Scientific publication trends of emergency department of International Federation for Emergency Medicine members, 2009 to 2018
a b s t r a c t
Background: Emergency medicine (EM) is a rapidly developing specialty worldwide. The Scientific publications trend is one of the parameters to evaluate national EM developmental milestones. This study was performed to analyze the publication trends from emergency departments (EDs) of International Federation for Emergency Medicine (IFEM) full member countries from 2009 to 2018.
Methods: All data were retrieved from the SciVerse Scopus database. IFEM full member countries where EM was recognized as a specialty before 2009 and annual publication numbers exceeded 12 in 2018 were included. The EM journals list was adopted from the 2017 Journal Citation Reports. Publications with the first author affiliated with EDs were divided into EM or non-EM journal groups according to the publishing journal. The slope (?) of the linear regression was used to assess the trends of publication numbers. The correlation between the 2009 publi- cation number and the trend of publication between 2009 and 2018 was measured by Pearson’s correlation co- efficient (r). The correlation between funding numbers and publication numbers was analyzed by Spearman’s rank correlation coefficient (rs).
Results: We identified 30,130 publications with first authors from EDs in 19 countries. The numbers of publica- tions in both EM and non-EM journals showed an increasing trend in 12 countries. Fifteen of the 19 countries had a greater increasing trend in non-EM journals than in EM journals. The 2009 publication numbers were pos- itively correlated with the publication increasing trend between 2009 and 2018 in both EM and non-EM journals (r = 0.854 and 0.947, respectively, both p < 0.001). The funded publication number was positively correlated with the total national publication amount (rs = 0.748, p < 0.001).
Conclusions: The research capacity of EDs has been increasingly recognized by other medical specialties. The na- tional publication numbers from EDs may predict the academic publication increasing trends in the subsequent 10 years.
(C) 2021
Emergency medicine (EM) is a relatively young Medical specialty [1]. Over the last half a century, EM has been recognized as an indepen- dent medical specialty in many countries [2]. The developmental mile- stones of EM, including the establishment of EM societies, publication of academic journals, standardization of resident training programs, and emergence as an independent medical specialty, has marked the evolution of EM in different countries [3]. However, these milestones could not provide dynamic and continuous evaluation of EM develop- ment after these static milestones had been achieved. The national sci- entific publication trend is a dynamic and continuous parameter that
* Corresponding author at: No.222, Maijin Rd., Anle Dist., Keelung City 204, Taiwan.
E-mail address: [email protected] (C.-H. Lee).
can be used to evaluate the research capacity and development of EM [4]. Publications and academic contributions were used previously to evaluate national EM development [5]. The publication trends from emergency departments (EDs), from a national perspective, may allow long-term evaluation and comparison of the worldwide academic de- velopment of EM as a discipline.
In 1991, national EM organizations from the UK, Australia, Canada, and the USA formed the International Federation for Emergency Medi- cine (IFEM) [6], which aimed to “promote access to, and lead the devel- opment of, the highest quality of Emergency medical care for all people” [7]. The IFEM full members are national EM organizations from coun- tries in which EM is officially recognized as a medical specialty and which also have recognized training programs in EM [6]. The IFEM full members grew from four in 1991 to more than 50 in 2019, making it the largest and most representative international EM organization.
https://doi.org/10.1016/j.ajem.2021.07.022
0735-6757/(C) 2021
Fig. 1. The inclusion process of study countries from the International Federation for Emergency Medicine (IFEM) full member countries. The countries are listed in alphabetical order.
Being one of the full members of IFEM also remarks the national EM de- velopmental milestone.
This study was performed to analyze the trends of scientific publica- tions from EDs of IFEM full member countries from 2009 to 2018 to evaluate the national academic EM developmental milestones.
This was an observational study, and it qualified for a waiver from our Institutional Review Board because no human subjects were involved.
