A bibliometric analysis of publications on emergency medicine in Türkiye

Abstract

OBJECTIVES: Publications and literature related to emergency medicine (EM) have been consistently increasing. There are 4048 studies in total in the EM journals published until the present day in Türkiye in the Web of Science (WoS) database. Our aim is to define the bibliometric features of scientific studies published in EM journals in Türkiye, to gain insights into the trends of the literature.

METHODS: We retrospectively analyzed the bibliometric data of scientific studies published in EM journals in Türkiye until today on the WoS database related to the EM field. The bibliometrix package of R statistical software was used in the bibliometric analyses in the study.

RESULTS: A total of 4048 scientific studies from Türkiye indexed on the WoS database from 10,263 authors in four different journals were analyzed. Among these, 3681 (90.9%) were articles, 188 (4.7%) were reviews, 97 (2.4%) were editorial material, 60 (1.5%) were letters, and 5 (0.1%) were corrections. Average number of citations per study was 3.6, with the most cited study having 2016 citations. The most frequent title’s words were emergency, patient, and acute.

CONCLUSION: This study shows that there is an increasing trend in the number of EM publications and citations in Türkiye with the first most cited study having 2016 citations, and the top contributing countries were Türkiye, Iran, and India. The results of this study may be useful in understanding the historical and prospective development of EM, including the identification of general information about its publications, differentiation of the top cited ones, and presentation of a bibliometric analysis of scientific activity to date.

Introduction

Emergency medicine (EM) residency program was first established in the United States in 1972. EM is a rapidly growing discipline in Türkiye since its establishment in 1993.[1] Since its establishment in Türkiye, the number of institutions providing residency training has been increasing daily. In Türkiye, there are 105 institutions providing residency training and approximately 3500 EM specialists.[2] When we look at scientific journals in the field of EM from Türkiye, the Turkish Journal of Trauma and Emergency Surgery was founded in 1995 and indexed in 2007 in the Web of Science (WoS). The Turkish Journal of EM was founded in 2000 and indexed in 2006 in the WoS. The Eurasian Journal of EM was founded in 2003 and indexed in 2006 in the WoS. The Journal of EM Case Reports was founded and indexed in 2010 in the WoS. In the period that has passed until today, the contribution of EM to the current medical literature has also been gradually increasing. When we evaluate the past literature summaries, in a study evaluating the contribution of EM to the literature in the first 10 years between 1993 and 2004, there were 84 articles in total, while there are 4048 studies in total when we look at the EM journals published until the present day in Türkiye in the WoS database.[3] Our aim in this study was to define the bibliometric features of scientific studies published in EM journals in Türkiye, to gain insights into the trends of the literature.

Material and Methods

Study design

We retrospectively analyzed the bibliometric data of scientific studies published in EM journals from Türkiye indexed in the WoS database until today.

Selection of sample

The WoS database allows the selection of subcategories such as subjects, journals, and region selection.[4] All publications, available in Clarivate Analytics’ WoS database, in the EM field until the current date were selected. Results were then refined to articles from Türkiye and then in the final to four journals that publish in this category. All publications from these four journals were included and analyzed.

Methods and measurements

While creating the dataset, “EM” was selected as a subcategory through the WoS search engine on December 18, 2023, and no date range was specified to gather all data on the database, since all publications of EM journals published in Türkiye would be included. According to the data obtained, it was seen that the first study in the WoS database was in 2006. Among the four scientific journals indexed in the WoS database, all were open-access journals; the Turkish Journal of Trauma and Emergency Surgery was indexed in the Science Citation Index Expanded, while the Turkish Journal of EM, Eurasian Journal of EM, and Journal of EM Case Reports were indexed in Emerging Sources Citation Index, and the data of all scientific studies from these were analyzed. Language selection was not specified in the published scientific studies. As this research was conducted with electronic bibliometric data from the WoS database and did not involve any patient data, ethical committee or institutional review board approval was not required.

