Top Medical Journals Research Articles

Characteristics of Vaccine Safety Observational Studies and Authors’ Attitudes: A Systematic Review

BackgroundPost-licensure observational studies are the mainstay of vaccine safety evaluation. However, these studies have well-known methodological limitations, rendering them particularly vulnerable to unmeasured confounding. We sought to describe high-impact observational studies of vaccine safety, investigate the authors’ attitudes towards their study's findings and limitations, and report on spin practices. MethodsWe conducted a Pubmed systematic review of comparative observational studies of vaccine safety published in the six top medical journals from inception to March 2024. ResultsThirty-seven studies were included, spanning publications from 1995 to 2024. Most studies focused on COVID19 and influenza vaccines (n=11, 30%, and n=10, 27%, respectively). Study designs and methodologies varied. Electronic health records (54%), passive surveillance databases (32%) and national registries (27%) were the most common data sources. Negative control outcomes were used in a single study. Residual confounding was conceded in 54% of studies, and an additional 24% did so implicitly. Spin was noted in 48.6% of the studies. This systematic review found that authors of observational vaccine safety studies in high-impact medical journals often acknowledge residual confounding, but rarely use methods like negative control outcomes to better detect unmeasured confounding. Furthermore, spin is common, occurring in approximately 50% of the studies. ConclusionsAlthough our findings are somewhat limited by subjectivity in study assessments, they suggest that editors and reviewers of high-impact journals should ensure the language used in reporting observational studies accurately reflects the findings and their limitations.

Exploring the implicit meanings of 'cultural diversity': a critical conceptual analysis of commonly used approaches in medical education.

Existing approaches to cultural diversity in medical education may be implicitly based on different conceptualisations of culture. Research has demonstrated that such interpretations matter to practices and people concerned. We therefore sought to identify the different conceptualisations espoused by these approaches and investigated their implications for education. We critically reviewed 52 articles from eight top medical education journals and subjected these to a conceptual analysis. Via open coding, we looked for references to approaches, their objectives, implicit notions of culture, and to implementation practices. We iteratively developed themes from the collected findings. We identified several approaches to cultural diversity teaching that used four different ways to conceptualise cultural diversity: culture as 'fixed patient characteristic', as 'multiple fixed characteristics', as 'dynamic outcome impacting social interactions', and as 'power dynamics'. We discussed the assumptions underlying these different notions, and reflected upon limitations and implications for educational practice. The notion of 'cultural diversity' challenges learners' communication skills, touches upon inherent inequalities and impacts how the field constructs knowledge. This study adds insights into how inherent inequalities in biomedical knowledge construction are rooted in methodological, ontological, and epistemological principles. Although these insights carry laborious implications for educational implementation, educators can learn from first initiatives, such as: standardly include information on patients' multiple identities and lived experiences in case descriptions, stimulate more reflection on teachers' and students' own values and hierarchical position, acknowledge Western epistemological hegemony, explicitly include literature from diverse sources, and monitor diversity-integrated topics in the curriculum.

Do infographics ‘spin’ the findings of health and medical research?

ObjectiveTo compare the prevalence of ‘spin’, and specific reporting strategies for spin, between infographics, abstracts and full texts of randomised controlled trials (RCTs) reporting non-significant findings in the field of...

Mapping the landscape of medical research in the Arab world countries: A comprehensive bibliometric analysis.