All data were retrieved from the SciVerse Scopus database [8]. The EM journals list (Table A.1) was adopted from the 2017 Journal Citation Reports (JCR) category of EM [9]. Non-EM journals were journals not classified into the JCR EM category. The journals classified into the EM category in the previous version of JCR but not in the 2017 JCR were classified as non-EM journals. The study period was between 2009 and 2018. The inclusion criteria of study countries were: (1) IFEM full members [10]; (2) EM was recognized as an independent specialty be- fore 2009, the year our study period began; and (3) > 12 annual publi- cations in 2018, the year our study period ended. Publications with first authors affiliated with EDs were classified as ED originating publications.
A computer-assisted literature search was conducted using the SciVerse Scopus database in December 2019. Publications with authors affiliated with EDs were retrieved using the search terms “AFFILCOUNTRY(Country) AND AFFIL(emergency) AND PUBYEAR AFT
2009 AND PUBYEAR BEF 2019″. The search term “Country” referred to the included country names of IFEM full members. One of the authors reviewed the results to retrieve publications with first authors affiliated with EDs according to the protocol listed below. The downloaded re- sults were documented in a spreadsheet. The column with author affil- iations and the first author’s affiliation were identified. The first author affiliated with the following affiliations, “emergency department”, “de- partment of emergency medicine”, “Dept Emergency Med”, “accident and emergency department” or “department of accident and emer- gency medicine” was defined as first author affiliated with EDs. A computer-assisted text search was conducted to facilitate the process and eliminate bias. Using this search string, we identified publications with first authors affiliated with EDs. The remaining publications were classified into EM and non-EM journal groups. We collected data re- garding publications, including journal name, Publication year, and funding for further analysis.
-
- Measurements
The primary outcome measure was the correlation between the na- tional publication numbers in 2009 and the increasing trend of publica- tion numbers between 2009 and 2018 to evaluate the relationship between publication number and the increasing trend of publication in the subsequent 10 years.
The secondary outcome measures were: (1) the annual national publication number in EM, non-EM journals, and total publication num- bers; (2) the increasing trends of national publication number in EM, non-EM journals, and total publications between 2009 and 2018; and
(3) the correlation between funding numbers and publication numbers of study countries.
-
- Data analysis