Outcome measures

The primary outcome was the number of publications, citation counts, and frequency of publications in the EM field in Türkiye. Secondary outcomes were the authors, countries, and keywords identifying common characteristics of the studies, publication index, and a look at the characteristics of the 10 most cited articles.

Data analysis

Bibliometric analysis includes WoS categories, publication types, scientific index, number of authors, number of citations, keywords, references, language, region, and journals in which the publications were published. The author information, publication journal, year of publication, and citation details of the top 10 most-cited studies were also examined. A word cloud matrix was created using bibliometric features of the data. The bibliometrix package of R statistical software (R Core Team, Vienna, Austria) was used in the bibliometric analyses in the study.[5]

Results

A total of 4048 scientific studies from four different journals were included in the analysis. While the total number of authors in these publications was 10,263, there were 186 studies published with a single author. The total number of publications was 34 in 2006 and 235 in 2023. The year with the highest number of publications was 2022 with 398 studies.

In terms of the number of citations per year, the highest number of citations was in 2022 with 398 citations, the mean total citations per both article and year was the highest in 2018. Details on number of citations per year are presented in Table 1.

Table 1. Average citations of publications per year

Regarding the types of publications in this study, 3681 (90.9%) were articles, 188 (4.7%) were reviews, 97 (2.4%) were editorial material, 60 (1.5%) were letters, and 5 (0.1%) were corrections. Of the published studies, 3230 (79.8%) were in English and 818 (20.2%) were in Turkish [Table 2].

Table 2. General characteristics and analysis of the publications reviewed in the study

In terms of the countries where the research studies were conducted, the top contributing countries were Türkiye (n = 3230, 79.8%), Iran (n = 114, 2.8%), India (n = 86, 2.1%), South Korea (n = 43, 1%), and China (n = 41, 1%). In terms of contributing authors, Türkiye (n = 7885), Iran (n = 291), India (n = 150), the United States of America (n = 104), and the Republic of Korea (n = 93) contributed the most. Contributions of the countries per author are presented in Figure 1.

Figure 1. Worldwide distribution of scientific production by country

The institutions with the highest number of published studies were University of Health Sciences (n = 395, 9.75%), Istanbul University (n = 260, 6.42%), Gulhane Military Medical Academy (n = 173, 4.27%), Selcuk University (n = 166, 4.10%), Ankara Numune Training and Research Hospital (n = 165, 4.07%), Dicle University (n = 152, 3.75%), Dokuz Eylul University (n = 144, 3.55%), Akdeniz University (n = 139, 3.43%), Ataturk University (n = 136, 3.35%), and Ege University (n = 133, 3.28%).

While the average number of citations per study was 3.6, the most cited study had 2016 citations. The number of articles published in journals, H index, G index, total number of citations, and average number of citations are shown in Table 3. These are academic evaluation methods in which productivity is measured according to the number of publications and citations.

Table 3. Citation analysis of the journals

Regarding the top 10 most-cited studies analyzed, the first most cited study had 2016 citations, while the second and third most-cited studies had 133 and 106 citations, respectively. Other characteristics of the most-cited studies are shown in Table 4.

Table 4. General characteristics of the 10 most‑cited studies

The most frequently used “Keyword plus,” “Author’s keywords,” and “Title’s words” were also analyzed and shown in Figure 2. Common words most frequently used as Keywords Plus were Management, Mortality, and Diagnosis, Author’s keywords were Emergency Department, Trauma, and Mortality, and Title’s words were Emergency, Patient, and Acute, respectively.

Figure 2. Word cloud analysis. Size of the word indicates the frequency

Discussion

While the average number of authors per study in the world medical literature is 4.4, the average number of authors per publication in our study is 4.7, which is comparable to the world average.[6] A bibliometric study analyzing EM field publications between 2008 and 2017, as published by Kokulu et al., reveals that Türkiye holds the 4^th position among other countries in terms of contributions to the EM literature.[7]

Considering the annual distribution of the number of studies, while the average number of studies per year is 225, this number is 398 in 2022, the year in which the highest number of studies were published. The reason for this increase might be due to the increase in the frequency of publication of the Turkish Journal of Trauma and Emergency Surgery, which contributes the most in terms of the number of studies among these journals, as of 2022, and the increased interest in the field of EM and the number of scientific studies conducted in this area over time.