To describe the productivity, performance, and impact of medical research in the Arab world countries. We carried out a bibliometric analysis using Clarivate Analytics databases from January 2017 to March 2023. We reported research productivity, national and international research collaboration patterns, impact of Arab medical research output compared to the global average, top medical journals publishing Arab-affiliated research, and performance of the most productive Arab institutions. The Arab world contributed 2.72% to global medical research publication, with a citation impact of 11.98 compared to the global impact of 12.02. Qatar, Lebanon, and Saudi Arabia led medical research publications per million population among Arab countries, ranking 26th, 36th, and 37th globally. Medical research publications increased by 87% annually from 2017-2022, with 70% of research originating from Saudi Arabia and Egypt. National collaborations accounted for 15% of Arab world publications, while international collaborations represented 66%. The median impact factor across the top 20 medical journals with Arab-affiliated authors was 5.14, with 50% being quartile one journals. The top 10 Arab-origin medical journals had a median impact factor of 3.13. Approximately 80% of the top 20 Arab institutions were academic, with a median publication count of 3,162.5 and a median citation impact of 14.5. The study provides insights into the state of medical research in the Arab countries, indicating room for improvement in the region's medical research.

Publishers’ and journals’ instructions to authors on use of generative artificial intelligence in academic and scientific publishing: bibliometric analysis

ObjectivesTo determine the extent and content of academic publishers’ and scientific journals’ guidance for authors on the use of generative artificial intelligence (GAI).DesignCross sectional, bibliometric study.SettingWebsites of academic publishers and...

A Medical Education Research Library: key research topics and associated experts

ABSTRACT When clinician-educators and medical education researchers use and discuss medical education research, they can advance innovation in medical education as well as improve its quality. To facilitate the use and discussions of medical education research, we created a prefatory visual representation of key medical education research topics and associated experts. We conducted one-on-one virtual interviews with medical education journal editorial board members to identify what they perceived as key medical education research topics as well as who they associated, as experts, with each of the identified topics. We used content analysis to create categories representing key topics and noted occurrences of named experts. Twenty-one editorial board members, representing nine of the top medical education journals, participated. From the data we created a figure entitled, Medical Education Research Library. The library includes 13 research topics, with assessment as the most prevalent. It also notes recognized experts, including van der Vleuten, ten Cate, and Norman. The key medical education research topics identified and included in the library align with what others have identified as trends in the literature. Selected topics, including workplace-based learning, equity, diversity, and inclusion, physician wellbeing and burnout, and social accountability, are emerging. Once transformed into an open educational resource, clinician-educators and medical education researchers can use and contribute to the functional library. Such continuous expansion will generate better awareness and recognition of diverse perspectives. The functional library will help to innovate and improve the quality of medical education through evidence-informed practices and scholarship.

The state of artificial intelligence in medical research: A survey of corresponding authors from top medical journals.

Natural Language Processing (NLP) is a subset of artificial intelligence that enables machines to understand and respond to human language through Large Language Models (LLMs)‥ These models have diverse applications in fields such as medical research, scientific writing, and publishing, but concerns such as hallucination, ethical issues, bias, and cybersecurity need to be addressed. To understand the scientific community's understanding and perspective on the role of Artificial Intelligence (AI) in research and authorship, a survey was designed for corresponding authors in top medical journals. An online survey was conducted from July 13th, 2023, to September 1st, 2023, using the SurveyMonkey web instrument, and the population of interest were corresponding authors who published in 2022 in the 15 highest-impact medical journals, as ranked by the Journal Citation Report. The survey link has been sent to all the identified corresponding authors by mail. A total of 266 authors answered, and 236 entered the final analysis. Most of the researchers (40.6%) reported having moderate familiarity with artificial intelligence, while a minority (4.4%) had no associated knowledge. Furthermore, the vast majority (79.0%) believe that artificial intelligence will play a major role in the future of research. Of note, no correlation between academic metrics and artificial intelligence knowledge or confidence was found. The results indicate that although researchers have varying degrees of familiarity with artificial intelligence, its use in scientific research is still in its early phases. Despite lacking formal AI training, many scholars publishing in high-impact journals have started integrating such technologies into their projects, including rephrasing, translation, and proofreading tasks. Efforts should focus on providing training for their effective use, establishing guidelines by journal editors, and creating software applications that bundle multiple integrated tools into a single platform.