Linear regression was used for trend analysis and the slope (?) of lin- ear regression was used to represent the trend. The correlation between
Publication numbers in EM journals, non-EM journals, and total publications group. (EM: emergency medicine)
Country |
Field |
2009 |
2010 |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
2017 |
2018 |
Total |
Australia |
EM |
69 |
68 |
77 |
74 |
96 |
81 |
85 |
88 |
87 |
105 |
830 |
Non-EM |
58 |
78 |
60 |
45 |
61 |
74 |
73 |
60 |
65 |
53 |
627 |
|
Total |
127 |
146 |
137 |
119 |
157 |
155 |
158 |
148 |
152 |
158 |
1457 |
|
Canada |
EM |
66 |
70 |
78 |
76 |
60 |
92 |
93 |
90 |
105 |
167 |
897 |
Non-EM |
65 |
60 |
60 |
75 |
85 |
87 |
115 |
105 |
125 |
148 |
925 |
|
Total |
131 |
130 |
138 |
151 |
145 |
179 |
208 |
195 |
230 |
315 |
1822 |
|
Hong Kong |
EM |
52 |
32 |
37 |
18 |
22 |
18 |
15 |
24 |
20 |
14 |
252 |
Non-EM |
10 |
12 |
9 |
15 |
10 |
9 |
10 |
14 |
7 |
13 |
109 |
|
Total |
62 |
44 |
46 |
33 |
32 |
27 |
25 |
38 |
27 |
27 |
361 |
|
India |
EM |
0 |
0 |
1 |
3 |
11 |
14 |
8 |
4 |
4 |
5 |
50 |
Non-EM |
13 |
15 |
13 |
23 |
32 |
42 |
38 |
67 |
41 |
45 |
329 |
|
Total |
13 |
15 |
14 |
26 |
43 |
56 |
46 |
71 |
45 |
50 |
379 |
|
Iran |
EM |
0 |
9 |
9 |
11 |
14 |
17 |
15 |
11 |
10 |
14 |
110 |
Non-EM |
1 |
7 |
20 |
34 |
40 |
65 |
46 |
66 |
62 |
62 |
403 |
|
Total |
1 |
16 |
29 |
45 |
54 |
82 |
61 |
77 |
72 |
76 |
513 |
|
Ireland |
EM |
7 |
11 |
4 |
4 |
10 |
7 |
6 |
4 |
2 |
4 |
59 |
Non-EM |
6 |
10 |
12 |
13 |
12 |
8 |
7 |
18 |
13 |
20 |
119 |
|
Total |
13 |
21 |
16 |
17 |
22 |
15 |
13 |
22 |
15 |
24 |
178 |
|
Israel |
EM |
9 |
4 |
5 |
7 |
7 |
7 |
9 |
5 |
3 |
9 |
65 |
Non-EM |
13 |
14 |
9 |
11 |
9 |
13 |
15 |
24 |
21 |
21 |
150 |
|
Total |
22 |
18 |
14 |
18 |
16 |
20 |
24 |
29 |
24 |
30 |
215 |
|
Poland |
EM |
0 |
0 |
1 |
0 |
1 |
2 |
14 |
44 |
23 |
7 |
92 |
Non-EM |
8 |
6 |
7 |
12 |
17 |
18 |
21 |
28 |
19 |
33 |
169 |
|
Total |
8 |
6 |
8 |
12 |
18 |
20 |
35 |
72 |
42 |
40 |
261 |
|
Saudi Arabia |
EM |
3 |
1 |
1 |
1 |
1 |
1 |
0 |
0 |
5 |
1 |
14 |
Non-EM |
9 |
11 |
10 |
2 |
6 |
7 |
10 |
11 |
8 |
14 |
88 |
|
Total |
12 |
12 |
11 |
3 |
7 |
8 |
10 |
11 |
13 |
15 |
102 |
|
Singapore |
EM |
10 |
10 |
13 |
9 |
15 |
10 |
11 |
14 |
10 |
10 |
112 |
Non-EM |
24 |
15 |
27 |
10 |
15 |
20 |
16 |
19 |
28 |
25 |
199 |
|
Total |
34 |
25 |
40 |
19 |
30 |
30 |
27 |
33 |
38 |
35 |
311 |
|
EM |
3 |
5 |
4 |
1 |
6 |
5 |
2 |
6 |
9 |
8 |
49 |
|
Non-EM |
3 |
8 |
22 |
18 |
15 |
18 |
18 |
26 |
28 |
42 |
198 |
|
Total |
6 |
13 |
26 |
19 |
21 |
23 |
20 |
32 |
37 |
50 |
247 |
|
South Korea |
EM |
29 |
33 |
53 |
74 |
77 |
64 |
74 |
68 |
87 |
91 |
650 |
Non-EM |
30 |
46 |
60 |
68 |
80 |
72 |
110 |
130 |
123 |
180 |
899 |
|
Total |
59 |
79 |
113 |
142 |
157 |
136 |
184 |
198 |
210 |
271 |
1549 |
|
Sweden |
EM |
1 |
0 |
9 |
5 |
5 |
1 |
3 |
6 |
9 |
13 |
52 |
Non-EM |
26 |
21 |
17 |
17 |
15 |
8 |
14 |
15 |
