanced degrees. Differences in editor turnover and multiple board positions were evaluated for each time interval. Over 20 years, the proportion of women on editorial boards increased from 5% to 19%. After controlling for time since board certification, no differences between men and women's number of advanced degrees, H-indices, or academic rank remained significant. Women and men were equally likely to hold multiple board positions (1997 P = 0.74; 2007 P = 0.42; 2017 P = 0.69), but men's editorial board tenure was longer across each time interval (1997-2007 P = 0.003; 2007-2017 P < 0.001; 1997-2017 P = 0.01). Women surgeons have a small but growing presence on surgical editorial boards, and gender-based qualification differences are likely attributable to practice length. Men's longer tenure on editorial boards may drive some of the observed disparity by limiting new appointment opportunities. Strategies such as imposing term limits or instituting merit-based performance reviews may help editorial boards capture the field's changing demographics.

Los top 100. Revisión de los artículos más citados en cirugía

IntroductionWe performed a study of the top 100 most cited articles in the five general surgery journals with the highest impact according to Journal Citation Report. MethodsWe selected the five journals with the highest impact in 2015: Annals of Surgery, British Journal of Surgery, JAMA Surgery, Surgery, and Journal of the American College of Surgeons. In January 2017, using the Web of Science application, we performed a search of all articles published by these journals and identified the 100 most cited articles (top 100). We evaluated the number of citations, year of publication, type of article, country and hospital of the article, area of interest and number of authors. ResultsThe median number of citations per top 100 paper was 490. Twenty percent of the top 100 papers have been published since 2000. Overall, 70% are original papers, 8% randomized control trials, 11% reviews, 1% meta-analyses and 11% other subtypes. There are 13% proceedings papers. Sixty-one percent are from the US. The most frequently discussed topic is hepato-pancreato-biliary surgery (33%). ConclusionsThe top 100 most cited articles tend to be original articles describing studies carried out in the US, reporting significant surgical breakthroughs. Hepato-pancreato-biliary surgery is the most common subject area. Annals of Surgery had twice as many citations as the other journals studied. The archetypal article of the Top15 most cited is an original paper published in the twentieth century, with an average of 2000 citations.

Assessment of Orthopedic Educational Research in 2015 Publications

Due to orthopedic surgery's unique educational model, recent changes within graduate medical education have the potential to impact the methods and outcomes of specialty training significantly. Using Mind the Gap: Representation of Medical Education in Cardiology-Related Articles and Journals (Allred et al., 2016) as a framework, this study investigates educational research within the field of orthopedics. Two main objectives were evaluated: (1) quantitative analysis of the amount and type of orthopedic education-related research in orthopedic, general surgery, and medical education journals and (2) estimate the priority of orthopedic journals to publish education-focused articles. Using a composite citation-based 5-metric scoring system, a complete list of journals pertaining to orthopedics, nonorthopedic specific surgery journals, and general medical education journals was ranked. All publications during 2015 for the selected cohort of journals were then analyzed for orthopedic education-related publications. Aim and scope of the top 15 selected orthopedic journals (along with the mission statements of their associated societies) were evaluated with a word cloud generator to determine priority on education. Review of 7112 articles from the top 15 selected orthopedic journals yielded 37 publications with an educational focus. Evaluation of 15 general surgery or medical education journals, containing 4661 publications, generated an additional 28 positive articles. In total, 51 unique orthopedic education-related publications (0.43% of total evaluated articles) were identified from the 11,773 articles published in the selected 30 journals for 2015. The lack of emphasis on orthopedic educational research output is multifactorial, needing further evaluation to determine specific causes and methods of improvement. This article adequately sheds light on the need to increase support of educational research programs within the field of orthopedics.

Impact factors of orthopaedic journals between 2010 and 2016: trends and comparisons with other surgical specialties.