The Best and Sustainable COVID-19 Policy in the World

This article will scientifically evaluate individual COVID-19 policies of countries around the world, U.S. states, and Japanese prefectures, respectively. The efficacy of the vaccines has been reported in many of the world’s top medical journals, but even after more than a year of vaccination, the claims have yet to be met. Human emotions, behaviors, and individual policies can significantly influence the outcome against the pandemic. The evaluation in this article is based on a single determinant of the policy outcome. Scoring policies is based on dividing the number of deaths due to COVID-19 by the population in millions. The lower the score, the better the policy. Unfortunately, scores monotonically increase, so that policymakers can only suppress them but cannot improve or decrease them. Therefore, mistakes by policymakers cannot be corrected in the future and they are fatal forever. The result using three tools will reveal the best COVID-19 policy in the world. The revealed policy should have been or be adopted in individual countries for mitigating and ending the COVID-19 pandemic. This article also suggests what is needed in our society for reducing the unnecessary deaths due to COVID-19.

Lifting of Embargoes to Data Sharing in Clinical Trials Published in Top Medical Journals

This study assesses data sharing status and lifting of embargoes in randomized clinical trials from top medical journals 3 to 5 years after publication.

The stories about racism and health: the development of a framework for racism narratives in medical literature using a computational grounded theory approach

IntroductionThe scientific study of racism as a root cause of health inequities has been hampered by the policies and practices of medical journals. Monitoring the discourse around racism and health inequities (i.e., racism narratives) in scientific publications is a critical aspect of understanding, confronting, and ultimately dismantling racism in medicine. A conceptual framework and multi-level construct is needed to evaluate the changes in the prevalence and composition of racism over time and across journals.ObjectiveTo develop a framework for classifying racism narratives in scientific medical journals.MethodsWe constructed an initial set of racism narratives based on an exploratory literature search. Using a computational grounded theory approach, we analyzed a targeted sample of 31 articles in four top medical journals which mentioned the word ‘racism’. We compiled and evaluated 80 excerpts of text that illustrate racism narratives. Two coders grouped and ordered the excerpts, iteratively revising and refining racism narratives.ResultsWe developed a qualitative framework of racism narratives, ordered on an anti-racism spectrum from impeding anti-racism to strong anti-racism, consisting of 4 broad categories and 12 granular modalities for classifying racism narratives. The broad narratives were “dismissal,” “person-level,” “societal,” and “actionable.” Granular modalities further specified how race-related health differences were related to racism (e.g., natural, aberrant, or structurally modifiable). We curated a “reference set” of example sentences to empirically ground each label.ConclusionWe demonstrated racism narratives of dismissal, person-level, societal, and actionable explanations within influential medical articles. Our framework can help clinicians, researchers, and educators gain insight into which narratives have been used to describe the causes of racial and ethnic health inequities, and to evaluate medical literature more critically. This work is a first step towards monitoring racism narratives over time, which can more clearly expose the limits of how the medical community has come to understand the root causes of health inequities. This is a fundamental aspect of medicine’s long-term trajectory towards racial justice and health equity.

#293 : Trends of Statistical Significance Reporting in Abstracts of Reproductive Medicine Studies from 1990 to 2022

