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Peer-Review Publication Patterns: A Comparison of International Radiography Journals
Journal of Medical Imaging and Radiation Sciences
Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Journal de l’imagerie médicale et des sciences de la radiation
www.elsevier.com/locate/jmir
Peer-Review Publication Patterns: A Comparison of International Radiography Journals Beverly A. Snaith, FCR, MSc* Lead Consultant Radiographer, Department of Radiology, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Wakefield, UK
ABSTRACT Background: Evidence-based practice is an expectation of all health care professionals, and the unique knowledge base of a profession is established through research and synthesis and most commonly shared through peer-review publication. The number of peerreview radiography journals has been increasing, and this bibliometric study aims to review the radiography profession in terms of these publications to explore the evidence base and identify its evolution internationally. Method: Four peer-review journals were examined over an eight-year period (2004–2011): the Journal of Medical Imaging and Radiation Sciences, Radiography, The South African Radiographer, and The Radiographer. The number and nationality of authors were collected, with whole counting of authors. Specific metrics allowed examination of author collaboration. Analysis of article type and subject enabled comparison of research and publication trends at the journal, author, and country levels. Results: Eight hundred thirty-five articles met the inclusion criteria, with 1,999 contributing authors and 43 countries represented. Differences in the type of articles were also evident, with research predominating. The data demonstrated an increase in the total number of authors contributing to individual articles, with resultant larger collaborative groups. Overall research articles comprised almost half of the articles published (410/835; 49.1%). In relation to subject, just over half of the articles were focused on a clinical practice topic (427/835; 51.1%), with the majority presenting research findings (228/427; 53.4%). Conclusions: This study suggests that radiography journal publication is active internationally. Research-focused and clinical practice articles predominate, but it is important that the area of radiography does not become complacent.
* Corresponding author: Ms. Beverly A. Snaith, Department of Radiology, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Aberford Road, Wakefield WF1 4DG, UK. E-mail address: [email protected] 1939-8654/$ - see front matter Ó 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jmir.2012.11.003
RESUM E Introduction: On s’attend a une pratique fondee sur la preuve de la part de tous les professionnels de la sante et la base des connaissances uniques a chaque profession est etablie par la recherche et la synthese, et le plus souvent communiquee par les revues a comite de lecture. Le nombre de revues a comite de lecture en radiographie a augmente et cette etude bibliometrique vise a examiner la profession de la radiographie a la lumiere de ces publications, dans le but d’explorer la base de preuve professionnelle et de determiner son evolution a l’echelle internationale. Methodologie: Quatre revues a comite de lecture ont fait l’objet d’un examen sur une periode de huit ans (2004–2011) : le Journal of Medical Imaging and Radiation Sciences, Radiography, South African Radiographer et The Radiographer. Le nombre d’auteurs et leur nationalite ont ete compiles, avec un decompte complet des auteurs. Des mesures specifiques ont permis d’examiner la collaboration entre les auteurs. L’analyze du type et du sujet des articles a permis de comparer les tendances en matiere de recherche et de publication, tant de la revue et de l’auteur que du pays. Resultats: 835 articles ont satisfait les criteres d’inclusion, representant 1 999 auteurs et 43 pays. Des differences dans le type des articles sont aussi apparues de fac¸on evidente, la recherche occupant la premiere place. Les donnees montrent une augmentation du nombre total d’auteurs contribuant a chaque article, avec des groupes de collaboration necessairement plus importants. Dans l’ensemble, les articles portant sur des travaux de recherche representent pres de la moitie des articles publies (n ¼ 410/835; 49,1 %). En ce qui a trait au sujet, un peu plus de la moitie des articles traitent d’un sujet de pratique clinique (n ¼ 427/835; 51,1 %), la majorite d’entre eux presentant des resultats de recherche (n ¼ 228/427; 53,4 %). Conclusion: Cette etude laisse voir que la publication des revues en radiographie est active a l’echelle internationale. Les articles sur la recherche et la pratique clinque predominent, mais il est important que la radiographie ne sombre pas dans la complaisance.