12 |
12 |
157 |
|
Total |
27 |
21 |
26 |
22 |
20 |
9 |
17 |
21 |
21 |
25 |
209 |
|
Taiwan |
EM |
50 |
50 |
46 |
61 |
67 |
49 |
47 |
39 |
43 |
44 |
496 |
Non-EM |
117 |
96 |
123 |
120 |
134 |
112 |
135 |
148 |
147 |
149 |
1281 |
|
Total |
167 |
146 |
169 |
181 |
201 |
161 |
182 |
187 |
190 |
193 |
1777 |
|
Thailand |
EM |
0 |
0 |
0 |
0 |
1 |
0 |
0 |
3 |
4 |
3 |
11 |
Non-EM |
0 |
3 |
3 |
6 |
7 |
8 |
9 |
16 |
17 |
13 |
82 |
|
Total |
0 |
3 |
3 |
6 |
8 |
8 |
9 |
19 |
21 |
16 |
93 |
|
The Netherlands |
EM |
3 |
2 |
3 |
6 |
7 |
6 |
9 |
16 |
12 |
15 |
79 |
Non-EM |
13 |
12 |
23 |
21 |
22 |
24 |
19 |
30 |
25 |
26 |
215 |
|
Total |
16 |
14 |
26 |
27 |
29 |
30 |
28 |
46 |
37 |
41 |
294 |
|
Turkey |
EM |
50 |
55 |
53 |
57 |
69 |
74 |
84 |
94 |
52 |
61 |
649 |
Non-EM |
57 |
74 |
70 |
97 |
136 |
180 |
181 |
156 |
123 |
121 |
1195 |
|
Total |
107 |
129 |
123 |
154 |
205 |
254 |
265 |
250 |
175 |
182 |
1844 |
|
United Kingdom |
EM |
78 |
68 |
66 |
57 |
51 |
54 |
45 |
43 |
41 |
52 |
555 |
Non-EM |
56 |
69 |
74 |
79 |
73 |
73 |
60 |
66 |
71 |
93 |
714 |
|
Total |
134 |
137 |
140 |
136 |
124 |
127 |
105 |
109 |
112 |
145 |
1269 |
|
United States |
EM |
750 |
731 |
899 |
1048 |
948 |
860 |
891 |
968 |
980 |
962 |
9037 |
Non-EM |
483 |
612 |
729 |
743 |
727 |
747 |
874 |
1005 |
1093 |
1199 |
8212 |
|
Total |
1233 |
1343 |
1628 |
1791 |
1675 |
1607 |
1765 |
1973 |
2073 |
2161 |
17,249 |
the 2009 publication numbers and the trend of publication between 2009 and 2018 was evaluated by Pearson’s correlation coefficient (r). Spearman’s rank correlation coefficient (rs) was calculated to analyze the correlation between funding numbers and publication numbers. All analyses were performed by IBM SPSS Statistics (version 22; IBM Corp., Armonk, NY, USA).
Of the 52 IFEM full members (Table A.2), seven countries were ex- cluded because EM was not recognized as a medical specialty before 2009 [11-17], and 26 countries were excluded because the annual
publication number in 2018 was less than 12 (Fig. 1). Of the remaining 19 countries, a total of 30,130 publications between 2009 and 2018 had first authors affiliated with EDs. These publications were classified into the EM journals group or non-EM journals group according to the pub- lishing journals shown in Table 1. The national annual total publication numbers are shown in Fig. 2. Between 2009 and 2018, the publication numbers in non-EM journals exceeded those in EM journals in 16 of the 19 study countries.
The publication trends (?) of the EM journals group, non-EM journals group, and total publications group are shown in Table 2. Four- teen countries showed positive increasing trends in EM journal publica- tions, and they were statistically significant in six of these countries. The
Fig. 2. a and b. Annual total publication numbers between 2009 and 2018.
