Citations to trials of nicotine replacement therapy were biased toward positive results and high-impact-factor journals

ObjectiveTo study variations in the number of times trials of nicotine replacement therapy (NRT) were cited, and which characteristics of trials predicted the number of citations and the impact factors of journals in which articles were published.Study Design and SettingWe used all 105 randomized controlled trials in the Cochrane review of NRT for smoking cessation. We obtained impact factors from the Journal Citation Reports and the number of citations from ISI Web of Knowledge and Google Scholar.ResultsTrials were cited from 0 to 632 times (median 23 times). Trials were cited more often when results were statistically significant than when they were not (median = 41 vs. 17 times, P < 0.001), and when impact factors were higher (10.2 more citations per impact factor point, P < 0.001). Patch trials were cited more often than gum trials (median = 29 vs. 17 times, P = 0.001), and trials funded by the pharmaceutical industry were cited more often than other trials (median = 28 vs. 16.5 times, P = 0.001). Trials with statistically significant results were published in journals with higher impact factors than trials with nonsignificant results (median impact factor = 2.80 vs. 1.81, P = 0.011).ConclusionCitations were biased toward trials with positive results and toward trials published in high-impact-factor journals.     

Evidence-based editing: factors influencing the number of citations in a national journal

PurposeCitations received by papers published within a journal serve to increase its bibliometric impact. The objective of this paper was to assess the influence of publication language, article type, number of authors, and year of publication on the citations received by papers published in Gaceta Sanitaria, a Spanish-language journal of public health.MethodsThe information sources were the journal website and the Web of Knowledge, of the Institute of Scientific Information. The period analyzed was from 2007 to 2010. We included original articles, brief original articles, and reviews published within that period. We extracted manually information regarding the variables analyzed and we also differentiated among total citations and self-citations. We constructed logistic regression models to analyze the probability of a Gaceta Sanitaria paper to be cited or not, taking into account the aforementioned independent variables. We also analyzed the probability of receiving citations from non-Spanish authors.ResultsTwo hundred forty papers fulfilled the inclusion criteria. The included papers received a total of 287 citations, which became 202 when excluding self-citations. The only variable influencing the probability of being cited was the publication year. After excluding never cited papers, time since publication and review papers had the highest probabilities of being cited. Papers in English and review articles had a higher probability of citation from non-Spanish authors.ConclusionsPublication language has no influence on the citations received by a national, non-English journal. Reviews in English have the highest probability of citation from abroad. Editors should decide how to manage this information when deciding policies to raise the bibliometric impact factor of their journals.     

Bibliometric Analysis of Parasitological Research in Iran and Turkey: A Comparative Study

Background

This study was designed to assess and compare the quantity and quality of Iranian and Turkish researchers working in the field of Parasitology from bibliometric point of view.

Methods

To assess the contributions and achievements of the Iranian and Turkish parasitologists, bibliometric analysis was carried out based on the citation data retrieved from Web of Science.

Results

The absolute productivity of Turkish and Iranian parasitologists’ papers has almost tripled for Turkey, from 12 papers in 2002 to 36 papers in 2011, and decuple for Iran, from 10 papers to 123 from 2002 to 2010. The average number of citation per article is about 5.8 and 4 for Turkish and Iranian parasitologists’ papers, respectively. The “Veterinary Parasitology” journal was the most cited journal in both countries. The majority (more than 90%) of cited items was foreign journal articles and one half of all references in journals articles dated 11 and 12 years while one half of cited books was dated within 14 to16 years for Turkish and Iranian papers, respectively.

Conclusion

Based on observed data and applied model, it is anticipated that the total number of Iranian and Turkish parasitologists’ publications in Web of Science will exceed of 2512 and 240 articles per annum for Iranian and Turkish in 2020, respectively.     

