98.08 An analysis of surgical literature trends over four decades

Posted on January 31, 2019

T. D. Madni1, P. Nakonezny1, H. G. Mayo1, J. B. Imran1, L. Taveras1, R. Vela1, Y. Goldenmerry1, A. T. Clark1, H. B. Cunningham1, M. W. Cripps1, H. A. Phelan1, S. E. Wolf2  1University of Texas Southwestern,Surgery,Dallas, TEXAS, USA 2University of Texas Medical Branch at Galveston,Surgery,Galveston, TEXAS, USA

Introduction:
Topics in surgical literature have evolved over time. We reviewed four decades of surgical publications to determine changes in focus in surgical science.

Methods:
We searched Ovid MEDLINE on 12/5/17 for articles published in Annals of Surgery, JAMA Surgery, Surgery, Journal of the American College of Surgeons, and American Journal of Surgery during years: 1984-86, 94-96, 04-06, 14-16; articles indexed to editorial, letter, or news were excluded. Three surgeons independently assigned two classifications to each article: 1) 1 of 22 subspecialty categories, 2) basic/translational science (yes/no). Intra-class Correlation Coefficients (ICC) assessed rater reliability.   

Results:
N=16225 articles were identified (1984-86: 3881, ‘94-96: 3415, ‘04-06: 3861, ‘14-16: 5068). Surgical literature increased on average 132 publications/year. ICC for raters of subspecialty categories was 0.833 (95% CI:  0.828 to 0.837;p=.0001), and ICC of basic science assignment was 0.870 (95% CI: 0.866 to 0.873;p=.0001). Overall, basic science publications decreased from 16 to 4% (-4.0% of the literature/decade). Significant decreases were noted in general/acute care (-2.8% of the literature/decade) and vascular surgery (-4.1% of the literature/decade).  Significant increases were seen in surgical oncology (+2.7 of the literature/decade) and other, which included outcome and education topics (+4.2% of the literature/decade) (Fig 1). Post-hoc analysis of other demonstrated increased surgical education publications from 0 to 6% between 1984-86 to 2014-16.

Conclusion:
This study reflects trends in surgical literature, demonstrating increased focus on both cancer and surgical education. We found a drastic decline in basic science and vascular surgery investigations, reflecting a significant shift from these fields in the common surgical literature.