Fig. 2 (continued).
leading five countries with increasing publication trends in EM journals were the USA, Canada, South Korea, Australia, and Poland. Seventeen countries showed positive increasing trends in non-EM journal publica- tions, 12 of which were statistically significant. The leading five coun- tries with increasing publication trends in non-EM journals were the USA, South Korea, Turkey, Canada, and Iran. Sixteen countries showed positive increasing trends in total journal publications, 13 of which were statistically significant. The leading five countries with increasing publication trends in total journals were the same as for non-EM journals, i.e., the USA, South Korea, Canada, Turkey, and Iran. Canada, South Korea, Thailand, and the Netherlands showed significant positive publication trends in both EM and non-EM journals. The trends of pub- lication in EM and non-EM journals between 2009 and 2018 are plotted in Fig. 3. Fifteen countries showed greater increasing trends in non-EM journals than in EM journals. In nine of these 15 countries, the 95% con- fidence interval (95% CI) of increasing trends in EM and non-EM journals did not overlap.
The correlation between the publication numbers in 2009 and the increasing publication trends between 2009 and 2018 in EM and non- EM journals are shown in Fig. 4 and Fig. 5, respectively. The Pearson’s Correlation coefficients (r) were 0.854 for EM journals and 0.947 for non-EM journals (both p < 0.001).
Among the total of 30,130 publications, 4189 were funded re- searches. The USA was found to have the greatest number of funded publications (3165), followed by Taiwan (276), South Korea (210), Canada (171), and Australia (107). The leading five countries with the highest proportion of funded publications were Sweden (48/209, 22.97%), followed by Thailand (20/93, 21.51%), the USA (3165/17249, 18.35%), Taiwan (276/1777, 15.53%), and South Korea (210/1549, 13.56%). The Spearman’s rank correlation coefficient (rs) between pub- lication numbers and funded publication numbers for the 19 study countries was 0.748 (p < 0.001).
- Discussion
The numbers of EM journals increased more rapidly than in other medical specialties between 2000 and 2009 [18]. Publications by
emergency physicians in 24 EM journals increased from 1124 in 2008 to 1650 in 2017 [19]. These results indicating the rapid global develop- ment of academic EM. Emergency medicine is a cross-disciplinary spe- cialty. Therefore, researches originated from EDs may also be published in non-EM journals. In the present study, we analyzed scien- tific publications originating in EDs from IFEM full member countries in which EM was recognized as an independent specialty before 2009 to determine the evolution of academic EM performance from an interna- tional perspective.
A previous study reported that the publication numbers and increas- ing trend of ED originating research were higher in non-EM journals than in EM journals in Taiwan [5]. This may have been because EM is a cross-disciplinary medical specialty. As the quality and quantity of ED originating research increase, the publications from EDs will be ac- cepted by journals in other specialties that are related to EM. It was un- clear whether this situation was unique to Taiwan or a common characteristic of the evolution of EM in other countries. The present study showed that in several IFEM full member countries, the publica- tion numbers and increasing trend of ED originating research in non- EM journals also exceeded those in EM journals. The results indicated that, in these countries, the academic contributions of EDs have been recognized not only in the field of EM but are also rapidly increasing in other medical specialties. The trend can be rationalized from both in- dividual and national perspectives. From individual perspective, the phenomenon of “publish-or-perish” forced the researchers to publish and pursue citations. More publication number, citations, and high im- pact factor of publishing journals lead to more funding to the institute and also personal Academic promotion [20,21]. The category aggregate impact factor in JCR referred to the average publication citations in cer- tain category [9]. The aggregate impact factor of category of EM rank last among 12 categories of clinical medicine [18]. Publications in non-EM journals might have a higher chance of being cited, which is helpful in promotion and applying for funding. Therefore, EM researchers may tend to submit their researches to non-EM journals prior than EM journals in order to obtain higher chance to be cited. The similar mindset had been discussed in previous study on ED researchers’ pref- erence to submit to international or domestic journals in order to get
Fig. 3. Correlation between the trends of publications in EM and non-EM journals between 2009 and 2018. (EM: emergency medicine).
Fig. 4. Correlations between publication numbers in 2009 and publication trends between 2009 and 2018 in EM journals. (EM: emergency medicine).
Fig. 5. Correlations between publication numbers in 2009 and publication trends between 2009 and 2018 in non-EM journals. (EM: emergency medicine).