PROMIS Fatigue Item Bank had Clinical Validity across Diverse Chronic Conditions

ObjectiveTo evaluate the comparability and responsiveness of Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue item bank across six chronic conditions.Study Design and SettingIndividuals (n = 1,430) with chronic obstructive pulmonary disease (n = 125), chronic heart failure (n = 60), chronic back pain (n = 218), major depressive disorder (n = 196), rheumatoid arthritis (n = 521), and cancer (n = 310) completed assessments from the PROMIS fatigue item bank at baseline and a clinically relevant follow-up. The cancer and arthritis samples were followed in observational studies; the other four groups were enrolled immediately before a planned clinical intervention. All participants completed global ratings of change at follow-up. Linear mixed-effects models and standardized response means were estimated to examine clinical validity and responsiveness to change.ResultsAll patient groups reported more fatigue than the general population (range = 0.2–1.29 standard deviation worse). The four clinical groups with pretreatment baseline data experienced significant improvement in fatigue at follow-up (effect size range = 0.25–0.91). Individuals reporting better overall health usually experienced larger fatigue changes than those reporting worse overall health.ConclusionThe results support the PROMIS fatigue measures's responsiveness to change in six different chronic conditions. In addition, these results support the ability of the PROMIS fatigue measures to compare differences in fatigue across a range of chronic conditions, thereby enabling comparative effectiveness research.     

Access and Unmet Needs of Orphan Drugs in 194 Countries and 6 Areas: A Global Policy Review With Content Analysis

ObjectivesThree hundred million people living with rare diseases worldwide are disproportionately deprived of in-time diagnosis and treatment compared with other patients. This review provides an overview of global policies that optimize development, licensing, pricing, and reimbursement of orphan drugs.MethodsPharmaceutical legislation and policies related to access and regulation of orphan drugs were examined from 194 World Health Organization member countries and 6 areas. Orphan drug policies (ODPs) were identified through internet search, emails to national pharmacovigilance centers, and systematic academic literature search. Texts from selected publications were extracted for content analysis.ResultsOne hundred seventy-two drug regulation documents and 77 academic publications from 162 countries/areas were included. Ninety-two of 200 countries/areas (46.0%) had documentation on ODPs. Thirty-four subthemes from content analysis were categorized into 6 policy themes, namely, orphan drug designation, marketing authorization, safety and efficacy requirements, price regulation, incentives that encourage market availability, and incentives that encourage research and development. Countries/areas with ODPs were statistically wealthier (gross national income per capita = $10 875 vs $3950, P < .001). Country/area income was also positively correlated with the scope of the respective ODP (correlation coefficient = 0.57, P < .001).ConclusionsGlobally, the number of countries with an ODP has grown rapidly since 2013. Nevertheless, disparities in geographical distribution and income levels affect the establishment of ODPs. Furthermore, identified policy gaps in price regulation, incentives that encourage market availability, and incentives that encourage research and development should be addressed to improve access to available and affordable orphan drugs.     

Retrospective cohort study highlighted outcome reporting bias in UK publicly funded trials

Objective

To assess outcome reporting bias and dissemination bias in trials funded by the National Health System (NHS) Health Technology Assessment (HTA) program.

Study Design and Setting

A retrospective cohort study of HTA monographs and corresponding journal publications including all clinical effectiveness randomized controlled trials published as HTA monographs between 1999 and 2005 by the NHS HTA program.

Results

There was a higher median P-value (P = 0.33, interquartile range [IQR]: 0.02-0.54) among trials without a journal publication compared with those with a journal publication (P = 0.14, IQR: 0.007-0.43), although the difference was not statistically significant (Mann-Whitney U test, z = −0.70; P = 0.48). A higher proportion of statistically significant findings were reported in journal articles when compared with the outcomes reported in the HTA monographs. Trials published in general medical journals tended to have smaller P-values (median: 0.05, IQR: 0.001-0.22) than those published in more specialist journals (median: 0.33 IQR: 0.008-0.58), although this result was not significant (Mann-Whitney U test, z = −1.63; P = 0.10).

Conclusions

Among journal-published trials, there were a greater proportion of statistically significant findings included in the journal reports compared with those in the HTA monographs.     

