Pediatric surgical research over the last decade: A bibliometric citation analysis

INTRODUCTION

The current age pediatric surgeon is faced with a deluge of printed and electronic information. Around 20–25 medical journals (in English language) dedicated solely to research in pediatric surgery are currently published around the world. Besides these, there are printed articles available from national and international conferences, various training courses, and CMEs.

Journals in non-English languages are also available with English translations. It would be interesting to know what does a pediatric surgeon read which would not only provide an insight into the type of manuscripts widely accessed but also will enable editorial teams in selection of informative articles preferred by the pediatric surgery readership.

With the vast volume of published material, one of the several methods of identifying significant works is by a bibliometric analysis, i.e., providing a quantitative assessment of the relative importance of a research paper by examining its citation history. Bibliometric analysis can be utilized for a variety of reasons, such as to uncover emerging trends in article and journal performance, collaboration patterns and research constituents. The citation count, amongst these, of a particular article is one of the indicators of its influence within the readership. Citation analysis also serves to rank journals based on the total number of citations normalized to the number of articles published within the journal over a defined time period (impact factor [IF]).^[1]

Although most journals quote their calculated IF, citation half-life, and other parameters, no information exists whatsoever about what was mostly read and how much. The websites of a few journals do have the statistics of the most cited articles, but on scrutiny, they are found to underestimate the number of citations by a considerable margin when compared with the most accessible database, i.e., “Google Scholar.”

It may be safely assumed that readers prefer journals ranking highly on the IF list and that those who are actively publishing are the ones who read these journals the most. Hence, a survey of the top 10 articles (in terms of citations per year) in pediatric surgery from 3 top international journals (Journal of Pediatric Surgery [JPS]; IF = 2.545, European Journal of Pediatric Surgery [EurJPS]; IF = 2.191, and Pediatric Surgery International [PSI]; IF = 1.827) and the foremost Indian journal (Journal of Indian Association of Pediatric Surgeons [JIAPS]; IF = 0.543) was done so as to know the scientific article that has been read and quoted the most in the last decade.

This study aims to identify, analyse and categorise the characteristics (the type of article, country of origin, topic, and the number of citations) of the articles published in JPS, EurJPS, PSI and JIAPS from January 2013 to May 2022. This study also aims to highlight as to what articles do the pediatric surgeons read and what is their focus of research.

MATERIAL AND METHODS

The number of citations of all articles published between January 2013 and May 2022 were obtained from three databases: “CrossRef,” “MEDLINE,” “Thomson Reuters Web of Science” and “Google Scholar” using A.W. Harzing’s “Publish or Perish^®” software (version 8). The entire data was collected over 24 h and the final tally was obtained by adding all the citations in the three databases after removing common entries.

The top 10 articles (as per citations per year) from each of the 4 journals (JPS, EurJPS, PSI, JIAPS) published between January 2013 and May 2022 were tabulated into a Microsoft Excel^® sheet. The type of article, authorship, journal of publication, publication year, country of origin, topic, total citations and number of citations per year were noted. The articles were then sorted based on the citations per year.

RESULTS

The total number of scientific articles, in the four journals, published between January 2013 to May 2022, was 7078. Out of which, 4098 (57.9%) were original articles, 1476 (20.85%) were case reports, 874 (12.35%) brief communications and 630 (8.9%) were review articles [Figure 1].

Close

Figure 1:

Distribution of articles published between 2013 and 2022 in the top pediatric journals.

Export to PPT

The top 10 articles, based on citations per year, in each of the 4 journals, published between January 2013 and May 2022 are shown in [Table 1]. These articles garnered a total of 3028 citations (18.7 citations per article per year) until May 2022.

Table 1: Top ten cited articles from each of JPS, EurJPS, PSI, JIAPS ranked by citations per year.

Out of the 40 articles, there were 13 review articles and 27 original articles – 12 retrospective reviews, 6 consensus papers, 6 surveys and 3 animal research studies [Figure 2].

Close

Figure 2:

Distribution of the top-cited articles published in pediatric surgery between 2013 and 2022.

Export to PPT

15 of these articles were from the United States of America (USA), 4 from Canada, 2 from Spain and 1 each from Italy, Ireland, Germany and Japan. Of the multi-institutional articles, 7 were from Europe and 3 were global, spanning continents (one had Asian authorship while two were from African institutions in collaboration with American and European centres).

In the Indian journal JIAPS, amongst the top 10 cited papers, 8 were from India, 1 from Italy and one multi-institutional review article with authors from Malawi, Poland, Switzerland, Italy and the United Kingdom [Table 1].

The various topics covered in these 40 articles are summarized in [Table 2].

DISCUSSION

EA-TEF, NEC, acute appendicitis, HD and CDH were the conditions in the most cited publications. The overwhelming attention received by neonatal surgical conditions is not surprising reflecting the overall improved survival rate of neonates with advances in treatment. Hence, despite the fact that these are common neonatal surgical afflictions with decades of research and well-laid protocols of management, these still form the bulk of the published material that are widely read and cited worldwide. We also see a lower priority of recent advances like telemedicine, ERP and tissue engineering as reflected by the relatively few cited clinical manuscripts despite being the state-of-the-art advances in pediatric surgery, probably because these are practically relevant in very few centres all over the world.

Pediatric surgery is now a firmly established field and JIAPS is the flagbearer pediatric surgical journal in India.^[2] A comparison of the number of original and review articles in the three leading international pediatric surgery journals with those in JIAPS, highlight a significant difference. Journals with higher IF and those with international repute have a higher number of review articles and original articles compared to retrospective series and case reports which are more in JIAPS.

The scientific community receives longer exposure toward older publications which, thereby, amass a large number of citations irrespective of their scientific significance.^[3] We have eliminated that bias (arising from the differences between the publication dates of manuscripts) by taking the citations per year into account rather than the total citation count. However, it was not possible to do away with biases such as self-citation, institutional bias, language bias, and powerful person bias in our study. As suggested by several other studies, manuscripts originating from the USA continue to receive a high number of citations which may be reflective of preferential citation of “local research.”^[4]

There are various databases from which bibliometric data of an article may be obtained, all of which have different catchment areas, and hence, have varying citation counts. The user base also varies, for example, “Google Scholar” is a free resource in contrast to the “Web of Science” which is a paid service. The “Google Scholar” citation count is usually higher as it incorporates citations beyond peer-reviewed articles (books, websites, dissertations and open-access online journals) and hence, bibliometric analyses obtained from “Google Scholar” are expected to be more realistic than the other sources.^[5]

Our observations on citation analysis have shown essential insights into what it takes to be read widely amongst your peers and be cited. Articles on areas that have a longstanding effect in the practice and research of pediatric surgery are the ones that gather the most citations. To become more meaningful, these analyses need to be repeated in certain intervals to project a trend rather than just a snapshot.

CONCLUSION

The most cited manuscripts as found in this study relate to etiology, diagnosis, and management of common surgical conditions, more so in neonates. Scientific articles on advances in surgical techniques were few. Journals with higher IF and those of international repute publish a higher number of review articles and original articles compared to the Indian journal, JIAPS, which publishes more of retrospective series and case reports.This information would be of value to young pediatric surgeons, especially those in training, to choose their prospective research and create a lasting impact on the field of pediatric surgery. In addition to being a reference of what could be considered as influential, this study also provides reference for researchers as to what makes a “citable” paper in pediatric surgery. For the editorial team, it provides insight into the kind of articles that are of interest to pediatric surgeons worldwide, and this would help develop ideas to further improve penetrance and quality of the journal in the long run.