National publication trends (?) in EM journals, non-EM journals, and total publications from 2008 to 2019. (EM: emergency medicine; CI: confidence interval) Country EM journals Non-EM journals Total
Trend (?) |
p-value |
95% CI |
Trend (?) |
p-value |
95% CI |
Trend (?) |
p-value |
95% CI |
||||
Australia |
3.212 |
0.003 |
1.442 to 4.982 |
-0.236 |
0.846 |
-2.952 to 2.480 |
2.976 |
0.040 |
0.181 to 5.771 |
|||
Canada |
7.861 |
0.008 |
2.716 to 13.005 |
9.388 |
0.000 |
6.866 to 11.910 |
17.248 |
0.000 |
10.370 to 24.127 |
|||
Hong Kong |
-3.055 |
0.008 |
-5.073 to -1.036 |
0.006 |
0.984 |
-0.671 to 0.683 |
-3.048 |
0.007 |
-4.987 to -1.110 |
|||
India |
0.642 |
0.233 |
-0.507 to 1.792 |
4.818 |
0.002 |
2.312 to 7.325 |
5.461 |
0.003 |
2.472 to 8.450 |
|||
Iran |
0.958 |
0.058 |
-0.043 to 1.959 |
7.424 |
0.000 |
4.881 to 9.967 |
8.382 |
0.000 |
5.196 to 11.568 |
|||
Ireland |
-0.527 |
0.097 |
-1.174 to 0.120 |
0.939 |
0.050 |
-0.002 to 1.881 |
0.412 |
0.390 |
-0.633 to 1.457 |
|||
Israel |
-0.006 |
0.982 |
-0.591 to 0.579 |
1.285 |
0.015 |
0.327 to 2.242 |
1.279 |
0.017 |
0.297 to 2.260 |
|||
Poland |
2.921 |
0.059 |
-0.143 to 5.986 |
2.721 |
0.000 |
1.763 to 3.680 |
5.642 |
0.004 |
2.324 to 8.960 |
|||
Saudi Arabia |
0.012 |
0.947 |
-0.393 to 0.417 |
0.327 |
0.398 |
-0.518 to 1.173 |
0.339 |
0.400 |
-0.541 to 1.219 |
|||
Singapore |
0.036 |
0.883 |
-0.513 to 0.586 |
0.503 |
0.477 |
-1.052 to 2.058 |
0.539 |
0.469 |
-1.098 to 2.177 |
|||
South Africa |
0.515 |
0.056 |
-0.016 to 1.046 |
3.115 |
0.001 |
1.676 to 4.554 |
3.630 |
0.001 |
2.033 to 5.228 |
|||
South Korea |
6.048 |
0.001 |
3.323 to 8.774 |
14.285 |
0.000 |
10.586 to 17.984 |
20.333 |
0.000 |
15.980 to 24.686 |
|||
Sweden |
0.885 |
0.046 |
0.019 to 1.751 |
-1.303 |
0.007 |
-2.145 to -0.461 |
-0.418 |
0.494 |
-1.763 to 0.927 |
|||
Taiwan |
-1.200 |
0.214 |
-3.250 to 0.850 |
4.806 |
0.003 |
2.157 to 7.456 |
3.606 |
0.041 |
0.194 to 7.019 |
|||
Thailand |
0.418 |
0.006 |
0.157 to 0.679 |
1.758 |
0.000 |
1.228 to 2.287 |
2.176 |
0.000 |
1.449 to 2.902 |
|||
The Netherlands |
1.521 |
0.000 |
0.998 to 2.045 |
1.448 |
0.007 |
0.510 to 2.387 |
2.970 |
0.000 |
1.776 to 4.163 |
|||
Turkey |
2.236 |
0.189 |
-1.359 to 5.832 |
9.970 |
0.032 |
1.086 to 18.853 |
12.206 |
0.046 |
0.289 to 24.123 |
|||
United Kingdom |
-3.461 |
0.001 |
-5.011 to -1.910 |
1.515 |
0.193 |
-0.941 to 3.972 |
-1.945 |
0.226 |
-5.367 to 1.476 |
|||
United States |
20.830 |
0.053 |
-0.389 to 42.050 |
70.327 |
0.000 |
54.201 to 86.454 |
91.158 |
0.000 |
61.806 to 120.510 |
more citations [22]. When the theme and quality of EM research can be recognized by both EM and non-EM journals, this consideration leads to research been published more in non-EM journals than in EM journals. From the national perspective, the national ED originating research in non-EM journals exceeded those in EM journals indicated that most of the theme and quality of EM research were recognized by not only EM field but also other specialties. Therefore, we propose that the differ- ences between publication numbers and trends in EM and non-EM journals may be a benchmark of academic EM development and could be adopted as a dynamic developmental milestone of national academic EM. Further studies over longer periods and in more countries are needed to confirm and validate this inference. On the other hand, fur- ther research is needed to determine whether the observation that in- creasing trends in publication number in non-Specialty journals outweigh those in specialty journals is unique to EM or is also the case in other medical specialties.