Introduction Evidence-based practice is an expectation of all health care professionals, whether clinically or academically employed, and it is
based on the understanding that practitioners will use and develop standards for optimal diagnosis and treatment. In practice, the evidence or knowledge base within an individual profession is established through research and synthesis, and it is most commonly shared through peer-review articles, textbook publication, or presentation of findings at conferences [1]. Over the past three decades, the radiography profession has evolved from hospital-based training to degree entry with opportunity and, in some countries, expectation for postgraduate and doctoral education. Alongside other nonmedical health professions, such as nursing and physiotherapy, radiography has built its own evidence base parallel to, and overlapping with, medical colleagues demonstrating a professional and academic maturity. As a result, the number of peerreview radiography journals has been increasing. Initially professional magazines, these journals have emerged as publications with an international readership and editorial boards, although none have yet achieved an impact factor. It is therefore timely to review the radiography profession in terms of these publications to explore the professional evidence base and identify its evolution internationally. The exploration of the unique characteristics of publication and its changes over time may be referred to as bibliometric research. Bibliometrics is a growing research field that has evolved over the past 50 years and is defined as ‘‘the application of mathematical and statistical methods to books and other communication medium’’ [2]. The most well-known methods are citation analysis and journal impact factor, both of which provide measures, or the inference, of the number of times a specific article has been referenced by others [3, 4], and a small number of previous studies in related imaging or oncology fields have focussed on these factors [5–7]. However, there are opportunities for a broader review of publication patterns, and this article builds on a recently published longitudinal review of the UK Radiography journal [8] and compares international peer-review journals within the radiography profession to identify publication patterns and trends. In this context, radiography describes the diagnostic and therapeutic disciplines, whose title may include radiographer, radiologic technologist, or radiation therapist, but for simplicity, in this article the single term ‘radiographer’ will be used.
Method
Although additional journals were identified, they were focussed on a single discipline or modality area (eg, Journal of Radiotherapy in Practice [therapy]; Radiation Therapist [therapy]; Radiologic Technology [diagnostic]; Ultrasound [sonography]) and, therefore, considered outside the scope of this study. A convenience sample approach was taken, and, given the variation in date of establishment of the journals in their current peer-review format, a common eight-year period (2004– 2011) was chosen. Research, review, guest editorials, and letters were included; however, book reviews, editorials, and professional columns were excluded, as this study related to novel professional publications contributing to the evidence base rather than pure information sharing. Data were collated and analyzed using Excel (Microsoft 2007). Statistical analysis was performed to identify patterns of authorship, including coauthorship and productivity, at the institutional, intranational, and international levels. A number of bibliometric indicators have been developed that allow analysis of specific factors, including the collaboration index (CI), the average number of authors per article; degree of collaboration (DC), the proportion of multiauthored articles; and collaboration coefficient (RCC), which provides a more representative numerical picture of collaboration, with fractionalized calculation of authors at this level. The analysis followed the method described by Liao and Yen [9] and provides the most effective evaluation of coauthorship. Categorization of article type followed the Cumulated Index to Nursing and Allied Health Literature (CINAHL) criteria used by Fayland [10] in her review of the nursing literature as (1) research (original research or systematic review), (2) journal article (nonsystematic review, discussion, or directed reading), (3) clinical literature (clinical innovation, case study, guidelines, or interventions), or (4) opinion piece (guest editorial, letter, or short communication). The number and nationalities of authors, together with the article subjects, were also collected, with whole counting of authors. Subject analysis enabled comparison of research and publication trends at the journal, author, and country levels.
Results
Given the two radiography disciplines, diagnostic and therapy, journals were limited to those whose aims and objectives were inclusive to both in order to identify changes in professional practice, role, and output across the whole profession. Limitations were also set in terms of English language and peer review. No single index covers all radiography journals, but a wider search elicited four journals for inclusion in this discussion: 1. Journal of Medical Imaging and Radiation Sciences (JMIRS) 2. Radiography 38
3. The Radiographer 4. The South African Radiographer (SAR)
A total of 835 articles met the inclusion criteria, with 1,999 contributing authors (Table 1). The majority of articles were published in the UK journal Radiography (447/835; 53.5%). Unfortunately, because there was no consistency across the journals in the reporting of author qualifications or job title, only their affiliation, the contribution of nonradiographers to publication is unknown. Although there were 1,999 contributing authors, this represented only 1,306 unique author names. Of these, 77.5% of authors were associated with a single article (1,012/1,306) with a maximum contribution to 19 articles by a single individual.
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Table 1 Overview of the Four Radiography Journals from 2004 to 2011 Journal
Country
Issues/year (No.)
Articles/year (Mean)
Total articles
Total authors
Journal of Medical Imaging and Radiation Sciences Radiography The South African Radiographer The Radiographer Total
Canada UK South Africa Australia
4 4* 2 4
23 55.9 7.9 17.6
184 447 63 141 835
433 1,116 102 348 1,999
*
Plus supplements.