With increased legislative efforts to utilize evidence-based medicine as a guide for clinical practice, orthopaedists feel increasing pressure to publish research in higher-quality journals that reach a larger audience. Impact factor (IF) is used to quantify and rank journal apparent quality, and is the most standardized method for journal appraisal. In this study, we assessed the trends for IF among orthopaedic journals and compared these trends to those of medicine and general surgery journals. Journal IFs from Journal Citation Reports (JCR) between the years 2010 to 2016 were obtained and analyzed for trends. Only journals that were considered primarily orthopaedic journals were included. The top 10 journals by IF in both internal medicine and surgery were also included for comparison. Each journal was analyzed by IF, and trends across time were noted. The differences in mean IF between orthopaedic specialty groups were analyzed using an independent samples t-test. The mean IF of orthopaedic increased from 1.4 (range, 0.0-3.9) in 2010 to 1.9 (range, 0.5-5.7) in 2016. In 2016, the percentage of English journals increased to 87.3% (n=48), while the percentage of journals published in the United States was 47.3% (n=26). There was a significant difference between the IF of journals published in English and those published in other languages (P=0.004). The mean IF of both general and specialized orthopaedic journals increased from 2010 to 2016, but the difference was nonsignificant. The mean IF of the top 10 journals in both surgery and internal medicine also increased from 2010 to 2016, but the increase was also nonsignificant. Overall, the mean IF for peer-reviewed orthopaedic journals has increased in the past years, as has the number of journals. English journals from the United States continue to have the largest impact when compared to non-English journals and journals from outside the United States. Future studies should aim to better qualify journal impact, while limiting confounders such as self-citation.

Medicine in small doses.

Medicine in small doses.

The top-cited articles in medical education: a bibliometric analysis.

To identify and examine the characteristics of the 50 top-cited articles in medical education. Two searches were conducted in the Web of Knowledge database in March 2014: a search of medical education journals in the category "Education, Scientific Discipline" (List A) and a keyword search across all journals (List B). Articles identified were reviewed for citation count, country of origin, article type, journal, authors, and publication year. Both lists included 56 articles, not 50, because articles with the same absolute number of citations shared the same rank. The majority of List A articles were published in Academic Medicine (34; 60.7%) and Medical Education (16; 28.6%). In List B, 27 articles (48.2%) were published in medical education journals, 19 (33.9%) in general medicine and surgery journals, and 10 (17.9%) in higher education and educational psychology journals. Twenty-six articles were included in both lists, with different rankings. Reviews and articles constituted the majority of articles; there were only 8 research papers in List A and 13 in List B. Articles mainly originated from the United States, Canada, the Netherlands, and the United Kingdom. The majority were published from 1979 to 2007. There was no correlation between year and citation count. The finding that over half of List B articles were published in nonmedical education journals is consistent with medical education's integrated nature and subspecialty breadth. Twenty of these articles were among their respective non-medical-education journals' 50 top-cited papers, showing that medical education articles can compete with subject-based articles.

Disclosure of Funding Sources and Conflicts of Interest in Phase III Surgical Trials: Survey of 10 General Surgery Journals

The last decade has shown burgeoning growth and the importance of industrial support for innovation and clinical trials that have advanced the practice of surgery. Quality clinical studies are expensive, as is the development of innovative technologies. The last decade has also shown only too clearly that some of those alliances have been abused by consequent bias of the outcomes or even for personal gain. As editors, we must be overly conscious of funding sources and especially situations of real or potential conflicts of interest. Editors, often informed by reviewers, must be on the look-out for malfeasance. However, as Tuech and colleagues have shown, we may miss some who stray from the righteous path. We thus fail in our responsibility to our readers to provide funding sources and how the ‘‘funding’’ was disbursed: for salary support of investigator, nurse, or study coordinator; materials/devices/medications used; data analysis; preparation of manuscript; unrestricted monetary ‘‘grants’’ often used for activities unrelated to the study at hand. Although we very closely and consciously review conflicts of interest that have been disclosed, there are others that were not disclosed, regardless of whether it was intentional. In those circumstances, neither we nor our readers are able to judge the validity of the reported data. Tuech et al. [1] have asked the question, and we, the Editors-in-Chief of the journal, SURGERY, as well as the Editor-in-Chief of the World Journal of Surgery, have heard them. We will address this topic at the next meeting of the Surgery Journal Editors Group (SJEG) this fall during the Clinical Congress of the American College of Surgeons. Each year the SJEG, which has representatives from many of the indexed surgery journals, meets to discuss topics of relevance to the field of medical publishing such as this important topic. It seems likely that the SJEG will adopt a general policy that all articles specify the source (and use) of funding and the presence or absence of pertinent disclosures of interest. The journal Surgery, which we co-edit, is adopting this policy immediately.

Disclosure of funding sources and conflicts of interest in phase III surgical trials: survey of ten general surgery journals.