Active implementation strategy of CONSORT adherence by a dental specialty journal improved randomized clinical trial reporting

ObjectiveTo describe a novel CONsolidated Standards of Reporting Trials (CONSORT) adherence strategy implemented by the American Journal of Orthodontics and Dentofacial Orthopedics (AJO-DO) and to report its impact on the completeness of reporting of published trials.Study Design and SettingThe AJO-DO CONSORT adherence strategy, initiated in June 2011, involves active assessment of randomized clinical trial (RCT) reporting during the editorial process. The completeness of reporting CONSORT items was compared between trials submitted and published during the implementation period (July 2011 to September 2013) and trials published between August 2007 and July 2009.ResultsOf the 42 RCTs submitted (July 2011 to September 2013), 23 were considered for publication and assessed for completeness of reporting, seven of which were eventually published. For all published RCTs between 2007 and 2009 (n = 20), completeness of reporting by CONSORT item ranged from 0% to 100% (Median = 40%, interquartile range = 60%). All published trials in 2011–2013, reported 33 of 37 CONSORT (sub) items. Four CONSORT 2010 checklist items remained problematic even after implementation of the adherence strategy: changes to methods (3b), changes to outcomes (6b) after the trial commenced, interim analysis (7b), and trial stopping (14b), which are typically only reported when applicable.ConclusionTrials published following implementation of the AJO-DO CONSORT adherence strategy completely reported more CONSORT items than those published or submitted previously.     

Citation networks of related trials are often disconnected: implications for bidirectional citation searches

Background and ObjectivesReports of randomized controlled trials (RCTs) should set findings within the context of previous research. The resulting network of citations would also provide an alternative search method for clinicians, researchers, and systematic reviewers seeking to base decisions on all available evidence. We sought to determine the connectedness of citation networks of RCTs by examining direct (referenced trials) and indirect (through references of referenced trials, etc) citation of trials to one another.MethodsMeta-analyses were used to create citation networks of RCTs addressing the same clinical questions. The primary measure was the proportion of networks where following citation links between RCTs identifies the complete set of RCTs, forming a single connected citation group. Other measures included the number of disconnected groups (islands) within each network, the number of citations in the network relative to the maximum possible, and the maximum number of links in the path between two connected trials (a measure of indirectness of citations).ResultsWe included 259 meta-analyses with a total of 2,413 and a median of seven RCTs each. For 46% (118 of 259) of networks, the RCTs formed a single connected citation group—one island. For the other 54% of networks, where at least one RCT group was not cited by others, 39% had two citation islands and 4% (10 of 257) had 10 or more islands. On average, the citation networks had 38% of the possible citations to other trials (if each trial had cited all earlier trials). The number of citation islands and the maximum number of citation links increased with increasing numbers of trials in the network.ConclusionAvailable evidence to answer a clinical question may be identified by using network citations created with a small initial corpus of eligible trials. However, the number of islands means that citation networks cannot be relied on for evidence retrieval.     

Effects of an Eating Ability Promotion Program for Community-Dwelling Older Adults

ObjectiveTaiwan is projected to become a super-aged society in 2026. Taiwan's government introduced an innovative preventive care policy to improve aging-related conditions in 2017. In this study, we examine the effectiveness of an eating ability promotion program (EAPP) on the physical and mental performance of community-dwelling older adults.DesignSingle-masked, cluster randomized trial.SettingTwo community care stations in Taichung, Taiwan.ParticipantsVolunteers were recruited from these 2 community care stations. The 70 participants were aged ≥60 years, able to walk independently and take care of themselves, and understood Mandarin or Taiwanese.InterventionThe volunteers were randomly assigned to an intervention; 40 participated in EAPP training courses (experimental group) and 30 participated in originally scheduled activities only (control group). EAPP training courses were conducted in the care stations 4 hours per week for 12 weeks (for a total of 48 hours).MeasuresThe physical performance outcomes were oral health, nutritional status, and fragility, assessed using the Oral Health Assessment Tool, the Mini Nutritional Assessment, and the Study of Osteoporotic Fractures fragility index, respectively. Cognitive function was evaluated with the Mini-Cog test. Measurements were performed at baseline, at the end of the 12-week intervention, and 1 month later.ResultsFollowing the EAPP intervention, controlling for baseline differences, the oral health (F = 33.29, P < .001), nutritional status (F = 7.30, P = .009), and scale of fragility (F = 19.05, P < .001) of the participants in the experimental group were significantly better than those reported in the control group.Conclusions and ImplicationsResults of this preliminary study suggest that the EAPP intervention may be an effective approach for improving oral health, nutritional status, and fragility in community-dwelling older adults. This training course, which provides clear and concise information regarding eating ability strategies, should undergo further evaluation and, if demonstrated to be effective and cost-effective in broader trials, may be useful in promoting healthy living.     

