A decade of Ecuador´s efforts to raise its health research output: a bibliometric analysis.

Background: Over the past decade, the political movement called 'Revolución Ciudadana' implemented a variety of policies and interventions (P&I) in Ecuador to improve higher education and strengthen local research capacity. We refer specifically to the 'Mandato 14' and the Higher Education Law (LOES, Spanish acronym) launched in 2008 and 2010, respectively. Objective: To assess the impact of these P&I (Mandato 14/LOES) on the production of health sciences-related articles (HSRA), and the relationship of these HSRA with the country's health priorities. Methods: A Scopus search was performed to retrieve HSRA published from 1999 to 2017. Bivariate analysis was used to assess variation between the period I (1999-2008) and period II (2009-2017). Further, we examined the association between the top 10 causes of mortality and the total HSRA output. Results: The final study sample consisted of 2784 articles. After 2008, Ecuadorian production of HSRA increased steadily from 671 to 2133 publications (p<.001). Overall (1999-2017), the most common study design was cross-sectional (32.3%), the primary research focus was in the clinical-surgical area (49.3%), and the academic institutions were the primary drivers of scientific production during period II (56.9% vs. 29.5%, p<.001). Further, we found a decrease in the production of randomized controlled trials (6.7% vs. 1.8%, p<.001). Only 9% of research production involved the primary causes of mortality, and the proportion has remained unchanged over time (8.2% vs. 9.3%, p>.05). Conclusions: Ecuadorian HSRA output increased significantly after 2008. This larger volume of scientific output could be the result to the Mandato 14/LOES implemented in the last decade. However, a low percentage of HSRA are dedicated to addressing the country's health priorities. Proper planning, execution and monitoring of national health research agendas would reduce the mismatch between health burden and the HSRA output in Ecuador and other low-and middle-income countries.

[Analysis of Spanish research collaboration in emergency medicine: 2010-2014]. / Análisis de redes de colaboración españolas en la investigación en Medicina de Urgencias y Emergencias (2010-2014).

OBJECTIVES: To describe the structure of the Spanish emergency medicine research network or networks, researchers' roles, and patterns of collaboration between hospitals. MATERIAL AND METHODS: The search for publications was carried out in the SCOPUS database for the 5-year period of 2010 to 2014. We used network analysis software to map ties between researchers and hospitals that had established at least 5 and 10 relationships, respectively, during the period under study. We calculated indicators of degree of centrality for individual scientists and hospitals and tabulated data for the main authors and centers. RESULTS: We identified 2626 articles with 12 372 different authors at 1134 hospitals in 75 countries. The largest number of international relations were with France, the United States, and the United Kingdom. Authors had established 93 687 connections that allowed us to identify 23 collaborating groups, the largest of which was comprised of 30 individuals. We also found 12 855 connections between hospitals that identified a single subnetwork of collaboration comprised of 19 hospitals, 1 of which was in Switzerland. Measures of centrality, intermediation, and proximity led to classification of the most important members of author and hospital networks. CONCLUSION: This analysis of research networks in emergency medicine has afforded the first details describing the relationships maintained by Spanish scientists and hospitals.

OBJETIVO: Estudio descriptivo que investiga cómo se estructura la red o redes de investigación en Medicina de Urgencias y Emergencias (MUE) en España, establece el rol de cada investigador, así como describe la red de colaboración entre los hospitales españoles dentro de esta especialidad médica. METODO: Se realizó una búsqueda en la base de datos SCOPUS® para el quinquenio 2010-2014. Mediante programas específicos de análisis de redes se dibujaron las redes de investigadores y de hospitales, bajo la condición de haber establecido al menos 5 y 10 relaciones, respectivamente, durante el periodo. Para investigadores y hospitales se calcularon los indicadores de centralidad de grado, cercanía e intermediación, y se tabularon los principales autores y centros. RESULTADOS: Se identificaron 2.626 artículos de 12.372 autores diferentes y 1.134 hospitales distintos de 75 países. El mayor número de relaciones internacionales se establecieron con Francia, Estados Unidos y Reino Unido. Los autores establecieron 93.687 conexiones que permitieron identificar 23 grupos de colaboración, el mayor formado por 30 integrantes. Además, se establecieron 12.855 conexiones entre hospitales, que permitieron identificar una única subred de colaboración formada por 19 hospitales, 1 de ellos suizo. Mediante los indicadores de centralidad, intermediación y cercanía se pudo establecer una clasificación de aquellos elementos más relevantes dentro de las redes de autores y hospitales. CONCLUSIONES: El análisis de redes de la investigación en MUE ha permitido conocer por vez primera al detalle las relaciones que se establecen entre investigadores y hospitales españoles.