A 42% increase in published articles was seen between 2004 and 2011, however, the number of articles published in The Radiographer and SAR remained relatively unchanged, with JMIRS and Radiography articles increasing over time (Figure 1). Within the eight-year review period, 36.9% (308/835) of the articles had a single author, although the proportional figures demonstrate an overall reduction in sole authorship over the period studied, from a high of 53.7% in 2005 (51/95) to only 20.0% in 2011 (23/115) (Figure 2). The data also demonstrated an increase in the total number of authors contributing to individual articles, with resultant larger collaborative groups. This increase in collaboration was further explored with calculation of the CI, DC, and RCC (Table 2). Across the journals the average number of authors (CI) per article was 2.4 with almost 85% of articles having multiple authors (DC). Variation was, however, noted between the journals over time, with the CI of The Radiographer, JMIRS, and SAR increasing by 57%, 64%, and 112%, respectively, over the eight years, whereas Radiography CI increased from 2.205 to 2.492, a modest 13% increase. In relation to collaborators, there was a tendency for authors to write with colleagues from the same institution, whether a hospital or university, but limited international collaboration was evident, although again there was variation evident between journals (Table 2). Forty-three countries were represented by the 1,999 contributing authors. Because a number of the 835 articles were international collaborations, with more than one country involved, a total of 896 separate country contributions were noted (Table 3). Differences in the type of articles were also evident, with research predominating.
Perhaps unsurprisingly, the four publishing countries were the most productive, but differences in the percentage of articles were noted, with 61.5% of Radiography articles having a UK-based author(s) (275/447) compared with 82.5% of SAR articles having a South Africa–based author(s) (52/63), 83.2% of JMIRS articles a Canadian contributor (153/184), and 92.6% of The Radiographer articles having an author(s) with an Australian address (132/141). In terms of discipline, the majority of articles related to diagnostic radiography (503/835; 60.2%), but this was not consistent across the journals (Table 4). The proportion of research articles was not significantly different between disciplines (z ¼ 0.99; P ¼ .320), with 49.3% of diagnostic-based (248/503) and 53.6% of therapeutic-based articles (96/179) presenting the findings of research. Overall research articles comprised almost half of the articles published (410/835; 49.1%); however, the proportion of research articles varied across the journals, with The Radiographer publishing the most (79/141; 56.0%), followed by Radiography (234/447; 52.3%), and SAR (23/36; 41.3%), with JMIRS publishing the least over the study period (71/184; 38.6%). The number of research articles has increased by 90% over time, from 45.7% in 2004 (37/81) to a high of 60.9% in 2011 (70/ 115), with the trend being consistent across all journals. In relation to subject, just over half of the articles were focused on a clinical practice topic (427/835; 51.1%) (Table 4), with the majority presenting research findings (228/427; 53.4%) or a discussion of practice (93/427; 21.8%). Although 18.7% of all clinical practice articles were case reports (80/427), numbers varied across journals, with 48.8% of clinical articles in the SAR comprising case reports (21/43) in comparison with 20.9% in Radiography
Figure 1. Comparison of the increase in the number of articles across the journals.
Figure 2. Number of authors contributing to each article by year as a percentage.
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
39
Table 2 Comparison of Collaboration Across the Journals Collaboration Metrics Collaboration index (CI) Degree of collaboration (DC) Revised collaboration coefficient (RCC) Author Sole author Institutional Intranational International Total
Journal of Medical Imaging and Radiation Sciences
Radiography
The South African Radiographer
The Radiographer
Total
2.353 0.822 0.371 No. (%) 53 (37.6) 52 (36.9) 29 (20.6) 7 (5.0) 141
2.497 0.880 0.438 No. (%) 135 (30.2) 145 (32.4) 131 (29.3) 36 (8.1) 447
1.619 0.578 0.203 No. (%) 43 (68.3) 7 (11.1) 11 (17.5) 2 (3.2) 63
2.468 0.848 0.406 No. (%) 77 (41.8) 61 (33.2) 34 (18.5) 12 (6.5) 184
2.394 0.846 0.399 No. (%) 308 (36.9) 265 (31.7) 205 (24.6) 57 (6.8) 835
Table 3 Productivity by Author Nationality Country
Research No. (%)
Opinion No. (%)
United Kingdom Australia Canada South Africa Eire United States New Zealand Nigeria Hong Kong Malta Norway Finland India Japan Kuwait Pakistan Uganda Morocco Portugal Singapore Sweden Turkey France Ghana Greece Indonesia Italy Korea Malaysia Austria Brazil China Czech Republic Fiji Germany Iran Kenya Lithuania Poland Slovenia Taiwan Trinidad & Tobago Tunisia Total
140 113 68 17 20 8 7 13 5 4 6 5 2 4 2 4 4
20 (7.0) 3 (1.5) 4 (2.4) d 1 (2.6) d 2 (13.0) d 1 (9.1) d d d d d 1 (25.0) d d d d d d d d d d d d d d d d d d d d d d d d d d d d 32 (3.6)
40