Discussions regarding disclosure of funding sources and conflicts of interest (COI) in published peer-reviewed journal articles are becoming increasingly more common and intense. The aim of the present study was to examine whether randomized controlled trials (RCTs) published in leading surgery journals report funding sources and COI. All articles reporting randomized controlled phase III trials published January 2005 through December 2010 were chosen for review from ten international journals. We evaluated the number of disclosed funding sources and COI, and the factors associated with such disclosures. From a review of 657 RCT from the ten journals, we discovered that presence or absence of a funding source and COI was disclosed by 47 % (309) and 25.1 % (165), respectively. Most articles in "International Committee of Medical Journal Editors (ICMJE)-affiliated journals" did not disclose COI. Disclosure of funding was associated with a journal impact factor >3 (51.7 vs 41.6 %; p < 0.01), statistician/epidemiologist involvement (64.2 vs 43.7 %; p < 0.001), publication after 2008 (52.9 vs 41.1 %; p < 0.01), and the journal being ICMJE-affiliated (49.3 vs 40 %; p < 0.05). Conflict of interest disclosure was associated with publication after 2008 (38.7 vs 11.3 %; p < 0.001), and with the journal not being affiliated with ICMJE (36.9 vs 21.3 %; p < 0.001). Of the published studies we investigated, over half did not disclose funding sources (i.e., whether or not there was a funding source), and almost three quarters did not disclose whether COI existed. Our findings suggest the need to adopt best current practices regarding disclosure of competing interests to fulfill responsibilities to readers and, ultimately, to patients.

Comparison of Randomized Controlled Trial Registry Entries and Content of Reports in Surgery Journals

To evaluate discrepancies between trial registry entries and final reports of randomized controlled trials (RCTs) published in major general surgical journals. Health care decisions are based on published results in peer-reviewed journals. Mandatory trial registration was introduced to increase transparency and reduce publication and outcome reporting bias. The discrepancy rate between trial registry entries and final reports of all RCTs published during 2010 in the Annals of Surgery, Archives of Surgery, and British Journal of Surgery was evaluated. Of 596 identified studies, 545 were excluded because they were not RCTs or interim reports/secondary analysis of RCTs or because of missing trial registry information.In the remaining 51 RCTs, prospective registration was found in 9.8% (n = 5), registration during trial conduct in 33.3% (n = 17), and retrospective registration in 56.9% (n = 29), respectively.For the primary and secondary outcomes, there was no discrepancy in 54.9% and 33.3%, complete omission in 7.8% and 31.3%, new introduction in 7.8% and 39.2%, a change in definition in 9.8% and 5.8%, downgrading from primary to secondary in 21.6%, and upgrading from secondary to primary in 13.7%. There were few discrepancies in randomization, blinding, and intervention and some in targeted sample size and inclusion/exclusion criteria. When interpreting the results of surgical RCTs, the possibility of selective reporting, and thus outcome reporting bias, has to be kept in mind. For future trials, prospective registration should be strictly respected with the ultimate goal to increase transparency and contribute to high-level evidence reports for optimal patient care in surgery.

Natural orifice transluminal endoscopic surgery (NOTES): where are we going? A bibliometric assessment

The aim of this study was to analyse natural orifice transluminal endoscopic surgery (NOTES)-related publications over the last 5 years. A systematic literature search was done to retrieve publications related to NOTES from 2006 to 2011. The following variables were recorded: year of publication; article type; study design; setting; Journal Citation Reports® journal category; authors area of surgical speciality; geographic area of origin; surgical procedure; NOTES technique; NOTES access route; number of clinical cases. A time-trend analysis was performed by comparing early (2006-2008) and late (2009-2011) study periods. Overall, 644 publications were included in the analysis and most papers were found in general surgery journals (50.9%). Studies were most frequently clinical series (43.9%) and animal experimental (48%), with the articles focusing primarily on cholecystectomy, access creation and closure, and peritoneoscopy. Pure NOTES techniques were performed in most of the published reports (85%) with the remaining cases being hybrid NOTES (7.4%) and NOTES-assisted procedures (6.1%). The access routes included transgastric (52.5%), transcolonic (12.3%), transvesical (12.5%), transvaginal (10.5%), and combined (12.3%). From the early to the late period, there was a significant increase in the number of randomised controlled trials (5.6% vs 7.2%) or non-randomised but comparative studies (5.6% vs 22.9%) (P < 0.001) and there was also a significant increase in the number of colorectal procedures and nephrectomies (P = 0.002). Pure NOTES remained the most studied approach over the years but with increased investigation in the field of NOTES-assisted techniques (P = 0.001). There was also a significant increase in the adoption of transvesical access (7% vs 15.6%) (P = 0.007). NOTES is in a developmental stage and much work is still needed to refine techniques, verify safety and document efficacy. Since the first description of the concept of NOTES, >2000 clinical cases, irrespective of specialty, have been reported. NOTES remains a field of intense clinical and experimental research in various surgical specialities.

