A bibliometric analysis of the conversion and reporting of pilot studies published in six anaesthesia journals

Pilot and feasibility studies are preliminary investigations undertaken before a larger study. We hypothesised that only a small proportion of pilot or feasibility studies published in anaesthesia journals were correctly labelled as such. We searched for papers published between 2007 and 2017 in six anaesthesia journals using the text words ‘pilot’ OR ‘feasibility’ and included 266 original articles with 26,682 human participants. Only 34 (12.8%) were correctly labelled as a pilot or feasibility study. They were more likely to: have more median (IQR [range]) participants, 73 (40–130 [4–2716]) vs. 27 (15–60 [2–3305], p < 0.001; report feasibility outcomes, 82.4% vs. 4.3%, p < 0.001; and report an intention to convert, 100% vs. 39.7%, p < 0.001. They were less likely to test the efficacy of the primary outcome, 50% vs. 72.8%, p = 0.009; and report firm clinical conclusions 41.2% vs. 67.7%, p = 0.004. Of the studies published more than 5 years ago, correctly labelled pilot or feasibility studies were more likely to precede a published conversion study, 53.8% vs. 16%, p = 0.004. There was no difference between the number of citations 18 (9–44 [2–216]) vs. 20 (7–47 [0–251]), p = 0.865. These results have important consequences for patients, trialists, researchers and funders. We argue that correctly labelled pilot studies enhance the quality of scientific research by encouraging methodological rigour, ensuring scientific validity and reducing research waste. Authors, reviewers, editors and publishers should ensure they adhere to the contents of the 2016 CONSORT extension for pilot and feasibility studies.     

Endocrine tumours and their significance to anaesthesia

Hormonally active tumours of the endocrine system are uncommon conditions, but they present a considerable anaesthetic challenge. The relative rarity of these tumours has meant that there are few, if any, comparative, controlled trials of one anaesthetic technique against another. Most of the management regimes advocated are based on anecdotal experience, and even though such experience may be considerable, it is difficult to establish one form of anaesthetic management as superior to another. This paper will review currently recommended approaches to the management of secreting endocrine tumours.     

Ethical considerations in anaesthesia journals

It has been shown that instructions to authors in nonanaesthesia biomedical journals often fail to require authors to state that the study was approved by an ethics committee and informed consent obtained from participants; articles also often omit mentioning these points. We examined 11 English-language journals, which are listed in the 'Anesthesiology' category of 1995 SCI Journal Citation Reports, to see whether the instructions to authors of anaesthesia journals mention the following ethical factors: approval of the study by an ethics committee, informed consent, redundant publication, fraud, authorship, conflict of interest and protection of patients' privacy. We also examined 673 articles which appeared in these anaesthesia journals ( July to December issues of 1996) to see whether they stated acquirement of ethics committee approval and informed consent. All journals addressed the avoidance of redundant publications and unjustifiable authorship. Ten journals required approval of studies and signatures from all authors, eight journals mentioned informed consent. Only seven required the disclosure of any conflict of interest and the protection of patients' privacy. More than 90% of the articles stated that the study was approved and informed consent obtained.     

Who publishes in the large anaesthesia journals

We have analysed, with the aid of an online database, the numberof all types of contributions from scientists of various countriesto four leading international anaesthesia Journals ('BritishJournal of Anaesthesia, Anaesthesia, Anesthesia and Analgesiaand Anesthesiology) during the period 1987–1991. AlthoughAmerican and British publications played the leading roles inthe total number of anaesthetic publications (40.4% and 32.5%,respectively), more detailed analysis revealed an unexpectedlyhigh "publication output" of smaller countries, which sometimesexceeded those of larger nations (publications per million inhabitants:United Kingdom 41.9, Denmark 24.2, Sweden 15.4, Finland 15.3,Israel 14.6, Ireland 13.1, U.S.A. 11.9, Switzerland 11.0).     