1 2 3 2 1 2 2 1 2 1 1 1 1
1 1 1 1 1 410
(49.0) (57.4) (40.0) (31.5) (51.3) (36.4) (46.7) (86.7) (45.5) (57.1) (85.7) (83.3) (33.3) (66.7) (50.0) (100.0) (100.0) d (33.3) (66.7) (100.0) d (100.0) (50.0) d (100.0) (100.0) (50.0) (100.0) d (100.0) (100.0) d (100.0) (100.0) d d d (100.0) (100.0) (100.0) (100.0) (100.0) (45.8)
Clinical No. (%) 43 35 16 22 2 6 2 1
2 2
3 1 3
2
1 1
1
139
(15.0) (18.0) (9.4) (41.0) (5.1) (27.0) d (13.0) (9.1) d d d (33.3) (33.3) d d d (100.0) d (33.3) d (100.0) d d (100.0) d d (50.0) d (100.0) d d d d d d (100.0) d d d d d d (16.0)
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Journal No. (%) 83 46 82 15 16 8 6 4 3 1 1 2 1
2
1
1
1 1
254
(29.0) (23.4) (48.2) (27.8) (41.0) (36.4) (40.0) d (36.4) (42.9) (14.3) (16.7) (33.3) d (25.0) d d d (66.7) d d d d (50.0) d d d d d d d d (100.0) d d (100.0) d (100.0) d d d d d (28.3)
Total 286 (31.9) 197 (22.0) 170 (19.0) 54 (6.0) 39 (4.4) 22 (2.5) 15 (1.7) 15 (1.7) 11 (1.2) 7 (0.8) 7 (0.8) 6 (0.7) 6 (0.7) 6 (0.7) 4 (0.4) 4 (0.4) 4 (0.4) 3 (0.3) 3 (0.3) 3 (0.3) 3 (0.3) 3 (0.3) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 896
Table 4 Comparison of Article Discipline and Subject Focus by Journal Article Discipline focus Diagnostic Therapy Generic Subject Clinical practice Dose/QA Roles/skill mix Education Research methods History Profession/policy Total
Journal of Medical Imaging and Radiations Sciences No. (%)
Radiography No. (%)
The South African Radiographer No. (%)
The Radiographer No. (%)
Total No. (%)
63 (34.2) 74 (40.2) 47 (25.5)
321 (71.8) 45 (10.1) 81 (18.1)
50 (79.4) 8 (12.7) 5 (7.9)
69 (48.9) 52 (36.9) 20 (14.2)
503 (60.2) 179 (21.4) 153 (18.3)
105 (57.1) 10 (5.4) 11 (6.0) 19 (10.3) 14 (7.6) 1 (0.5) 24 (13.0) 184
211 (47.2) 27 (6.0) 70 (15.7) 49 (11.0) 27 (6.0) 19 (4.3) 44 (9.8) 447
43 5 3 4
68 (48.2) 9 (6.4) 17 (12.1) 16 (11.3) 8 (5.7) 2 (1.4) 21 (14.9) 141
427 51 101 88 49 22 97 835
(44/211), 14.7% in The Radiographer (10/68), and only 4.8% in JMIRS (5/105). In relation to the articles on a clinical practice topic, the most common diagnostic themes were modality or equipment related, in particular general radiography, magnetic resonance imaging, computed tomography, and ultrasound, with other popular topics being gastrointestinal or vascular imaging. This compares to therapeutic articles where the most popular subjects were patient support or counselling, image-guided radiotherapy, planning, and intensity-modulated radiotherapy. Further analysis of content related to skill mix and role development was undertaken, which identified that the majority of articles were on skill mix in diagnostic or therapy-based articles, with 68.8% (11/16) relating to advanced and consultant practice concepts, and only a small number of diagnostic articles discussing assistant or support worker roles’ or broadbased reviews. Diagnostic articles on role development (including image interpretation) included a number related to discussions around opportunities, standards, or education for roles (15/55; 27.3%). The remainder were focussed toward a modality, with the greatest attention being general radiography (n ¼ 18 of 40; 45.0%) and breast (14/40; 35.0%). In contrast, only a small number of role development articles were specific to the therapeutic topics of image-guided radiotherapy or planning (2/7; 28.6%) and patient support (1/7; 14.3%), with the remainder discussing broad issues or education. Discussion This study used bibliometric methods to analyze publication patterns across four international radiography journals over an eight-year period (2004–2011). The bibliometric review of publications in this manner is relatively novel in radiography, but can provide a useful benchmark on which to evaluate trends and explore opportunities within a profession or subject [11]. The scope of this study only included those journals that included both diagnostic and therapeutic articles, and it is recognized that there are a number of other
(68.3) (7.9) (4.8) (6.4) d d
8 (12.7) 63
(51.1) (6.1) (12.1) (10.5) (5.9) (2.6) (11.6)
journals within the radiography field that are focussed toward a single discipline or modality, which will also influence the overall picture. Further, the sharing of knowledge, whether research or opinion based, is also facilitated through books and conference presentations, although analysis of the latter is often limited because of the inconsistency of indexing or recording of information [11, 12]. Unfortunately, there is no single simple mechanism for creating a bibliometric database for radiographic publications, as the traditional method for collating publication data is via online through individual publisher’s resources or journal collections such as Web of Science [3], MEDLINE, or CINAHL [13]. As the radiography journals examined involve a number of publishers with no single database excerpt available, and are not included in the Web of Science or MEDLINE because they are not impact factored, and are not complete in CINAHL, data collection required that a hand search be performed. This method has a number of limitations, including time required, lack of citation data, risks with data cleanliness, and inability