Citation analysis of identical consensus statements revealed journal-related bias

ObjectiveTo examine whether the prestige of a journal, measured by its impact factor, influences the numbers of citations obtained by published articles, independently of their scientific merit.Study Design and SettingIn this cohort study, citation counts were retrieved for articles describing consensus statements that were published in multiple journals and were correlated with the impact factors of the source journals.ResultsFour consensus statements were published in multiple copies: QUOROM (QUality Of Reporting Of Meta-analyses) was published in three journals, CONSORT (CONsolidated Standards Of Reporting Trials) in eight journals, STARD (STAndards for Reporting of Diagnostic accuracy) in 14 journals, and STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) in eight journals. For each consensus statement, the impact factor of the source journal and the number of citations were highly correlated (Spearman correlation coefficients: QUOROM, 1.00; CONSORT, 0.88; STARD, 0.65; and STROBE, 0.81—all P < 0.02). When adjusted for time since publication, each logarithm unit of impact factor predicted an increase of 1.0 logarithm unit of citations (95% confidence interval: 0.7–1.3, P < 0.001), and the variance explained was 66% (adjusted r² = 0.66).ConclusionsThe prominence of the journal where an article is published, measured by its impact factor, influences the number of citations that the article will gather over time. Citation counts are not purely a reflection of scientific merit.     

Social work‐generated evidence in traumatic brain injury from 1975 to 2014: A systematic scoping review

The International Network for Social Workers in Acquired Brain Injury (INSWABI) commissioned a systematic scoping review to ascertain the social work‐generated evidence base on people with traumatic brain injury (TBI) of working age. The review aimed to identify the output, impact and quality of publications authored by social workers on this topic. Study quality was evaluated through assessment frameworks drawn from the United Kingdom National Service Framework for Long‐Term Conditions. In the 40‐year period from 1975 to 2014, 115 items were published that met the search criteria (intervention studies, n = 10; observational studies, n = 52; literature reviews, n = 6; expert opinion or policy analysis, n = 39; and others, n = 8). The publications could be grouped into five major fields of practice: families, social inclusion, military, inequalities and psychological adjustment. There was a significant increase in the number of publications over each decade. Impact was demonstrated in that the great majority of publications had been cited at least once (80.6%, 103/115). Articles published in rehabilitation journals were cited significantly more often than articles published in social work journals. A significant improvement in publication quality was observed across the four decades, with the majority of studies in the last decade rated as high quality.     

A Journal-Level Analysis of Health Communication

Citation data from 2006 through 2008 were used to examine the journal citation network of Health Communication in comparison to 26 related journals indexed by Journal Citation Reports, a database published by the Institute for Scientific Information (ISI) Web of Knowledge. A recently advanced journal relatedness factor based on out-degree (i.e., cited journals) and in-degree (i.e., citing journals) citations was used to determine the network of peer journals. Results indicate Health Communication serves to link communication and health-related journals. Data were also reported on journal impact and 5-year journal impact factors. When compared to ISI-indexed communication journals, Health Communication is consistently ranked in the top 25% across impact factors and citations to the journal are consistent over the 7 years of analysis from 2002 through 2008. Methods of increasing the impact of Health Communication among journals in social sciences are discussed.     

