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The Journal of Bone and Joint Surgery (American) 86:1012-1016 (2004)
© 2004 The Journal of Bone and Joint Surgery, Inc.

Doubling the Impact: Publication of Systematic Review Articles in Orthopaedic Journals

Mohit Bhandari, MD, MSc1, Victor M. Montori, MD, MSc1, Philip J. Devereaux, MD1, Nancy L. Wilczynski, MSc1, Douglas Morgan1, R. Brian Haynes, MD, PhD1 and the Hedges Team

1 Department of Clinical Epidemiology and Biostatistics (M.B., V.M.M., N.L.W., D.M., and R.B.H.) and Health Research Methodology Program (P.J.D.), McMaster University Medical Centre, 1200 Main Street West, Room 2C9, Hamilton, ON L8N 3Z5, Canada. E-mail address for M. Bhandari: bhandari{at}simpatico.ca

Investigation performed at the Health Information Research Unit, McMaster University, Hamilton, Ontario, Canada

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the United States National Library of Medicine and a senior research fellowship from the Canadian Institutes of Health Research (P.J.D.). None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Investigators aim to publish their research papers in top journals to disseminate their findings to the widest possible audience. Systematic reviews of the literature occupy the highest position in currently proposed hierarchies of evidence. We hypothesized that the number of citations (a measure of scholarly interest) for systematic reviews (or meta-analyses) published in leading orthopaedic journals would be greater than the number of citations for narrative reviews published in the same journals.

Methods: We identified fifteen journals that had high Science Citation Index impact factors for the orthopaedic subspecialty and were believed to have a higher yield of studies and reviews of scientific merit and clinical relevance. For the year 2000, six research associates applied methodological criteria to each article in each issue of the fifteen journals to determine whether the article was scientifically sound (rigorous versus nonrigorous). Of the 3916 articles identified, 2331 were original or review articles. We queried the ISI (Institute for Scientific Information) Web of Science database to ascertain, as of March 2003, the number of subsequent citations to each one of the reviews after its original publication in all journals that published both narrative and systematic reviews.

Results: Of the 2331 articles published across the fifteen journals in the year 2000, 110 were review articles. Only seventeen (15%) of the 110 reviews met our criteria for systematic reviews with rigor. Rigorous systematic reviews received more than twice the mean number of citations compared with other systematic or narrative reviews (13.8 compared with 6.0, p = 0.008). The rigor of a review was a significant predictor of the number of citations in other orthopaedic journals (p = 0.01). In addition, rigor was significantly associated with the number of citations in nonorthopaedic journals (p = 0.03).

Conclusions: Our findings suggest that journal editors and authors can improve the relevance and scholarly interest in their reviews (as shown by the number of citations) by meeting standard guidelines for methodological rigor.


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Focus on Impact Factors Misses Out an Important Source of Orthopaedic Systematic Reviews
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JBJS Online, 23 Jun 2004 [Full text]