to map author networks. It does, however, allow for custom-made data gathering at the macro or micro level. The results demonstrate an increase in articles published over the study period, although this growth was not consistent across the journals. This could be influenced by the relative size of the radiographic population within the individual countries or may be related to page (and financial) constraints. The latter may limit the potential for growth within individual journals; however, the opportunity to expand online-only content and special virtual editions can successfully increase capacity without the associated printing costs. Both SAR and The Radiographer are open access journals and freely available electronically, whereas JMIRS and Radiography are both published by Elsevier and available only to individual professional society members (including reciprocally) or through institutional subscription to Scopus. This lack of open access does not appear to have deterred submissions, as these journals demonstrated the greatest increase in published articles over the study period.
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Along with the growth in publication, the number of contributing authors has also increased, demonstrating more collaboration and a corresponding decrease in single-person authorship. Of the articles reviewed, 36.9% had a single author, compared with 31.4% in a longitudinal review of Radiography [8]. The proportion of sole-authored articles has fallen over the eight-year period, with only 20% of articles being attributable to one author in 2011, closer to the figure of 16.0% in a recent nursing study [14]. There is overt similarity between the Canadian, Australian, and UK journals, with most articles being collaborative. Whereas in the JMIRS or The Radiographer, institutional collaboration is in the majority, and this is not replicated in Radiography, where coauthorship is almost as likely to be intranational as institutional. No attempt was made to ascertain the basis for the variation in this study, but previous research [8] may provide evidence that this may represent the growth in Radiography clinical academic coauthorship. Development of the evidence base is reliant on contribution from both clinical and academic research to initiate changes in clinical practice and also academic curricula, thereby influencing the next generation of practitioners [1]. The reasons for the increase in the number of publishing authors remain unclear, but various initiatives have been identified as influencing participation, such as full-time or parttime faculty appointment [15, 16], academic progression [14], and involvement in writing groups [17, 18]. There does, however, appear to be a persistent problem with maintaining practitioner engagement in research and scholarship, with over three-quarters of authors contributing only a single article to any of the four journals over the eight-year period. Some of these contributions may be from individuals within other professions; however, because author role or discipline was not universally collected, this cannot be confirmed. The number of radiographers in the four countries exceeds 45,000 [19–21] and although there are other journals, these publications represent the primary professional body publication within each of the home countries and should be considered as key journals for author submission. Therefore, the number actually contributing to the published evidence base appears to represent a very small percentage of the radiography profession, and contributing more than one article is extremely limited. There were clear differences in the international origin of publications within individual journals. The author affiliation at time of publication was used within this study, but a small number of authors were observed to move country during the study period, thereby creating an opportunity to influence their new location with future activity and publications. Although a large number of countries were represented by authors in the four journals, there were single-article contributions from 14 of the 43 countries. Radiography proved to be the most international journal over the eightyear period, with 38.5% of articles having a non-UK–based author. Although similar proportions of international authors were evident in the JMIRS and SAR (16.8% and 17.5%, 42