Comparative Validity of Mostly Unprocessed and Minimally Processed Food Items Differs Among Popular Commercial Nutrition Apps Compared with a Research Food Database

BackgroundCommercial nutrition apps are increasingly used to evaluate diet. Evaluating the comparative validity of nutrient data from commercial nutrition app databases is important to determine the merits of using these apps for dietary assessment.ObjectiveNutrient data from four commercial nutrition apps were compared with a research-based food database, Nutrition Data System for Research (NDSR) (version 2017).DesignComparative validation study.Participants/settingAn investigator identified the 50 most frequently consumed foods (22% of total reported foods) from a weight-loss study in Chicago, IL, during 2017. Nutrient data were compared between four commercial databases with NDSR.Main outcome measuresComparative validity of energy, macronutrients, and other nutrient data (ie, total sugars, fiber, saturated fat, cholesterol, calcium, and sodium).Statistical analyses performedIntraclass correlation coefficients (ICCs) evaluated agreement between commercial databases with the NDSR for foods that were primarily un- and minimally processed and by the three most frequently consumed food groups. Bland-Altman plots determined degree of bias for calories between commercial databases and NDSR.ResultsThis study observed excellent agreement between NDSR and CalorieKing (ICC range = 0.90 to 1.00). Compared with NDSR, agreement for Lose It! and MyFitnessPal ranged from good to excellent (ICC range = 0.89 to 1.00), with the exception of fiber in MyFitnessPal (ICC = 0.67). Fitbit showed the widest variability with NDSR (ICC range = 0.52 to 0.98). When evaluating by food group, Fitbit had poor agreement for all food groups, with the lowest agreement observed for fiber within the vegetable group (ICC = 0.16). Bland-Altman plots confirmed ICC energy results but also found that MyFitnessPal had the poorest agreement to NDSR (mean 8.35 [SD 133.31] kcal) for all food items.ConclusionsDegree of agreement varied by commercial nutrition app. CalorieKing and Lose It! had mostly excellent agreement with NDSR for all investigated nutrients. Fitbit showed the widest variability in agreement with NDSR for most nutrients, which may reflect how well the app can accurately capture diet.     

COVID-19 vaccine website accessibility dashboard

BackgroundThe COVID-19 pandemic has exacerbated historical inequities for people with disabilities including barriers in accessing online information and healthcare appointment websites. These barriers were brought to the foreground during the vaccine rollout and registration process.ObjectiveThis cross-sectional study aimed to examine accessibility of U.S. state and territory COVID-19 information and registration centralized websites.MethodsThe Johns Hopkins Disability Health Research Center created a COVID-19 Vaccine Dashboard compiling COVID-19 information and vaccine registration web pages from 56 states and territories in the United States (U.S.) reviewed between March 30 through April 5, 2021 and analyzed accessibility using WAVE Web Accessibility Evaluation Tool (WAVE). WAVE identifies website accessibility barriers, including insufficient contrast, alternative text, unlabeled buttons, total number of errors, and error density. Web pages were ranked and grouped into three groups by number of errors, creating comparisons between states on accessibility barriers for people with disabilities.ResultsAll 56 U.S states and territories had COVID-19 information web pages and 29 states had centralized state vaccine registration web pages. Total errors, error density, and alert data were utilized to generate accessibility scores for each web page, the median score was 259 (range = 14 to 536 and IQR = 237) for information pages, and 146 (range = 10 to 281 and IQR = 105) for registration pages.ConclusionsThese results highlight barriers people with disabilities may encounter when accessing information and registering for the COVID-19 vaccine, which underscore inequities in the pandemic response for the disability community and elevate the need to prioritize accessibility of public health information.     

A bibliometric analysis of occupational therapy publications

Background: Bibliometrics involves the statistical analysis of the publications in a specific discipline or subject area. A bibliometric analysis of the occupational therapy refereed literature is needed.

Aim: A bibliometric analysis was completed of the occupational therapy literature from 1991-2014, indexed in the Science Citation Index-Expanded or the Social Sciences Citation Index.

