A worldwide bibliometric analysis of published literature in plastic and reconstructive surgery.

BACKGROUND: Bibliometrics is the analysis of the content and citations of journal articles to quantify trends in published data. In this study, we aimed to use bibliometric analysis to identify the contribution of various countries to the plastic surgical literature over a 5-year period. METHODS: In this study, the top 20 countries publishing articles on surgery and 10 plastic surgical journals with the highest impact factors (IFs) were included. The number of scientific articles published in each journal per year (2009-2013) in each country was found using PubMed. As a marker of quality, the mean IF for each country was calculated using the number of articles and journal IF. These data were compared with population, gross domestic product (GDP) and dollars spent on research. RESULTS: A total of 10,051 articles were included. The USA was the largest contributor, with 4008 articles published over 5 years, followed by the UK (1163 articles). The USA's mean IF was 2.084, closely followed by Canada (2.037). The UK had the highest number of publications per million population (PMP; 18.14 publications PMP). When considering the overall research spending per country, Turkey had the most cost-effective publication output. The least cost-effective country was South Korea. Sweden, the Netherlands and Canada had the greatest increase in publication quality. CONCLUSIONS: Bibliometric analysis can be used to identify not only major centres of plastic surgical research, such as the USA and UK, but also centres that produce high-quality data, such as Canada, and cost-effective research, such as Turkey. It can also highlight the areas of increasing success in plastic surgical research.

Inter- and intrarater reliability of osteoarthritis classification at the trapeziometacarpal joint.

PURPOSE: To assess the reliability of the Eaton and Glickel classification for base of thumb osteoarthritis. METHODS: The interrater and intrarater reliability of this classification were assessed by comparing ratings from 6 raters using quadratic weighted kappa scores. RESULTS: Median inter-rater reliability ranged from kappa of .53 to .54; intrarater reliability ranged from kappa of .60 to .82. Using unweighted kappa interrater reliability was "slightly" reliable, and intrarater reliability was "fairly" reliable. Overall, the value of the intraclass correlation for all 6 raters was .56. CONCLUSIONS: This radiological classification does not describe all stages of carpometacarpal joint osteoarthritis accurately enough to permit reliable and consistent communication between clinicians. Therefore we believe it should be used with an understanding of its limitations when communicating disease severity between clinicians or as a tool to assist in clinical decision making.

A prospective case-control study to compare the sensitivity and specificity of the grind and traction-shift (subluxation-relocation) clinical tests in osteoarthritis of the thumb carpometacarpal joint.

The diagnosis of osteoarthritis of the thumb carpometacarpal joint is made predominantly by correlating examination findings with patients' symptoms and radiographs. The importance of clinical examination is enhanced due to the poor correlation between radiological severity of osteoarthritis of this joint and symptoms. Despite the importance of clinical examination findings, no previous studies have analyzed the traction-shift test nor compared clinical tests for this diagnosis. In this prospective case-control study the relative performance of the commonly used grind and traction-shift (subluxation-relocation) tests were compared in 30 patients and 30 unaffected controls. The traction-shift test had greater sensitivity (66.7%) and specificity (100%) than the grind test (30% and 96.7%, respectively), whilst also demonstrating superior positive (100%) and negative (75%) predictive value than the grind test (90% and 58%, respectively). Therefore, we believe this to be the superior clinical test for osteoarthritis of the carpometacarpal joint of the thumb.

High resolution ultrasonography of the hand and wrist: three-year experience at a District General Hospital Trust.

A retrospective analysis of 227 patients undergoing ultrasonography (US) of the hand/wrist over a three-year period in a district general hospital trust was performed. The usefulness in each case was assessed by two independent reviewers using a qualitative rating system, as (A) Useful: determines management, (B) Useful: contributory, (C) Not useful: not misleading, or (D) Not useful: misleading/potentially harmful. US was useful in 74.8% of cases but misleading/potentially harmful in 13.1%. Misleading rates exceeding 10% in sub-categories including tendinopathy, carpal tunnel syndrome, foreign body and lumps, where US findings may influence the decision to operate or not, are particularly worrying. There were a number of cases where US led to unnecessary operations or suggested operating on the wrong structures, and also cases where US findings wrongly suggested that surgery was unnecessary. Various recommendations aimed to improve the usefulness of US in the Hand and Wrist, including mandatory/formal musculoskeletal US training, are made.