Background and Aims: Despite efforts to minimize publication reporting bias in medical research, it remains unclear whether the magnitude and patterns of the bias have changed over time. We aim to assess the frequency in which the statistical information is presented in forms other than P-values and evaluate how statistical significance was reported in the abstracts of reproductive medicine studies. Method: We studied reproductive medicine studies published in 23 Q1 journals in reproductive medicine, and five top medical journals, including JAMA, Lancet, BMJ, NEJM, and PLOS Medicine. We text-mined abstracts from 1990 to 2022 to extract P-value, confidence interval (CI), and text description in statistical significance; the presence of effect size metrics and Bayes factors were searched. One thousand abstracts were randomly selected and manually checked. The extracted statistical significance information was then analysed for temporal trends and distribution. Results: We identified 24,550 reproductive medicine abstracts. The proportion of abstracts reporting isolated P-values was 13.9% in 1990 and 18.8% in 2021 (Figure 1); reporting isolated P-values was 3.0% (95% CI, 0.5%-11.3%) in meta-analyses, 20.8% (95% CI, 11.3%-34.5%) in randomized controlled trials, and 33.3% (95% CI, 23.8%-44.3%) in basic research in 2021. By contrast, the proportion of abstracts in reporting effect measures without P-value surged from 4.1% to 23.3% from 1990 to 2021. The reported P-values (n = 18,132) mainly clustered at 0.001 (20.0%) and 0.05 (16.2%). Of the 14,689 abstracts containing at least one statement describing statistical significance, 74.9% of abstracts made at least one statistically significant statement; this proportion had merely changed over time (Figure 2). Conclusion: Despite the increasing adoption of effect measures to convey statistical significance, reporting isolated P-values remains common. Publication reporting bias is pervasive and persisting in reproductive medicine abstracts; the inflated treatment could mislead all types of patient care and policy decisions.

Changing patterns of the grammatical stance devices in medical research articles (1970–2020)

While the grammatical marking of stance in academic writing is dynamic and susceptible to change over time, relatively few studies have tracked the changing patterns of stance expressions in contemporary medical academic writing. Based on 480 medical research articles published in top medical journals between 1970 and 2020, this study investigated the use of three major types of stance devices (modals, stance adverbials, and that-complement clauses) from a diachronic perspective. Results showed that the three types of stance devices and their functional/syntactic categories displayed a clear downward trend. In terms of stance markers within functional/syntactic categories, results demonstrated that stance markers indicating certainty declined in use, whereas stance markers conveying uncertainty increased. The results indicate that medical academic writing tends to become less interpersonal and more informational over time. In addition, medical writers are inclined to make more cautious and tentative knowledge claims across the years. These changes may be related to the development of medical science and have important pedagogical implications.

Estimating the false discovery risk of (randomized) clinical trials in medical journals based on published p-values.

The influential claim that most published results are false raised concerns about the trustworthiness and integrity of science. Since then, there have been numerous attempts to examine the rate of false-positive results that have failed to settle this question empirically. Here we propose a new way to estimate the false positive risk and apply the method to the results of (randomized) clinical trials in top medical journals. Contrary to claims that most published results are false, we find that the traditional significance criterion of α = .05 produces a false positive risk of 13%. Adjusting α to.01 lowers the false positive risk to less than 5%. However, our method does provide clear evidence of publication bias that leads to inflated effect size estimates. These results provide a solid empirical foundation for evaluations of the trustworthiness of medical research.

Current Status and Trends in mHealth-Based Research for Treatment and Intervention in Tinnitus: Bibliometric and Comparative Product Analysis.

As a global medical problem, tinnitus can seriously harm human health and is difficult to alleviate, ranking among the top 3 complex diseases in the otolaryngology field. Traditional cognitive behavioral therapy and sound therapy require offline face-to-face treatment with medical staff and have limited effectiveness. Mobile health (mHealth), which, in recent decades, has been greatly applied in the field of rehabilitation health care, improving access to health care resources and the quality of services, has potential research value in the adjunctive treatment of tinnitus. This study aimed to understand the research trends, product characteristics, problems, and research transformation of tinnitus treatment software by analyzing the research progress of mHealth for tinnitus treatment based on the literature and related marketed apps. Bibliometric methods were used to describe the characteristics of the relevant literature in terms of the number and topics of publications, authors, and institutions. We further compared the features and limitations of the currently available tinnitus treatment software. Data published until February 28, 2022, were collected. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standardized screening process, 75 papers were included. The country with the highest number of publications was Germany, followed by the United Kingdom and the United States, whereas China had only a single relevant study. The most frequently found journals were the American Journal of Audiology and the Journal of the American Academy of Audiology (18/75, 24%). With regard to publication topics, cognitive behavioral therapy started to become a hot topic in 2017, and research on mHealth apps has increased. In this study, 28 tinnitus treatment apps were obtained (n=24, 86% from product data and n=4, 14% from literature data); these apps were developed mainly in the United States (10/28, 36%) or China (9/28, 32%). The main treatment methods were sound therapy (10/28, 36%) and cognitive behavioral therapy (2/28, 7%). Of the 75 publications, 7 (9%) described apps in the market stage. Of the 28 apps, 22 (79%) lacked literature studies or evidence from professional bodies. We found that, as a whole, the use of mHealth for treatment and intervention in tinnitus was showing a rapid development, in which good progress had been made in studies around sound therapy and cognitive behavioral therapy, although most of the studies (50/75, 67%) focused on treatment effects. However, the field is poorly accepted in top medical journals, and the majority are in the research design phase, with a lack of translation of the literature results and clinical validation of the marketed apps. Furthermore, in the future, novel artificial intelligence techniques should be used to address the issue of staged monitoring of tinnitus.