Análisis de redes de colaboración españolas en la investigación en Medicina de Urgencias y Emergencias (2010-2014) / Analysis of Spanish research collaboration in emergency medicine: 2010-2014

Objetivo. Estudio descriptivo que investiga cómo se estructura la red o redes de investigación en Medicina de Urgencias y Emergencias (MUE) en España, establece el rol de cada investigador, así como describe la red de colaboración entre los hospitales españoles dentro de esta especialidad médica. Método. Se realizó una búsqueda en la base de datos SCOPUS(R) para el quinquenio 2010-2014. Mediante programas específicos de análisis de redes se dibujaron las redes de investigadores y de hospitales, bajo la condición de haber establecido al menos 5 y 10 relaciones, respectivamente, durante el periodo. Para investigadores y hospitales se calcularon los indicadores de centralidad de grado, cercanía e intermediación, y se tabularon los principales autores y centros. Resultados. Se identificaron 2.626 artículos de 12.372 autores diferentes y 1.134 hospitales distintos de 75 países. El mayor número de relaciones internacionales se establecieron con Francia, Estados Unidos y Reino Unido. Los autores establecieron 93.687 conexiones que permitieron identificar 23 grupos de colaboración, el mayor formado por 30 integrantes. Además, se establecieron 12.855 conexiones entre hospitales, que permitieron identificar una única subred de colaboración formada por 19 hospitales, 1 de ellos suizo. Mediante los indicadores de centralidad, intermediación y cercanía se pudo establecer una clasificación de aquellos elementos más relevantes dentro de las redes de autores y hospitales. Conclusión. El análisis de redes de la investigación en MUE ha permitido conocer por vez primera al detalle las relaciones que se establecen entre investigadores y hospitales españoles (AU)

Objectives. To describe the structure of the Spanish emergency medicine research network or networks, researchers' roles, and patterns of collaboration between hospitals. Methods. The search for publications was carried out in the SCOPUS database for the 5-year period of 2010 to 2014. We used network analysis software to map ties between researchers and hospitals that had established at least 5 and 10 relationships, respectively, during the period under study. We calculated indicators of degree of centrality for individual scientists and hospitals and tabulated data for the main authors and centers. Results. We identified 2626 articles with 12 372 different authors at 1134 hospitals in 75 countries. The largest number of international relations were with France, the United States, and the United Kingdom. Authors had established 93 687 connections that allowed us to identify 23 collaborating groups, the largest of which was comprised of 30 individuals. We also found 12 855 connections between hospitals that identified a single subnetwork of collaboration comprised of 19 hospitals, 1 of which was in Switzerland. Measures of centrality, intermediation, and proximity led to classification of the most important members of author and hospital networks. Conclusion. This analysis of research networks in emergency medicine has afforded the first details describing the relationships maintained by Spanish scientists and hospitals (AU)

Producción científica de los urgenciólogos españoles durante el quinquenio 2010-2014 y comparación con el quinquenio 2005-2009 / Productivity of Spanish emergency physicians: comparison of the 5-year periods 2010-2014 and 2005-2009