Reference Accuracy in the General Surgery Literature

Reference inaccuracy in scientific articles brings the scientific validity of the research into question and may create difficulty when accessing the cited background data. The objective of this study was to examine the reference accuracy in the general surgery literature and its correlation with the journal impact factor. Five general surgery journals were chosen with varying impact factors. From the year 2007, one issue was randomly chosen from each journal, and from each issue 180 citations were randomly chosen for review. Three investigators evaluated the chosen references for primary, citational, and quotational errors. The impact factor of each journal was compared to the percentage of errors detected. The total number of errors per journal ranged from 31.3 to 39.3%, with a total of 35.4% of all citations reviewed containing some type of error. The most common error type detected was incorrect citation of the primary source supporting a statement, the incidence of which ranged from 13.8 to 25.2%, depending on the journal, and accounting for 53.6% of the total errors found. Citational errors, which included incorrect author names, pagination, dates, and issue and volume numbers, ranged from 1.8 to 18.1% and accounted for 20.4% of the total errors detected. Qualitative errors, which occurred when the author misquoted another author's written assertions or conclusions, ranged from 7.4 to 16.0% and accounted for 34.7% of the total errors detected. Quantitative errors (misquoted numerical data) ranged from 3.1 to 8.6% and accounted for 17.9% of the total errors detected. No association between impact factor and error rate was demonstrated. Reference inaccuracy is common in the general surgery literature. The impact factor has no clear association with the error rate, demonstrating that journal quality does not necessarily correlate with reference quality. Further investigation into potential methods for improving reference accuracy in the general surgery literature is warranted.

Cited Brazilian papers in general surgery between 1970 and 2009

OBJECTIVESTo identify the most cited articles in general surgery published by Brazilian authors.INTRODUCTIONThere are several ways for the international community to recognize the quality of a scientific article. Although controversial, the most widely used and reliable methodology to identify the importance of an article is citation analysis.METHODSA search using the Institute for Scientific Information citation database (Science Citation Index Expanded) was performed to identify highly cited Brazilian papers published in twenty-six highly cited general surgery journals, selected based on their elevated impact factors, from 1970 to 2009. Further analysis was done on the 65 most-cited papers.RESULTSWe identified 1,713 Brazilian articles, from which nine papers emerged as classics (more than 100 citations received). For the Brazilian contributions, a total increase of about 21-fold was evident between 1970 and 2009. Although several topics were covered, articles covering trauma, oncology and organ transplantation were the most cited. The majority of classic studies were done with international cooperation.CONCLUSIONSThis study identified the most influential Brazilian articles published in internationally renowned general surgery journals.

Global survey of factors influencing choice of surgical journal for manuscript submission

An increasing number of general and affiliated specialty society journals make finding the right place for manuscript submission of an article challenging. Little is known about what factors surgeons hold important when choosing a journal for article submission. A global e-mail survey of authors publishing in 5 general surgery journals (Annals of Surgery, British Journal of Surgery, World Journal of Surgery, Archives of Surgery, and Surgery) from January 1, 2007, to December 31, 2008. Demographic data were collected. 15 arbitrarily chosen factors associated with submission strategy were rated for importance on a 5-point modified Likert scale (ranging from 1 representing "unimportant" and 5 representing "very important"). Of 1,855 authors, 250 (14%) responded. Representing 41 countries, 23 (10%) of the respondents were female and 250 (90%) were male. About two thirds of the authors had less than 10 years of clinical practice, with general surgery or gastrointestinal surgery as the major fields of interest represented. Of the 15 factors, the journal "reputation" was rated "very important" (5 points) by 62% of the respondents, followed by the journal "impact factor," which was rated "very important" by 61%, although some geographic differences were noted in this rating. Grouping several factors together in categories, the journal "prestige" and "turnaround time" category was held to be most important based on the average scores received. Age correlated with valued importance of the journal reputation (Spearman rho=0.141; P=.033). The factors considered the least important included the journal's acceptance/rejection rate, the option to suggest peer reviewers, and open access. The majority of seasoned surgeons held the overall reputation of the journal as the most important factor followed by the impact factor when choosing a journal for manuscript submission.