Our analysis demonstrated a positive correlation between publica- tion numbers in 2009 and publication increasing trends between 2009 and 2018 in both EM and non-EM journals. This indicated that the pub- lication numbers in a specific year may predict the academic EM devel- opmental trend in the subsequent 10 years. A similar prediction has also been made in the academic performance of EM journals [18]. The phe- nomenon in EM journals was considered to be the result of a positive feedback effect in which high impact factor journals attract more high-quality research, leading to a more Rapid increase in impact factors in subsequent years. The phenomenon in national ED originating publi- cations demonstrated in our study may also have resulted from positive feedback between research infrastructure and research outcome. The performance of medical research is reliant on multiple types of infra- structure, including funding, research labs, quality and quantity of re- searchers, and health care systems [23]. Our study disclosed that in academic EM, funded publication number was positively correlated with the total amount of national publications. More robust research en- vironments resulted in more publications, and more publications attract more resources that make the environment more robust in the future. This positive feedback may explain why the publication numbers in a specific year may predict the publication increasing trend in the subse- quent 10 years. Scientific publication numbers increase faster in leading countries results in an increasing gap between leading and other coun- tries. Further studies and international collaborations are required to develop interventions to reduce the academic gap between leading
and other countries, to improve global EM development regardless of current academic performance.
The study by Kokulu et al. [19], which focused on the publications by emergency physicians in 24 EM journals between 2007 and 2018 is comparable to our study. The leading five countries with publication numbers in Kokulu’s study were the USA, Canada, Australia, Turkey, and the UK. In our study, the leading five countries in 26 EM journals were the USA, Canada, Australia, South Korea, and Turkey. The rank of leading countries was similar regardless of whether the inclusion criteria in Kokulu’s study were “emergency physicians in the main pro- ductive countries which had produced at least 1% of the overall publica- tions from 2008 to 2017”, or “EDs of IFEM member countries which EM was recognized as an independent specialty before 2009” in our study. This indicated that the ranks of leading countries in publication num- bers in EM journals did not vary significantly with different inclusion criteria. The leading five countries in non-EM journals in our study were the USA, Taiwan, Turkey, Canada, and South Korea. The variation in ranking indicated that viewpoints from non-EM journals provided a different and comprehensive perspectives on publications from EDs. The national publication number increasing rate in Kokulu’s study was evaluated by average annual growth rate and the leading five countries were South Korea, Turkey, Spain, Germany, and Canada. In our study, linear regression was used to evaluate increasing rate and the leading five countries were the USA, Canada, South Korea, Australia, and Poland. The methods for evaluating an increase in publications deserve discussion. First, the average annual growth rate was determined by publication numbers in 2008 and 2017. The publication numbers in- between did not contribute to the average annual growth rate. The trend of linear regression was determined by all the annual publication numbers which reflected the influence of every year in the study period. Second, growth rate may be influenced by base period. The same incre- ment in lower base period results in higher growth rate. Countries with relatively small base period are favored in the calculation of average an- nual growth rate.
