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Publication Bias in the Hand Surgery Literature
Nicholas J. Lemme, BS; Brian C. Drolet, MD; Benjamin R. Johnston, PhD; Jonathan Bass, MD; Edward Akelman, MD; Scott Schmidt, MD
Alpert Medical School, Brown University, Providence, RI

Introduction: Scientific publications are the primary vehicle for the delivery of novel experimental data and clinical practices in medicine. Therefore, it is important that research publications make meaningful contributions to the advancement of medical science. However, certain topics seem to dominate the published literature in many fields including hand surgery. Although it is not clear if this is a form of publication bias, or merely the primary focus of researchers in these fields, the most frequently published subjects in the hand surgery literature have never been quantified.

Methods: We reviewed each of the three major hand surgery journals HAND, Journal of Hand Surgery (American), and Journal of Hand Surgery (European) to identify the most frequently published topics in the hand literature. During the initial hypothesis-testing phase, we used content analysis to create a list of topic domains from a 6-month pilot period. We then reviewed each issue of the hand journals from May 2012 to May 2015 to quantify the total number of scientific articles according to topic domain. We also collected level of evidence, length, and frequency of citation for each article

Results: Two topics were significantly dominant: distal radius (DR) and flexor tendon (FT). DR accounted for the highest proportion of the published literature with 131 scientific articles in the 3-year period (7% of articles). These articles combined for a total of 754 pages, with an average length of 6.4 pages. DR articles were cited an average of 2.1 times annually following publication. We also identified 119 FT articles (6% of all articles), with an average length of 6.3 pages, and a total of 653 pages. Citation frequency for FT articles was 2.8 annually.

Conclusions: There is a high publication frequency of scientific articles on DR and FT injury and treatment in the hand surgery literature. Together these subjects accounted for 250 articles, 1407 pages, and 16% of all scientific publications in a 3-year period more than a two-volume textbook. It is unclear whether these results are due to topic publication bias or increased attention to these subjects by researchers. We believe such high frequency and volume of publication creates a challenge for many hand surgeons to keep up with the current literature and the standard of care for such subjects. Our future research will study the perception of hand surgeons regarding the frequency of these publications, and the overall impact on clinical practice.

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