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October 20, 2019
10/20/2019 7:45:00 AM - 10/20/2019 9:45:00 AM
Room W312C
A 2 Decade Analysis of Publication Trends in Anesthesiology Literature
Jennifer Cha, B.S., Anke Wang, B.S., Dilip S. Sidhu, M.D.
Albany Medical College, Albany, New York , United States
Disclosures: J. Cha: None.A. Wang: None.D.S. Sidhu: None.
The purpose of publication of scholarly articles in any peer-reviewed journal is to present quality research which contributes to the scientific community. However, in the field of anesthesiology, research production in the United States has been on a decline sharply since the 1980s (Pagel and Hudetz, 2012). Previous studies have shed light on this trend but on a rather superficial level. In this study, we aim to assess the content, study design, and quality of literature published in a major journal from two different regions in the field of anesthesiology - the United States and the United Kingdom.

We performed a literature search through two journals: Anesthesiology: the Journal of the American Society of Anesthesiologists (ASA) and the British Journal of Anaesthesia (BJA). We identified all original research articles from the month of January for over a twenty year period - 1997, 2000, 2003, 2006, 2009, 2012, 2015, and 2018. We analyzed the papers for measures of quality and article type which includes Centre for Evidence Based Medicine (CEBM) study type; retrospective versus prospective; single versus multi-center; presence or absence of controls; blinding, and randomization; and use of administrative databases. Two different reviewers who were blinded to each other’s assessments performed the data collection. The assessments were then analyzed for concordance using kappa which signifies agreement beyond chance.

A total of 301 articles were assessed from the two journals. When comparing publication quantity trends, the ASA has had a drastically decreasing rate of publication; while the BJA has had a fairly stable publication quantity trend over the last 15 years. It is worth noting that the quantity of publications initially decreased going into the 2000’s. The most common CEBM study types were overwhelmingly Therapy/Prevention (ASA 49%, BJA 52%) and Etiology/Harm (ASA 41%, BJA 26%), followed by the two least common study types Prognosis (ASA 7%, BJA 19%) and Diagnosis (ASA 3%, BJA 3%). The majority of publications in ASA were single center or institution (95%) rather than a collaboration between multiple entities (5%). Most publications in ASA, however, were prospective (85%) rather than retrospective (14%), and one publication utilized both retrospective and prospective study designs. Ten percent (10%) of publications in ASA utilized administrative databases. There were a fair amount of publications in ASA which utilized randomization (40%) and controls (57%), but few used any form of blinding (27%) in the study design. Between the two reviewers, concordance was high with the unweighted kappa values falling well within the 95% confidence intervals.

Etiology/Harm and Therapy/Prevention are the most common study types when it comes to anesthesiology literature; this may be due to the lack of need of diagnostic procedures in anesthesia. However, the deficit in prognostic studies is alarming as anesthetic drugs can have an impact on the prognosis of a patient’s medical condition. There is an evolution within the field of anesthesia towards anesthesiologists caring for patients in the perioperative period. This can potentially lead to a rise in the volume of prognostic and outcomes studies stemming from the work of our specialty. Furthermore, it can be noted that the field of anesthesia is broad with many journals covering pain care, pediatric anesthesia, and other sub-fields independently.

In summary the decline, however slight it may be, of publications in large journals is troubling. The results of this study may serve clinicians and researchers in understanding the climate of anesthesiology research. A third journal from another region, as well as more issues per year, will be added to the study as it progresses in order to provide further insight into publication trends in the field of anesthesiology.

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