Surgical research publication in a selection of research and surgical speciality journals

A prior study revealed a paucity of surgical research in the 5 top-rated general surgery journals for 1998. The hypothesis of the current study was that a large amount of surgical research was published in other journals. In all, 15 research journals and 9 surgery specialty journals were reviewed for basic research, funded clinical studies, randomized clinical trials, and drug trials. The funding sources and the surgeon's role were recorded. The findings were compared with research published in the previously studied 5 journals in 1998 and 2005. Of 6,016 papers in the research and surgery specialty journals, 19% were research, of which 76% were basic research. Funding from 1,101 sources was provided to 825 studies (70%). Seventy-four percent of funded studies were basic research. Government was the source for 46% of grants, private for 41%, and industry for 13%. A surgeon was the sole or senior author in 72% of studies. A total of 1,172 research articles were published in the research and surgery specialty journals in 1998. In comparison, 369 research papers were published in the general surgery journals in 1998 and 306 papers were published in 2005. With respect to the type of research, there were 896 basic research papers in the research and specialty journals in 1998, 200 such papers in the general surgery journals in 1998, and 164 in 2005. There were 87 randomized trials in the research and the surgery specialty journals in 1998, 46 such papers in the general surgery journals in 1998, and 29 in 2005. A 3-fold greater volume of surgical research and more than a 4-fold greater volume of basic research was found in the research and the surgical specialty journals than in the general surgical journals in 1998, and this margin is increased when compared with the data for 2005. Consideration of only the general surgical journals greatly underestimates the surgical research being conducted.

Trends in the Quality of Highly Cited Surgical Research Over the Past 20 Years

To evaluate whether the methodologic quality of the most highly cited surgical clinical evidence has improved over the past 20 years. There have been increasing efforts to promote the practice of evidence-based medicine among surgeons, although it is unclear whether high-quality evidence is being used. A bibliometric review was performed among general surgery and medicine journals to identify the 50 most highly cited general surgery clinical research studies from 4 consecutive time periods (1985-1989, 1990-1994, 1995-1999, 2000-2004). Methodologic characteristics and overall data quality for all 200 highly cited studies were assessed by 3 independent reviewers using the validated GRADE scoring system and trends over time were analyzed. Among 200 extracted articles, the quality of evidence was graded as very low in the majority of studies (48%); fewer studies contained data of low (13%), moderate (13%), or high (26%) quality. Study quality significantly improved over the time periods examined, with an increase in the proportion of studies graded as high quality from 12% in 1985 to 1989 to 40% in 2000 to 2004 (P < 0.001). The improvement in data quality over time was associated with an increased proportion of randomized trials (26% vs. 48%; P < 0.05) and increased reporting of adjusted, multivariate regression analyses (22% vs. 54%; P < 0.001). There have been significant improvements in the quality of the most highly cited surgical evidence, characterized by more randomized trials and improved statistical methodology. These findings suggest that surgeons are increasingly recognizing and citing higher quality surgical evidence.

Plastic Surgery Classics: Characteristics of 50 Top-Cited Articles in Four Plastic Surgery Journals since 1946

Citation of published articles by peers provides an indication of the relevance of the scientific work. Still, it is unknown what kinds of plastic surgery articles are cited most often. The authors set out to identify the characteristics of the 50 top-cited articles as published in four international, peer-reviewed, PubMed-indexed general plastic surgery journals. The 50 most-cited articles were identified in each of the following journals: Plastic and Reconstructive Surgery, the British Journal of Plastic Surgery, the Annals of Plastic Surgery, and the Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery. These 200 articles were ranked after their citation index, defined as the mean number of times they were cited per year during the first 16 years after publication. The top-50 articles thus ranked were analyzed for citation and journal distribution, geographic and institutional origin, surgical and anatomical subject, and level of evidence. Forty-one of the 50 top-cited articles (82 percent) were published in Plastic and Reconstructive Surgery and 35 articles (70 percent) originated from institutions within the United States. Most of the articles dealt with the reconstruction of acquired defects (45 percent) and with basic or experimental research (41 percent). Research that offered means for clinical improvement, rather than a high level of evidence or the results of multi-institutional collaboration, was most often cited. An article featuring a clinical or nonclinical innovation, observation, or discovery that leads to clinical improvement has the best potential to become a "classic."

Why Should Surgeons Care about Clinical Research Methodology?

A low prevalence of high-level clinical studies in the surgical literature has been reported previously. We reviewed a recent sample of surgical publications to assess the current status of clinical research. A 3-month sample of journal articles in Archives of Surgery, Surgery, and Annals of Surgery in 2005 was evaluated by two independent reviewers to determine the distribution of articles in established evidence classes. A total of 133 publications were identified in the three journals during the time periods reviewed, including 101 clinical articles and 30 basic science articles. Among the clinical papers, there were 8 class I studies (7.9%), 34 class II studies (33.7%), and more than half were class III studies (59 of 101, or 58.4%). The low prevalence of high-level evidence to guide surgical management of patients persists in major general surgery journals. We believe that education about proper research methodology is not only important for researchers, but is also important for practicing surgeons, and can have important health policy implications as well.