Relationship between journal impact factor and levels of evidence in anaesthesia

Evidence-based medicine uses a hierarchy of publication types according to their vulnerability to bias. A widely used measure of journal "quality" is its impact factor, which describes the citation rate of its publications. We investigated the relationship between impact factor for eight anaesthesia journals and publication type with respect to their level of evidence 1-4 using Spearman rank correlation (rho). There were 1418 original publications during 2001 included in the analysis. The number (%) of publication types according to evidence-based medicine level were: level 1:6 (0.4%), level 2:533 (38%) level 3:329 (23%), level 4:550 (39%). There was no correlation between journal ranking according to impact factor and publication type (rho =-0.03, P=0.25). The correlation between journal rank and the proportion of publications that were randomized trials was -0.35 (P<0.001). The correlation between journal rank and number of publications was 0.65 (P<0.001). The correlation between journal rank and number of level 1 or 2 studies was 0.58 (P<0.001). The overall level of evidence published in anaesthesia journals was high. Journal rank according to impact factor is related to the number of publications, but not the proportion of publications that are evidence-based medicine level 1 or 2.     

Neuromuscular contributions in eight anaesthesia journals

Entries in the index issues of eight English-language anaesthesia journals were examined for the years 1950-1990, noting the number of original articles, reviews and editorials. Those which included topics involving neuromuscular blockade were examined in greater detail; these averaged almost one-tenth of the annual totals, despite its eightfold increase over the four decades. During the eighties the strongest research interest involved atracurium, pancuronium, succinylcholine, tubocurarine, and vecuronium, but the share for the long-acting agents was waning by 1990.     

The "impact factor" of anesthesia and intensive care journals

The "impact factor" (IF) of scientific journals is defined as the number of citations obtained over a one-year period of articles published during the two previous years in a journal, divided by the number of articles published in that journal during the preceding two years. The IF, initially devised as an indicator of the quality of a journal, is at present mainly considered as an indicator of the quality of an article contained in that journal. However the IF of a journal is not equivalent to the actual impact of an article. Therefore the IF is not an accurate tool for assessment of the scientific quality of the author of that article. The IFs of journals published in English are significantly higher than the IFs of those in another language, mainly as English is the language used for international communication and as English speaking authors rarely cite articles published in another language. The IF of the journal of the French society for anaesthesiology and intensive care, the Annales fran?aises d'anesthésie et de réanimation (Afar), is about seven times below the IF of Anesthesiology, which has the highest IF in the category "Anesthesiology". From 1992 to 1998, the relative impact value of the Afar has increased by 429%. However the absolute value remains low.     

Accuracy of subject and author indexes in five anaesthesia journals

To determine the accuracy of subject and author indexes in fiveanaesthesia journals we examined all 1989 and 1991 volumes ofAnesthesia and Analgesia, Anesthesiology, British Journal ofAnaesthesia, Canadian Journal of Anaesthesia and European Journalof Anaesthesiology, and counted the number of entries and thenumber of errors in both indexes. The number of errors was expressedas a percentage of the number of entries, and the incidencesof errors were compared by chi-square contingency table tests.The overall error rate in both indexes and for both years (1989and 1991) differed significantly among the five journals (P< 0.001). Many of the individual differences were also significant.British Journal of Anaesthesia had the lowest error rate (0.9%),followed by Anesthesia and Analgesia (2.4%), Anesthesiology(3%), European Journal of Anaesthesiology (2.9%) and CanadianJournal of Anaesthesia (11.4%). The combined index accuracywas improved from 1989 to 1991 for Anesthesia and Analgesia,British Journal of Anaesthesia and Canadian Journal of Anaesthesia,did not change for European Journal of Anaesthesiology and wasworse for Anesthesiology. Presented in part at the 15th Scientific Meeting of the EuropeanAcademy of Anaesthesiology, Oporto, September 1993. ^* Present address: Department of Anesthesiology, Medical Collegeof Wisconsin, Milwaukee, WI, USA.     