Gender parity in high impact neurology journals

BackgroundAlthough female representation has been growing among physicians, women continue to be underrepresented in neurology, particularly regarding academic research in authorship and leadership. Analyzing recent trends in high-impact neurology journals highlights the underrepresentation of women and helps explore barriers to female representation in academic neurology. Methods and resultsJournal Citation Reports (JCR) for 2021 was used to screen neurology journals for selection. The first 15 journals with the highest impact factors (JIF) were included. 15,404 total articles in neurology were examined for gender distribution of editorial staff and authorship with the highest total citations from January 1st, 2018 to October 31st, 2021. Gender was classified using biographical information from public and personal media sources. Genderize.io was used in cases of ambiguity, predicting gender at probability of ≥95%. Our data demonstrated that these journals only had 13% female editor-in-chiefs and 35% female editorial staff. The data further demonstrated that females accounted for 39% of first authors and 26% for last authors. During the four years examined males continued to account for the vast majority of both first and last authors for publications accepted and journal editorial staff members. ConclusionWomen are significantly under-represented in the field of neurological research in leadership positions as editor-in-chiefs, editorial board members as well as first or senior authors in top neurology medical journals. With continued underrepresentation of women occupying leading publishing roles, parity with men is still a work in progress. Additional work is needed to identify and address barriers to academic advancement for women physicians in academic neurology.

Faster, higher, stronger – together? A bibliometric analysis of author distribution in top medical education journals

IntroductionMedical education and medical education research are growing industries that have become increasingly globalised. Recognition of the colonial foundations of medical education has led to a growing focus on issues...

Assessment of Topics Published in Leading Medical Journals Using Natural Language Processing

Introduction: Topic detection can be used to identify trends in literature, providing valuable insight into the direction of the field. We developed a natural language processing (NLP) based method to identify topics from given abstracts and assessed the main topics of published articles by top medical journals in the last three years.
 Methods: This study utilized a two-part methodology to extract and classify original articles published by four non-specialized medical journals; Lancet, New England Journal of Medicine, Journal of the American Medical Association, and British Medical Journal. The first part employed bibliometric data collection to search for original articles published between 2020 and 2022. The second part used an NLP approach based on the BERTopic model to classify the articles included into separate topics.
 Results: The model was able to classify 1,540 articles out of the included 2,081 (79.42%) into 39 different topics in 11 fields. COVID-19-related and cancer treatment-related articles constituted approximately 25% and 7% of all published papers during 2020-2022 respectively. The study found that each of the included general medical journal tended to focus on certain topics more than others.
 Conclusion: We identified a new methodology that can identify topics discussed in medical literature from abstracts as an input. We also demonstrated the potential of this methodology for analyzing trends in medical literature more efficiently and effectively. This study's methodology can be replicated on a larger scale with more papers, more journals, and over a longer period, highlighting the importance of further research using NLP models.

Rapid, accurate publication and dissemination of clinical trial results: benefits and challenges.