Objetivo: Estudiar la producción científica de los urgenciólogos españoles durante el quinquenio 2010-2014 y compararla con la del quinquenio anterior (2005-2009). Método: Se seleccionaron todos los documentos, excluyendo comunicaciones a congresos, firmados por urgenciólogos con filiación española localizados a través de Science Citation Index (SCI)-Expanded. Se recogieron variables sobre año de publicación, autores (número, filiación y orden de firma), revista y factor de impacto (FI), tipo de documento, citas recibidas y áreas de investigación. La búsqueda se realizó para el periodo 2010-2014 y se compararon los datos con datos históricos correspondientes a 2005-2009. Resultados: Durante el quinquenio 2010-2014 se publicaron 1.433 documentos (52,4% artículos originales), un 56% más que en 2005-2009 (p = 0,01). La media de FI fue discretamente superior (2,587 frente a 2,483), la mediana menor (2,295 frente a 3,085), pero con un percentil 90 superior (4,036 frente a 3,085, p = 0,01), lo que muestra un incremento de publicaciones en revistas de alto FI. Los artículos continúan publicándose preferentemente en español-castellano (67,8%) aunque ha incrementado significativamente la producción en inglés (de 25,2% a 32,1%; p = 0,001). La actividad del urgenciólogo investigador es mayoritariamente en servicios de urgencias hospitalarios (SUH) (89%). La filiación universitaria de los autores es baja, aunque ha aumentado significativamente (de 10,9% a 16,2%; p = 0,001). Aumentó la colaboración, tanto con centros de la misma u otra comunidad autónoma (de 24,7% a 36%, y de 10,9% a 19%, respectivamente; p = 0,001 para ambos), como internacional (2,3% a 8,4%; p = 0,001). Las áreas de investigación con más documentos son cardiovascular (13,1%), infecciosas (13,0%), toxicología/farmacología (9,2%), pediatría (8,0%), neumología (7,4%), reanimación cardiopulmonar (6,7%) y organización (6,0%). Cataluña fue la comunidad que más documentos produjo (427; 29,8%). El Hospital Clínic lideró la producción hospitalaria (145, 11,4% de la producción de los SUH) y SUMMA- 112 la extrahospitalaria (43; 36,7% de la producción extrahospitalaria). Cataluña, Madrid, Castilla-La Mancha, Canarias, Murcia, Islas Baleares y La Rioja aumentaron su peso relativo en la producción española un 20% o más respecto al quinquenio previo. Nueve artículos de 2010-2014 ya han alcanzado consideración de clásicos de citación. Conclusiones: La producción científica de los urgenciólogos españoles siguió creciendo a buen ritmo durante el quinquenio 2010-2014, con un incremento de publicaciones en revistas de alto FI, y se aprecian cambios significativos en la dinámica y la temática de investigación (AU)

Objective: To study the publication productivity of Spanish emergency physicians in the 5-year period from 2010 through 2014 and compare it with the previous period (2005–2009). Methods: Articles authored by emergency physicians affiliated with institutions in Spain were selected from the Science Citation Index–Expanded; conference presentations were excluded. We collected data for year of publication, author information, journal, the journal's impact factor (IF), type of article, cites received, and area of research. We searched at 2010-2014 period, and these data were compared with historic data from the 2005-2009 period. Results: A total of 1433 articles were published in 2010-2014; 52.4% were original research articles (56% more than in 2005–2009, P=.01). The mean journal IF associated with the publications was slightly higher in 2010-2014 (2.587 vs 2.483 for 2005–2009). The median was slightly lower (2.295 vs 3.085 in the earlier period), but the 90th percentile was higher (4.036 vs 3.085, P=0.01), reflecting an increase in the number of publications in journals with high IFs. Most articles continue to be published in Castilian Spanish (67.8%), although the percentage of articles published in English increased significantly, from 25.2% in the previous period to 32.1% in 2010-2014; P=.001). Scientific publications in emergency medicine come mainly from specialists working in hospital emergency departments (89%). Authors affiliated with a university are in the minority, although their percentage increased significantly from 10.9% in the previous period to 16.2% in the recent one (P=.001). Collaboration increased in the recent period in all categories: between hospitals in the same Spanish autonomous community (from 24.7% to 36%), in different communities (from 10.9% to 19%), or in different countries (from 2.3% to 8.4%) (P=.001, all comparisons). The most productive research areas were cardiovascular conditions (accounting for 13.1% of the publications), infectious diseases (13.0%), toxicology and pharmacology (9.2%), pediatric emergencies (8.0%), respiratory diseases (7.4%), cardiopulmonary resuscitation (6.7%), and management (6.0%). Catalonia produced the largest number of papers (427 [29.8%]). Hospital Clínic de Barcelona ranked first among hospitals publishing research, with 145 articles (11.4% of the total in this category); the emergency services of Madrid (SUMMA-112) ranked first among out-of-hospital research groups, with 43 publications (36.7% of the total in this category). Catalonia, Madrid, Castile–La Mancha, the Canary Islands, Murcia, the Balearic Islands, and La Rioja increased their contributions to Spanish productivity by 20% or more over their output in the earlier 5-year period. Nine of the 2010-2014 articles have already attracted enough cites to be considered citation classics. Conclusions: The productivity of Spanish emergency physicians continued to grow at a good pace in the 2010-2014 period. Publications in journals with IFs increased and there were significant changes in the dynamics of publication and the subjects covered (AU)

[Productivity of Spanish emergency physicians: comparison of the 5-year periods 2010-2014 and 2005-2009]. / Producción científica de los urgenciólogos españoles durante el quinquenio 2010-2014 y comparación con el quinquenio 2005-2009.