National representation in the anaesthesia literature: a bibliometric analysis of highly cited anaesthesia journals*

While previous studies have investigated the country of origin of anaesthetic publications, they have generally used a medline computer search to identify original articles and have often excluded non‐English language articles. We undertook a hand‐search of journals in the Journal Citation Reports^® using the subject category of Anesthesiology. We quantified the number of original articles, editorials, review articles, case reports and correspondence attributed to each country. We also calculated the proportion of articles of each type from countries of each national income category. We analysed 9684 articles published in 2007 and 2008. The United States published more original articles than any other country. High‐income countries published 89.2% of original articles, middle‐income countries 10.5%, and low‐income countries just 0.3%. There were more articles published by middle‐income countries during the study period than a decade earlier, notably from Turkey, China and India. We discuss barriers to publications from low‐income countries.     

An analysis of citations of publications in anaesthesia journals

Which journals cite work published in anaesthetic journals is of potential interest to authors, editors and publishers. We analysed citations made in 2017–2018 for articles, reviews, editorials and letters published by 12 anaesthetic journals in 2016, using the Web of Science™ citation index platform. We analysed 12,544 citations made for 3518 items. Citations were most often made by specialist anaesthesia journals and critical care journals, and occurred most commonly in articles, followed by reviews, editorials and letters. The median (IQR [range]) number of citations made per item was 3.3 (2.6–4.1 [1.6–5.1]). The median (IQR [range]) number of journals that cited the 12 source journals was 302 (236–449 [139–671]). The median (IQR [range]) proportion of citations made by the same journal that published the items (i.e. ‘self-citations’) was 15% (11–17% [5–32%]). There were 1305/1932 (68%) citations made by North American journals for items published in North American journals and 1712/2063 (83%) citations made by European journals for items published in European journals, p < 0.0001. Our analysis may inform authors, editors and publishers where to submit work, what editorial policy to pursue and what journal strategy to follow, respectively.     

An analysis of review articles published in four anaesthesia journals

Purpose

To see if the authors of review articles in anaesthesia journals are making use of systematic methods in their preparation.

Methods

Twenty-five review articles published in 1995 in four major anaesthesia journals were analysed and compared with standard guidelines for the appraisal of reviews.

Results

Of the 25 articles, only 14 stated a clear purpose. Only two revealed the search strategy used to identify articles for the review. None of the reviews featured any type of quality assessment of the primary studies included, or stated what criteria, if any, were used to determine what material was included or excluded. Useful areas for future research were highlighted in only seven reviews.

Conclusion

There is little evidence that reviews currently accepted for publication m anaesthesia journals have been prepared systematically.     

Citation classics in anaesthesia and pain journals: a literature review in the era of the internet

BACKGROUND: The number of citations an article receives reflects its scientific impact. The introduction of internet-based resources to search and access articles has made it possible to review even whole scientific areas. This study identifies the top 50 most-cited articles over the last 25 years in specialty journals dedicated to anaesthesia and pain, respectively. METHODS: Twenty-two journals listed in The Science Citation Index Expanded in the field of anaesthesiology and nine major medical journals were screened using the cited reference option to identify articles cited more than 100 times between 1986 and 2002. The top 50 articles in specialty journals and the top 10 articles in major medical journals concerning anaesthesia and pain were retrieved for further analysis. RESULTS: The most-cited articles in specialty journals were published from 1986 to 1997 and received a mean of 222 (anaesthesia) and 279 (pain) citations. Sixty-seven institutions produced the most-cited articles and of those 28 were located outside North America. The articles were published in six journals led by the Journal of Pain (50 articles) and Journal of Anaesthesiology (39 articles). Forty-seven articles were classified as related to clinical experience, 33 were review articles, and 20 discussed basic science. CONCLUSION: To make an article a possible 'citation classic' in anaesthesiology, it should be published in one of six leading journals and originate from an established institute in North America. Internet resources to publish and cite the literature have to date not advanced any article published in the last 5 years to the top 100 list.