High-impact papers in the field of anesthesiology: a 10-year cross-sectional study

Trends of high-impact papers in anesthesiology

High-impact papers in the field of anesthesiology increased from 462 in 2011 to 520 in 2020. The average CNCI value of high-impact papers was 4.50, which ranked about 139 among the 254 research areas (Electronic Supplementary Material [ESM] eTable 1). It decreased from 4.69 in 2011 to 4.21 in 2017 and then increased to 4.38 in 2019. Finally, the CNCI value increased substantially in 2020, reaching 5.46 (Fig. 1). The characteristics of the top ten CNCI value papers and top ten cited papers are shown in ESM eTable 2. The study with the highest CNCI value was a methodological study entitled Correlation coefficients: appropriate use and interpretation, which was published in Anesthesia and Analgesia in 2018,28 with a total of 1,176 citations and a CNCI value of 115.95. The publication with the second highest CNCI value was a guideline entitled Consensus guidelines for managing the airway in patients with COVID-19: Guidelines from the Difficult Airway Society, the Association of Anesthetists the Intensive Care Society, the Faculty of Intensive Care Medicine and the Royal College of Anesthetists,29 which was published in Anaesthesia in 2020, with a total of 335 citations and a CNCI value of 75.75. The most cited publication was a review entitled Central sensitization: implications for the diagnosis and treatment of pain,30 which was published in Pain in 2011, with a total of 2,010 citations and a CNCI value of 40.52. The journals with the highest impact factors were The Lancet, The New England Journal of Medicine (NEJM), JAMA, and The BMJ, which published 15, four, 19, and 14 high-impact papers, respectively.

Fig. 1figure 1

Number and citation impact of high-impact papers in anesthesiology from 2011 to 2020. CNCI = Category Normalized Citation Impact

Subject categories of high-impact papers

When searching for the 4,685 papers via WOS Core Collection, only 4,682 were found, including 3,994 articles (reports of research on original works) and 688 reviews (renewed studies of material previously studied). The average and median citation times for articles were 72 and 57, respectively. The average and median citation times for reviews were 120 and 89, respectively. The results suggested that the reviews were cited more than the articles. The 4,682 high-impact papers could be divided into 15 WOS subject categories (ESM eFig. 1). After “Anesthesiology,” “Clinical Neurology” had the highest number of papers (n = 1,475), followed by “Neurosciences” (n = 1,126) and “Medicine General Internal” (n = 331). The 4,582 high-impact papers were cited by a total of 179,117 papers, which were distributed in more than 100 WOS subject categories. The 15 most frequently cited subject categories are shown in ESM eFig. 2. “Anesthesiology” accounted for the largest number of papers, with 39,402 citing papers. The citation impact of these high-impact papers extended to “Clinical Neurology” (n = 19,835), “Neurosciences” (n = 17,944), “Medicine General Internal” (n = 15,170), and “Surgery” (n = 12,688).

Location of high-impact papers

The locations that published the most high-impact papers in the field of anesthesiology were the USA, UK, Canada, and Germany (ESM eTable 3).

Organization of origin of high-impact papers

The organizations that published the most high-impact papers in anesthesiology were the League of European Research Universities, Harvard University, University of Toronto, University of London, University of California System, and UDICE-French Research Universities (ESM eTable 4). The top 15 organizations and their CNCI values are shown in Fig. 2 and ESM eTable 4, respectively.

Fig. 2figure 2

Numbers of high-impact papers in anesthesiology and CNCI values of the top 15 production institutions. APHP = Assistance Publique Hopitaux Paris; Inserm = Institut National de la Sante et de la Recherche Medicale, National Institute of Health and Medical Research in France; CNCI = Category Normalized Citation Impact; LERU = League of European Research Universities; UDICE = French Research Universities

Cooperation network of institutions of high-impact papers

Figure 3 shows the network of cooperation among institutions with the highest number of high-impact papers in anesthesiology from 2011 to 2020. Each color represents a cluster, which means that there was cooperation between institutions with the same color. The size of each node represents the number of papers, and the connecting line indicates cooperation. The network map revealed that there were six leading collaborative circles among institutions, which were mainly universities from the same country and region. Specifically, the largest node was the university groups from the USA and Canada (at the above corner), including the University of Toronto, Stanford University, and Duke University. The top collaborative circles were mainly in the USA, UK, and Canada (ESM eFig. 3).

Fig. 3figure 3

Map of collaborative networks among institutions of high-impact papers

Subject-term heatmap of high-impact papers

We used VOS viewer to perform natural language processing on the titles and abstracts of the 4,682 high-impact papers and divide the processed subject terms and phrases into clusters. The warmer the color of topic terms on the heatmap, the higher the frequency of terms appeared in the literature. In the heatmap of all studies (Fig. 4), three main hot research topics were found. Postoperative analgesia was the first hotspot, including “analgesia,” “block,” “ultrasound,” “opioid consumption,” “pain score,” “Visual Analogue Scale,” and “vomiting.” Pain, especially chronic pain, was the second hot research topic, including “pain,” “chronic pain,” “pain intensity,” “pain severity,” “pain modulation,” “depression,” and “disability.” Perioperative complications was the third research hotspot, including “complications,” “mortality,” “delirium,” “cardiac surgery,” “failure,” “discharge,” and “comorbidity.”

Fig. 4figure 4

Subject terms heat map of high-impact papers in anesthesiology

To evaluate the latest progress, we performed a subject-term heatmap analysis on papers published in 2020. From the heatmap (ESM eFig. 4), COVID-19 was found to be the new research hotspot, which included “COVID,” “pandemic,” “recommendation,” “risk factor,” and “coronavirus disease.”

To evaluate the difference in progress between article types, we performed a further analysis based on the article and review. In the heatmap of all articles (ESM eFig. 5), three main hot research topics, including postoperative analgesia, pain, and perioperative complications, were found. In the heatmap of reviews (ESM eFig. 6), postoperative analgesia, pain, perioperative complications, and COVID-19 were the main research topics.

To evaluate the most high-impact papers, we performed a further analysis based on the top 1% papers. A total of 482 papers were included. In the heatmap (ESM eFig. 7), four main hot research topics were included, which included postoperative analgesia, pain, perioperative complications, and COVID-19.

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