OBJECTIVES: To study the publication productivity of Spanish emergency physicians in the 5-year period from 2010 through 2014 and compare it with the previous period (2005-2009). MATERIAL AND METHODS: Articles authored by emergency physicians affiliated with institutions in Spain were selected from the Science Citation Index-Expanded; conference presentations were excluded. We collected data for year of publication, author information, journal, the journal's impact factor (IF), type of article, cites received, and area of research. We searched at 2010-2014 period, and these data were compared with historic data from the 2005-2009 period. RESULTS: A total of 1433 articles were published in 2010-2014; 52.4% were original research articles (56% more than in 2005-2009, P=.01). The mean journal IF associated with the publications was slightly higher in 2010-2014 (2.587 vs 2.483 for 2005-2009). The median was slightly lower (2.295 vs 3.085 in the earlier period), but the 90th percentile was higher (4.036 vs 3.085, P=0.01), reflecting an increase in the number of publications in journals with high IFs. Most articles continue to be published in Castilian Spanish (67.8%), although the percentage of articles published in English increased significantly, from 25.2% in the previous period to 32.1% in 2010-2014; P=.001). Scientific publications in emergency medicine come mainly from specialists working in hospital emergency departments (89%). Authors affiliated with a university are in the minority, although their percentage increased significantly from 10.9% in the previous period to 16.2% in the recent one (P=.001). Collaboration increased in the recent period in all categories: between hospitals in the same Spanish autonomous community (from 24.7% to 36%), in different communities (from 10.9% to 19%), or in different countries (from 2.3% to 8.4%) (P=.001, all comparisons). The most productive research areas were cardiovascular conditions (accounting for 13.1% of the publications), infectious diseases (13.0%), toxicology and pharmacology (9.2%), pediatric emergencies (8.0%), respiratory diseases (7.4%), cardiopulmonary resuscitation (6.7%), and management (6.0%). Catalonia produced the largest number of papers (427 [29.8%]). Hospital Clínic de Barcelona ranked first among hospitals publishing research, with 145 articles (11.4% of the total in this category); the emergency services of Madrid (SUMMA-112) ranked first among out-of-hospital research groups, with 43 publications (36.7% of the total in this category). Catalonia, Madrid, Castile-La Mancha, the Canary Islands, Murcia, the Balearic Islands, and La Rioja increased their contributions to Spanish productivity by 20% or more over their output in the earlier 5-year period. Nine of the 2010-2014 articles have already attracted enough cites to be considered citation classics. CONCLUSION: The productivity of Spanish emergency physicians continued to grow at a good pace in the 2010-2014 period. Publications in journals with IFs increased and there were significant changes in the dynamics of publication and the subjects covered.