respectively), the number of non-Australian authors publishing in The Radiographer was small (7.4%). No previous study has analyzed international authorship in radiography; however, given that the lowest contributions came from Europe and Asia, this may be influenced by language barriers or differences in education, role, or status as has been observed elsewhere [22]. The relatively low number of articles published by authors from the United States may appear surprising, given its numbers of radiographers; however, there are active diagnostic and therapy journals in the United States, which may contribute to the relatively low submission levels to the publications studied. Despite differences in international contribution, it is reassuring to note that research articles predominate, accounting for almost half of the articles published, acknowledging the growing strength of radiography research. A requirement of a minimum of five research papers per issue has been suggested to achieve an impact factor, the ultimate aim of a peer-review journal [1], but the lack of an impact factor is not unique to radiography, and many nursing [11] and most physiotherapy [12] journals are similarly positioned. Journal articles, which include nonsystematic reviews and discussion pieces, are the second most common article type (28.3%); this compares favourably to a radiology study where review articles were the most popular article type [23]. Their benefit is to collate research evidence, provide debate on a subject, and draw conclusions or identify the need for future study, and these articles tend to be highly cited [24]. Interestingly, few opinion articles were published, and the majority of these were from UK authors. Given that opinion pieces include guest editorials, it is likely that this may represent a journal’s specific structure and articles solicited from authors known to the editor or editorial board. There were few letters and commentaries published in any journal, and the reasons for this are unclear but may include disinterest or a lack of confidence to challenge published work or authors. Variations in the subject basis of articles published by each of the journals were evident, with all publishing more on clinical practice than any other type. The JMIRS published the least number of case reports, whereas SAR did not published any articles on research methods or radiography history. Clinical practice topics followed modality or equipment developments in both branches, which probably fits with the greatest innovation and analyzes undertaken in the clinical workplace. Role development and skill mix articles were more likely to be published in the UK and Australian journals, possibly representing the advancement in role seen in these countries [25]. The topics appear to represent the areas with greatest advancement internationally, with a long history of general radiography and breast role developments in the diagnostic branch and patient support roles in therapeutic radiography. It will be interesting to see if there are significant changes in these in the future. It is perhaps unsurprising that diagnostic radiography articles predominate, given the significantly larger number of diagnostic radiographers. This is particularly evident in
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Radiography and SAR, the former possibly relating to a separate UK-based radiotherapy journal, although the reason for the latter being unclear. The higher proportion of therapy articles in JMIRS and The Radiographer was unanticipated; however, this may relate to the maturity of the therapy discipline in research terms in these countries, but it is worthy of further research. It also raises questions regarding the ability of a single journal to represent the broad interests of a profession, as is the aim of each of these publications. But whether there is the appetite for or financial incentive to increase the number of relevant journals in the future is unclear, and it is expected that radiographers will continue to publish in other journals as befits the subject matter they wish to convey. The variations in publication practices across the journals are likely to be multifactorial, influenced by profession size, current academic, and role development, together with external academic pressure and institutional reward. However, it is clear from the continued growth in publication and still limited author numbers that there remains significant opportunity for further development of the professional evidence base within these and other radiography journals. The question is whether there is an appetite for research engagement from the individual academic and clinician communities to develop more proactive author networks to advance the current pace of change. Conclusion The derived data suggest that radiography evidence-based practice through journal publication is active internationally with many cross-fertilized links. Some journals appear to maintain a single country focus, whether this is deliberate or related to poor promotion overseas is beyond the scope of this article, but may merit further evaluation. Research-focused and clinical practice articles predominate, which is reassuring both for the professional communities and journal editorial boards. Yet it is important that radiography not become complacent, as the number of authors publishing just one article remains high and reasons for nonreturn to authorship need to be examined. This group does, however, present an opportunity for journals and authors to reengage individuals in future research and writing activity. References [1] French, J. (2007). The last piece in the puzzledthe importance of publishing and establishing the professional status of medical radiation technologists. Canadian J Med Radiat Technol 3, 23–36. [2] Pritchard, A. (1969). Statistical bibliography or bibliometrics? J Document 25, 348–349.