Our study reveals that the mean total citations per article and year were the highest in 2018. This increase can be attributed to two reviews published in 2018 in the Turkish Journal of EM. On examining these articles, it is evident that studies related to statistical analysis occupy the first two ranks among the 10 most-cited studies. The reason for this may be that statistical analysis is also used and of interest in fields other than EM.

Among the top 10 most-cited studies, three focused on acute appendicitis, and one other about spinal cord injury in animal models was from the Turkish Journal of Trauma and Emergency Surgery. Although indexed under the EM category, the journal is dedicated to trauma and emergency surgery, which might contribute to a higher citation rate in those subjects, especially when considering academics in the fields of surgery and anesthesiology. In addition, acute appendicitis is one of the most common abdominal emergencies, and the high prevalence, clinical complexity, and diagnostic challenges of the subject may also have contributed to the substantial number of citations.

Another notable finding of the study is that the majority of the published studies are published in English. This shows that researchers in Türkiye aim to reach and influence a wider audience in the international arena.

When the countries contributing to the studies are examined, it is seen that there is a high rate of studies and authors originating from Türkiye. This may indicate that collaborative studies might have been published in other scientific journals located outside of Türkiye.

Although the University of Health Sciences is observed as the institution producing the highest number of studies, there are a total of 60 individual training and research hospitals in Türkiye, with 25 located in Istanbul, 15 in Ankara, and 18 in other cities across the country; they are gathered under a single name in the WoS database.

The average number of citations per study is 3.6 in this analysis. In a study by Cetin et al. examining EM publications worldwide in the last 10 years, the average number of citations per study was 11.7.[8] Factors such as language choice, research design, methodology, publication strategies and the level of international collaboration may be underlying this difference. This suggests that EM studies in Türkiye have the potential to receive more citations on a global scale.

Based on the studies, when the performance of four journals in the field of EM in Türkiye is evaluated, the Turkish Journal of Trauma and Emergency Surgery stands out with its high H-index and overall number of publications, while the Turkish Journal of EM stands out with its average number of citations per publication and G index. This assessment can guide researchers in journal selection and help them better understand the performance of journals.

When the most commonly used words are analyzed, it is seen that these words are mostly words reflecting general medicine (management, mortality, and diagnosis) but also reflect the characteristics and dynamics of EM (emergency and acute).

Limitations

Similar to other bibliometric studies, this study has some important limitations. Only journals in the WoS database were used. This may cause studies published outside of WoS to be unrecognized. In the WoS database, other article types such as case series and case reports are also included under the article category besides the original research paper, which may have affected the expected number of citations per publication. Another limitation is that the Turkish Journal of Trauma and Emergency Surgery includes other subsections besides EM, like surgery.

Conclusion

This study shows that there is an increasing trend in the number of EM publications and citations in Türkiye with the first most cited study having 2016 citations, and the top contributing countries were Türkiye, Iran, and India. The results of this study may be useful in understanding the historical and prospective development of EM, including the identification of general information about its publications, differentiation of the top-cited ones, and presentation of a bibliometric analysis of scientific activity to date.

How to cite this article: Güzelce MC, Orhan E, Özgür S. A bibliometric analysis of publications on emergency medicine in Türkiye. Turk J Emerg Med 2024;24:145-50.

Since this study was conducted on electronic bibliometric data obtained from the WoS database and did not include any patient data, an ethics committee or institutional review approval was not required.

• Mustafa Can Güzelce: Conceptualization, methodology, formal analysis, investigation, Writing - Original Draft, Review and Editing, Supervision, Project administration
• Ertuğ Orhan and Sefer Özgür: Conceptualization, methodology, investigation, software, resources, data curation, visualization, writing – review and editing.

None Declared.

None.

References

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We would like to thank Prof. Ersin Aksay, MD, for his help in conducting this study.