OBJETIVO: Estudiar la producción científica de los urgenciólogos españoles durante el quinquenio 2010-2014 y compararla con la del quinquenio anterior (2005-2009). METODO: Se seleccionaron todos los documentos, excluyendo comunicaciones a congresos, firmados por urgenciólogos con filiación española localizados a través de Science Citation Index (SCI)-Expanded. Se recogieron variables sobre año de publicación, autores (número, filiación y orden de firma), revista y factor de impacto (FI), tipo de documento, citas recibidas y áreas de investigación. La búsqueda se realizó para el periodo 2010-2014 y se compararon los datos con datos históricos correspondientes a 2005-2009. RESULTADOS: Durante el quinquenio 2010-2014 se publicaron 1.433 documentos (52,4% artículos originales), un 56% más que en 2005-2009 (p = 0,01). La media de FI fue discretamente superior (2,587 frente a 2,483), la mediana menor (2,295 frente a 3,085), pero con un percentil 90 superior (4,036 frente a 3,085, p = 0,01), lo que muestra un incremento de publicaciones en revistas de alto FI. Los artículos continúan publicándose preferentemente en español-castellano (67,8%) aunque ha incrementado significativamente la producción en inglés (de 25,2% a 32,1%; p = 0,001). La actividad del urgenciólogo investigador es mayoritariamente en servicios de urgencias hospitalarios (SUH) (89%). La filiación universitaria de los autores es baja, aunque ha aumentado significativamente (de 10,9% a 16,2%; p = 0,001). Aumentó la colaboración, tanto con centros de la misma u otra comunidad autónoma (de 24,7% a 36%, y de 10,9% a 19%, respectivamente; p = 0,001 para ambos), como internacional (2,3% a 8,4%; p = 0,001). Las áreas de investigación con más documentos son cardiovascular (13,1%), infecciosas (13,0%), toxicología/farmacología (9,2%), pediatría (8,0%), neumología (7,4%), reanimación cardiopulmonar (6,7%) y organización (6,0%). Cataluña fue la comunidad que más documentos produjo (427; 29,8%). El Hospital Clínic lideró la producción hospitalaria (145, 11,4% de la producción de los SUH) y SUMMA- 112 la extrahospitalaria (43; 36,7% de la producción extrahospitalaria). Cataluña, Madrid, Castilla-La Mancha, Canarias, Murcia, Islas Baleares y La Rioja aumentaron su peso relativo en la producción española un 20% o más respecto al quinquenio previo. Nueve artículos de 2010-2014 ya han alcanzado consideración de clásicos de citación. CONCLUSIONES: La producción científica de los urgenciólogos españoles siguió creciendo a buen ritmo durante el quinquenio 2010-2014, con un incremento de publicaciones en revistas de alto FI, y se aprecian cambios significativos en la dinámica y la temática de investigación.

Los servicios de emergencias médicas en el Ecuador: una tarea pendiente / Medical emergency services in Ecuador: a outstanding task

Pre-hospital care is a relatively new discipli-ne within the field of medicine. However, it is becoming one of the most complex and important areas for the management of acute pathology. Pre-hospital services do not currently fit a unique model because they must meet countries' specific needs. The inadequate replication of a specific model could lead to failure of these services, causing ineffi-cient and inaccurate management of ti-me-dependent pathologies.In Ecuador, the development of pre-hos-pital emergency medical care has been uneven. Attempts to organize services have not been successful. A national pro-gram for emergency care is currently being implemented that aims to achieve coordi-nation among institutions. However, there are still problems related to organizational structure, which we discuss in this paper.

La atención prehospitalaria es una disciplina relativamente nueva en el campo de la medicina. Sin embargo, se está convirtiendo en una de las áreas más complejas e importantes para el manejo de la patología aguda.Los servicios prehospitalarios no encajan actualmente como un modelo único, pues deben cumplir con las necesidades específicas de cada país. La réplica inadecuada de un modelo específico podría llevar al fracaso de estos servicios, haciendo que la gestión sea ineficiente e inexacta en pa-tologías dependientes del tiempo.En Ecuador, el desarrollo de atención médica prehospitalaria de emergencia ha sido desigual. Los intentos de organizar los servicios no han tenido éxito. Un programa nacional para la atención de emergencia está siendo implementado actualmente, teniendo como objetivo, lograr la coordinación entre las instituciones. Sin embargo, todavía hay problemas relacionados con la estructura de la organización, lo que se discute en este trabajo.

Características y evolución temporal de las citas electrónicas de cuatro de las principales revistas biomédicas españolas / Characteristics and Longevity of Electronic Citations in Four Leading Biomedical Journals in Spain