Method: Publications were searched by title, abstract, keywords, and KeyWords Plus. Total number of article citations, citations per journal, and contributions per country, individual authors, and institution were calculated.

Results: 5,315 occupational therapy articles were published in 821 journals. It appears that there is a citation window of an approximate 10-year period between the time of publication and the peak number of citations an article receives. The top three most highly cited articles were published in Developmental Medicine and Child Neurology, JAMA, and Lancet. AJOT, BJOT and AOTJ published the largest number of occupational therapy articles with the United States, Australia, and Canada producing the highest number of publications. McMaster University, the University of Queensland, and the University of Toronto were the institutions that published the largest number of occupational therapy journal articles.

Conclusion: The occupational therapy literature is growing and the frequency of article citation is increasing.     

Cost-Effectiveness of Medicinal Cannabis for Management of Refractory Symptoms Associated With Chronic Conditions: A Systematic Review of Economic Evaluations

ObjectivesAlthough there is a growing body of evidence suggesting that cannabinoids may relieve symptoms of some illnesses, they are relatively high-cost therapies compared with illicit growth and supply. This article aimed to comprehensively review economic evaluations of medicinal cannabis for alleviating refractory symptoms associated with chronic conditions.MethodsSeven electronic databases were searched for articles published up to September 6, 2020. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to types of medical conditions, organized into tables, and reported narratively.ResultsThis review identified 12 cost-utility analyses conducted across a variety of diseases including multiple sclerosis (MS) (N = 8), pediatric drug-resistant epilepsies (N = 2), and chronic pain (N = 2). The incremental cost-effectiveness ratio varied widely from cost saving to more than US$451 800 per quality-adjusted life-year depending on the setting, perspectives, types of medicinal cannabis, and indications. Nabiximols is a cost-effective intervention for MS spasticity in multiple European settings. Cannabidiol was found to be a cost-effective for Dravet syndrome in a Canadian setting whereas a cost-utility analysis conducted in a US setting deemed cannabidiol to be not cost-effective for Lennox-Gastaut syndrome. Overall study quality was good, with publications meeting 70% to 100% (median 83%) of the Consolidated Health Economic Evaluation Reporting Standards checklist criteria.ConclusionsMedicinal cannabis-based products may be cost-effective treatment options for MS spasticity, Dravet syndrome, and neuropathic pain, although the literature is nascent. Well-designed clinical trials and health economic evaluations are needed to generate adequate clinical and cost-effectiveness evidence to assist in resource allocation.     

The impact of Facebook’s vaccine misinformation policy on user endorsements of vaccine content: An interrupted time series analysis

ObjectivesTo evaluate the impact of Facebook’s vaccine misinformation policy in March 2019 on user endorsements of vaccine content on its platform.MethodsWe identified 172 anti- and pro-vaccine Facebook Pages and collected posts from these Pages six months before and after the policy. Using interrupted time series regression models, we evaluated the policy impact on user endorsements (i.e., likes) of anti- and pro-vaccine posts on Facebook.ResultsThe number of likes for posts on anti-vaccine Pages had decreased after the policy implementation (policy = 153.2, p < 0.05; policy*day = ?0.838, p < 0.05; marginal effect at the mean = ?22.74, p < 0.01; marginal effect at the median = ?24.56, p < 0.01). When the number of subscribers was considered, the policy effect on the number of likes for anti-vaccine posts was much smaller, but still statistically significant (policy = 4.849, p < 0.05; policy*day = ?0.027, p < 0.05; marginal effect at the mean = ?0.742, p < 0.01; marginal effect at the median = ?0.800, p < 0.01). There was no policy effect observed for posts on pro-vaccine Pages.ConclusionsOur analysis suggested that Facebook’s March 2019 vaccine misinformation policy moderately impacted the number of endorsements of anti-vaccine content on its platform. Social media companies can take measures to limit the popularity of anti-vaccine content by reducing their reach and visibility. Future research efforts should focus on evaluating additional policies and examining policies across platforms.