Large-scale clinical trials are essential in cardiology and require rapid, accurate publication, and dissemination. Whereas conference presentations, press releases, and social media disseminate information quickly and often receive considerable coverage by mainstream and healthcare media, they lack detail, may emphasize selected data, and can be open to misinterpretation. Preprint servers speed access to research manuscripts while awaiting acceptance for publication by a journal, but these articles are not formally peer-reviewed and sometimes overstate the findings. Publication of trial results in a major journal is very demanding but the use of existing checklists can help accelerate the process. In case of rejection, procedures such as easing formatting requirements and possibly carrying over peer-review to other journals could speed resubmission. Secondary publications can help maximize benefits from clinical trials; publications of secondary endpoints and subgroup analyses further define treatment effects and the patient populations most likely to benefit. These rely on data access, and although data sharing is becoming more common, many challenges remain. Beyond publication in medical journals, there is a need for wider knowledge dissemination to maximize impact on clinical practice. This might be facilitated through plain language summary publications. Social media, websites, mainstream news outlets, and other publications, although not peer-reviewed, are important sources of medical information for both the public and for clinicians. This underscores the importance of ensuring that the information is understandable, accessible, balanced, and trustworthy. This report is based on discussions held on December 2021, at the 18th Global Cardiovascular Clinical Trialists meeting, involving a panel of editors of some of the top medical journals, as well as members of the lay press, industry, and clinical trialists.

Abstract 13117: Gender Parity in High Impact Cardiology Journals

Background: Despite advances in representation of women in medical training, women continue to be underrepresented in cardiology, particularly in senior roles of authorship and leadership. Analyzing trends in high-impact cardiology journals can highlight underrepresentation of women and help elucidate barriers to female representation in academic cardiology. Methods and Results: Using the SCImago Journal and Country Rank (SCR), we analyzed 20 journals (31,540 total articles) in cardiology and cardiovascular medicine with the highest total citations from January 1 st 2018 to October 31 st 2021 for gender distribution of editorial staff and authorship. Gender of individuals was classified using biographical information from public and personal media sources. In cases of ambiguity, Genderize.io was used to help predict gender at probability of ≥95%. Our data demonstrated that 27% of articles had women as first authors and 20% as senior authors. Men constituted the majority of both first authors (73%) and senior authors (80%). The editorial staff was 77% men, with women accounting for 23%. Only 10% of editors-in-chief were women. There was a statistically significant negative correlation between the percentage of women first authors and percentage of men on the editorial board. There was no statistical significance between journal impact factor and percentage of men and women as authors. Overall, female authorship increased from 26% first and 19% senior authors in 2018 to 29% first and 22% senior authors in 2021. Conclusion: Women are significantly under-represented in the field of cardiology as first or senior authors, editorial board members, and editors-in-chief in the top medical journals. Although there has been a slight uptrend in percentage of women occupying leading publishing roles, parity with men is still a work in progress. Additional work is needed to identify and address barriers to publishing and academic advancement for women physicians in cardiology.

Establishing an institutional EAP teacher development scheme based on BALEAP's competency framework: A critical review of the competencies

In clinical research, randomised controlled trials (RCTs) are considered to be “the gold standard” for evaluating treatments. Accordingly, RCT reporting in top English-medium medical journals is specifically regulated by The Consolidated Standards of Reporting Trials (CONSORT) Statement. However, although the CONSORT Statement prescribes the content items that are to be included in a report, little guidance is offered on how the content can be communicated effectively. This paper explores a linguistic construction of a research gap in the introductory sections of medical research articles that report on RCTs (i.e., RCT reports), which has been identified as crucial in the process of RCT justification. In this study, a sample of Introduction sections extracted form recently published RCT reports was analysed using a systemic functional linguistic (SFL) approach to genre and evaluation. The findings indicate that RCT report writers tend to create a research gap by embedding the rhetorical structures of three arguing genres – expositions, discussions, and challenges – into their research warrants. The results of this study carry pedagogical implications for RCT report writing training.