Introducción y objetivos El objetivo es determinar la frecuencia de uso y la disponibilidad en función del tiempo de las citas electrónicas recogidas en Revista Española de Cardiología y otras tres revistas biomédicas españolas, así como los factores que pueden influir en la disponibilidad y la recuperabilidad de los enlaces. Métodos Estudio descriptivo transversal que incluyó todas las citas de los trabajos publicados en el primer número del año de las revistas seleccionadas en los años pares desde 2002 hasta 2012. Se recogieron datos de revista, publicación, citas y enlaces. Las variables resultado fueron: porcentaje de artículos con al menos una cita electrónica, porcentaje de cita electrónica respecto al total de citas y porcentaje de accesibilidad y recuperabilidad de los enlaces. Resultados Se incluyeron 377 trabajos, de los que 73 (19,4%; intervalo de confianza del 95%, 15,2-23,5) incluyeron al menos una cita electrónica, y 7.077 citas bibliográficas, de las que 164 (2,3%; intervalo de confianza del 95%, 2,0-2,7) fueron citas electrónicas. Revista Española de Cardiología incluyó 17 (15,2%) y 38 (1,3%) respectivamente. La frecuencia de uso se incrementó significativamente con el tiempo (tendencia lineal, p<0,001); 58 (35,4%; intervalo de confianza del 95%, 27,7-43,0) enlaces estaban accesibles y la información se recuperó en 55 casos (51,9%; intervalo de confianza del 95%, 41,9-61,9). La disponibilidad disminuyó significativamente con el tiempo (tendencia lineal, p<0,001); 45 citas electrónicas (27,5%; intervalo de confianza del 95%, 20,3-34,6) presentaban toda la información adicional. La recuperabilidad se ha relacionado significativamente con la cantidad de información adicional (tendencia lineal, p<0,001). Conclusiones Se está haciendo un uso cada vez más frecuente de citas electrónicas en ciertas revistas biomédicas españolas. La disponibilidad se pierde con el tiempo, y la probabilidad de recuperarla se relaciona con la información adicional (AU)

Introduction and objectives We aimed to determine the frequency of use and accessibility over time of electronic citations in Revista Española de Cardiología and 3 other Spanish biomedical journals, and to identify the factors that influence the accessibility and retrievability of these links. Methods A cross-sectional, descriptive study was performed of all the references in articles published in the first issue of each even year from 2002 to 2012 in selected journals. Data were collected on the journal, publication, references, and links. The variables analyzed were the percentage of articles with at least 1 electronic citation, the percentage of electronic citations with respect to the total number of citations in the full sample, and the percentages of link accessibility and retrievability. Results We included 377 articles, of which 73 (19.4%; 95% confidence interval, 15.2%-23.5%) had at least 1 electronic citation, and a total of 7077 references, of which 164 (2.3%; 95% confidence interval, 2.0%-2.7%) were electronic citations. Revista Española de Cardiología had 17 (15.2%) and 38 (1.3%), respectively. Use of electronic citations significantly increased over time (linear tendency, P < .001); 58 (35.4%; 95% confidence interval, 27.7%-43.0%), links were accessible, and information was retrieved in 55 cases (51.9%; 95% confidence interval, 41.9%-61.9%). Accessibility significantly decreased over time (linear tendency, P < .001); 45 electronic citations (27.5%; 95% confidence interval, 20.3%-34.6%) had complete additional information. Retrievability was significantly associated with the amount of additional information (linear tendency, P < .001). Conclusions Electronic citations are increasingly used in some Spanish biomedical journals. Access to electronic citations is lost over time, and the probability of its retrieval is associated with the existence of additional information

Characteristics and longevity of electronic citations in four leading biomedical journals in Spain.

INTRODUCTION AND OBJECTIVES: We aimed to determine the frequency of use and accessibility over time of electronic citations in Revista Española de Cardiología and 3 other Spanish biomedical journals, and to identify the factors that influence the accessibility and retrievability of these links. METHODS: A cross-sectional, descriptive study was performed of all the references in articles published in the first issue of each even year from 2002 to 2012 in selected journals. Data were collected on the journal, publication, references, and links. The variables analyzed were the percentage of articles with at least 1 electronic citation, the percentage of electronic citations with respect to the total number of citations in the full sample, and the percentages of link accessibility and retrievability. RESULTS: We included 377 articles, of which 73 (19.4%; 95% confidence interval, 15.2%-23.5%) had at least 1 electronic citation, and a total of 7077 references, of which 164 (2.3%; 95% confidence interval, 2.0%-2.7%) were electronic citations. Revista Española de Cardiología had 17 (15.2%) and 38 (1.3%), respectively. Use of electronic citations significantly increased over time (linear tendency, P < .001); 58 (35.4%; 95% confidence interval, 27.7%-43.0%), links were accessible, and information was retrieved in 55 cases (51.9%; 95% confidence interval, 41.9%-61.9%). Accessibility significantly decreased over time (linear tendency, P < .001); 45 electronic citations (27.5%; 95% confidence interval, 20.3%-34.6%) had complete additional information. Retrievability was significantly associated with the amount of additional information (linear tendency, P < .001). CONCLUSIONS: Electronic citations are increasingly used in some Spanish biomedical journals. Access to electronic citations is lost over time, and the probability of its retrieval is associated with the existence of additional information.