- Limitations
This study has some limitations. First, 33 of the 52 IFEM full member countries with low publication numbers or in which EM was not an independent specialty before 2009 were not included within the scope of this study. Countries with few publications or where EM is
not an independent specialty require other measurements to continu- ously evaluate their evolution. Second, this study evaluated academic performance according to the number of publications with first authors affiliated with EDs. The themes of these publications, study design, indi- cators of impact including Citation numbers, journal impact factor, H index, and publications with co-authors affiliated with EDs were not evaluated. Qualitative analysis of research and collaborations between emergency physicians and other medical specialties may demonstrate academic performance from different perspectives. Future studies should focus on these fields to achieve a more comprehensive evalua- tion of academic EM performance.
- Conclusions
EM is a continuous growing specialty worldwide from the perspec- tive of scientific publications. The research capacities of EDs of the lead- ing countries have also been increasingly accepted and acknowledged by other medical specialties. The publication numbers may predict the publication trends for the subsequent 10 years.
Financial support
This study was unfunded.
Declaration of Competing Interest
HHC, CWC and CHL report no conflict of interest.
Appendix A. Appendices
Table A.1 List of journals in the 2017 Journal Citation Reports category of emergency medicine. Rank according to 2017 journal impact factor. (*ISSN: International Standard Serial Number)
Full Journal Title ISSN*
Resuscitation 0300-9572
Annals of Emergency Medicine 0196-0644
Emergencias 1137-6821
World Journal of Emergency Surgery 1749-7922
Academic Emergency Medicine 1069-6563
Scandinavian Journal of Trauma Resuscitation & Emergency Medicine 1757-7241 prehospital emergency care 1090-3127
Injury-International Journal of The Care of The Injured 0020-1383
Emergency Medicine Journal 1472-0205
European Journal of Emergency Medicine 0969-9546
European Journal of Trauma and Emergency Surgery 1863-9933
Canadian Journal of Emergency Medicine 1481-8035
Emergency Medicine Clinics of North America 0733-8627
Emergency Medicine Australasia 1742-6731
American Journal of Emergency Medicine 0735-6757
Journal of Emergency Medicine 0736-4679
Pediatric Emergency Care 0749-5161
Prehospital and Disaster Medicine 1049-023x
Unfallchirurg 0177-5537
Journal of Emergency Nursing 0099-1767
Notfall & Rettungsmedizin 1434-6222
Ulusal Travma ve Acil Cerrahi Dergisi-Turkish Journal of Trauma & Emer- 1306-696x gency Surgery
Emergency Medicine International 2090-2840
Notarzt 0177-2309
Hong Kong Journal of Emergency Medicine 1024-9079
Signa Vitae 1334-5605
Table A.2
International Federation for Emergency Medicine full member countries in alphabetical order.
Argentina |
Hungary |
Oman |
Sudan |
Australia |
Iceland |
Pakistan |
Sweden |
Bahrain |
India |
Papua New Guinea |
Taiwan |
Canada |
Iran |
Paraguay |
Tanzania |
Chile |
Iraq |
Panama |
Thailand |
Colombia |
Ireland |
Peru |
The Netherlands |
Costa Rica |
Israel |
Philippines |
Trinidad and Tobago |
Denmark |
Japan |
Poland |
Turkey |
Dominican |
Libya |
Rwanda |
United Arab Emirates |
Finland |
Malaysia |
Saudi Arabia |
United Kingdom |
Georgia |
Mexico |
Singapore |
United States |
Ghana |
Nepal |
South Africa |
Vietnam |
Hong Kong |
Norway |
South Korea |
Yemen |
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