[3] Chew, F. S., & Relyea-Chew, A. (1988). How research becomes knowledge in radiology: an analysis of citations to published papers. Am J Roentgenol 150, 31–37. [4] Nightingale, J., & Marshall, G. (2012). Citation analysis as a measure of article quality, journal influence and individual researcher performance. Radiography 18, 60–67. [5] Chew, F. S. (1988). Coauthorship in radiology journals. Am J Roentgenol 150, 23–26. [6] Burnham, J. F. (1997). Mapping the literature of radiologic technology. Bull Med Libr Assoc 85, 289–292. [7] Mohanti, B. K., Bansal, M., Sharma, D. N., Gairola, M., & Majhail, N. S. (2004). Publications by radiation oncologists from India: a brief survey. Natl Med J India 17, 195–197. [8] Snaith, B. (2012). Collaboration in radiography: a bibliometric analysis. Radiography 18, 270–274. [9] Liao, C. H., & Yen, H. R. (2012). Quantifying the degree of research collaboration: a comparative study of collaborative measures. J Infometr 6, 23–33. [10] Fayland, M. J. (2008). Mapping the literature: A bibliometric analysis of evidence based practice literature in English language nursing journals. Louisiana State University. Doctoral thesis. Available at: http://search. proquest.com/docview/304819060 Accessed November 30, 2012. [11] Smith, D. R., & Hazleton, M. (2011). Bibliometric awareness in nursing scholarship: can we afford to ignore it any longer? Nurs Health Sci 13, 384–387. [12] Smith, D. R., & Rivett, D. A. (2009). Bibliometrics, impact factors and manual therapy: balancing the science and art. Man Ther 14, 456–459. [13] Allen, M., Jacobs, S. K., & Levy, J. R. (2006). Mapping the literature of nursing: 1996–2000. J Med Libr Assoc 94, 206–220. [14] Polit, D., & Beck, C. T. (2009). International differences in nursing research. J Nurs Scholarsh 41, 44–53. [15] Harnett, N., Palmer, C., Bolderston, A., Wenz, J., & Catton, P. (2008). The scholarly radiation therapist. Part one: charting the territory. J Radiother Pract 7, 99–104. [16] Smith, T., Brown, L., & Cooper, R. (2009). A multidisciplinary model of rural allied health clinical-academic practice. J Allied Health 38, 236– 241. [17] Jackson, D. (2009). Mentored residential writing retreats: a leadership strategy to develop skills and generate outcomes in writing for publication. Nurs Outlook 29, 9–15. [18] Murray, R., & Newton, M. (2008). Facilitating writing for publication. Physiotherapy 94, 29–34. [19] Canadian Association of Medical Radiation Technologists. Radiologic technologists. Available at: http://www.camrt.ca/abouttheprofession/ abouttheprofession/radiologicaltechnologists/. Accessed November 30, 2012. [20] Health and Care Professions Council. Radiographers. Available at: http://www.hpc-uk.org/aboutregistration/professions/index.asp?id¼12. Accessed November 30, 2012. [21] Australian Institute of Radiography. Discussion paper. A model of advanced practice in diagnostic imaging and radiation therapy in Australia. Available at: http://www.air.asn.au/cms_files/09_AdvancedPractice/ APWG_Final_Report_260609.pdf. Accessed November 30, 2012. [22] Freeman, P., & Robbins, A. (2006). The publishing gap between rich and poor: the focus of AuthorAID. J Public Health Policy 27, 196–203. [23] Johnson, C. A., & Toms, A. P. (2009). The impact of European research ethics legislation on UK radiology research activity: a bibliometric analysis. Clin Radiol 64, 983–987. [24] Marshall, G. (2007). Writing review articles. Radiography 13, 2–3. [25] Cowling, C. (2008). A global overview of the changing roles of radiographers. Radiography 14, e28–e32.
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Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Journal de l’imagerie médicale et des sciences de la radiation
www.elsevier.com/locate/jmir
Peer-Review Publication Patterns: A Comparison of International Radiography Journals Beverly A. Snaith, FCR, MSc* Lead Consultant Radiographer, Department of Radiology, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Wakefield, UK
ABSTRACT Background: Evidence-based practice is an expectation of all health care professionals, and the unique knowledge base of a profession is established through research and synthesis and most commonly shared through peer-review publication. The number of peerreview radiography journals has been increasing, and this bibliometric study aims to review the radiography profession in terms of these publications to explore the evidence base and identify its evolution internationally. Method: Four peer-review journals were examined over an eight-year period (2004–2011): the Journal of Medical Imaging and Radiation Sciences, Radiography, The South African Radiographer, and The Radiographer. The number and nationality of authors were collected, with whole counting of authors. Specific metrics allowed examination of author collaboration. Analysis of article type and subject enabled comparison of research and publication trends at the journal, author, and country levels. Results: Eight hundred thirty-five articles met the inclusion criteria, with 1,999 contributing authors and 43 countries represented. Differences in the type of articles were also evident, with research predominating. The data demonstrated an increase in the total number of authors contributing to individual articles, with resultant larger collaborative groups. Overall research articles comprised almost half of the articles published (410/835; 49.1%). In relation to subject, just over half of the articles were focused on a clinical practice topic (427/835; 51.1%), with the majority presenting research findings (228/427; 53.4%). Conclusions: This study suggests that radiography journal publication is active internationally. Research-focused and clinical practice articles predominate, but it is important that the area of radiography does not become complacent.
* Corresponding author: Ms. Beverly A. Snaith, Department of Radiology, Mid Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Aberford Road, Wakefield WF1 4DG, UK. E-mail address: [email protected] 1939-8654/$ - see front matter Ó 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jmir.2012.11.003
RESUM E Introduction: On s’attend a une pratique fondee sur la preuve de la part de tous les professionnels de la sante et la base des connaissances uniques a chaque profession est etablie par la recherche et la synthese, et le plus souvent communiquee par les revues a comite de lecture. Le nombre de revues a comite de lecture en radiographie a augmente et cette etude bibliometrique vise a examiner la profession de la radiographie a la lumiere de ces publications, dans le but d’explorer la base de preuve professionnelle et de determiner son evolution a l’echelle internationale. Methodologie: Quatre revues a comite de lecture ont fait l’objet d’un examen sur une periode de huit ans (2004–2011) : le Journal of Medical Imaging and Radiation Sciences, Radiography, South African Radiographer et The Radiographer. Le nombre d’auteurs et leur nationalite ont ete compiles, avec un decompte complet des auteurs. Des mesures specifiques ont permis d’examiner la collaboration entre les auteurs. L’analyze du type et du sujet des articles a permis de comparer les tendances en matiere de recherche et de publication, tant de la revue et de l’auteur que du pays. Resultats: 835 articles ont satisfait les criteres d’inclusion, representant 1 999 auteurs et 43 pays. Des differences dans le type des articles sont aussi apparues de fac¸on evidente, la recherche occupant la premiere place. Les donnees montrent une augmentation du nombre total d’auteurs contribuant a chaque article, avec des groupes de collaboration necessairement plus importants. Dans l’ensemble, les articles portant sur des travaux de recherche representent pres de la moitie des articles publies (n ¼ 410/835; 49,1 %). En ce qui a trait au sujet, un peu plus de la moitie des articles traitent d’un sujet de pratique clinique (n ¼ 427/835; 51,1 %), la majorite d’entre eux presentant des resultats de recherche (n ¼ 228/427; 53,4 %). Conclusion: Cette etude laisse voir que la publication des revues en radiographie est active a l’echelle internationale. Les articles sur la recherche et la pratique clinque predominent, mais il est important que la radiographie ne sombre pas dans la complaisance.
Introduction Evidence-based practice is an expectation of all health care professionals, whether clinically or academically employed, and it is
based on the understanding that practitioners will use and develop standards for optimal diagnosis and treatment. In practice, the evidence or knowledge base within an individual profession is established through research and synthesis, and it is most commonly shared through peer-review articles, textbook publication, or presentation of findings at conferences [1]. Over the past three decades, the radiography profession has evolved from hospital-based training to degree entry with opportunity and, in some countries, expectation for postgraduate and doctoral education. Alongside other nonmedical health professions, such as nursing and physiotherapy, radiography has built its own evidence base parallel to, and overlapping with, medical colleagues demonstrating a professional and academic maturity. As a result, the number of peerreview radiography journals has been increasing. Initially professional magazines, these journals have emerged as publications with an international readership and editorial boards, although none have yet achieved an impact factor. It is therefore timely to review the radiography profession in terms of these publications to explore the professional evidence base and identify its evolution internationally. The exploration of the unique characteristics of publication and its changes over time may be referred to as bibliometric research. Bibliometrics is a growing research field that has evolved over the past 50 years and is defined as ‘‘the application of mathematical and statistical methods to books and other communication medium’’ [2]. The most well-known methods are citation analysis and journal impact factor, both of which provide measures, or the inference, of the number of times a specific article has been referenced by others [3, 4], and a small number of previous studies in related imaging or oncology fields have focussed on these factors [5–7]. However, there are opportunities for a broader review of publication patterns, and this article builds on a recently published longitudinal review of the UK Radiography journal [8] and compares international peer-review journals within the radiography profession to identify publication patterns and trends. In this context, radiography describes the diagnostic and therapeutic disciplines, whose title may include radiographer, radiologic technologist, or radiation therapist, but for simplicity, in this article the single term ‘radiographer’ will be used.
Method
Although additional journals were identified, they were focussed on a single discipline or modality area (eg, Journal of Radiotherapy in Practice [therapy]; Radiation Therapist [therapy]; Radiologic Technology [diagnostic]; Ultrasound [sonography]) and, therefore, considered outside the scope of this study. A convenience sample approach was taken, and, given the variation in date of establishment of the journals in their current peer-review format, a common eight-year period (2004– 2011) was chosen. Research, review, guest editorials, and letters were included; however, book reviews, editorials, and professional columns were excluded, as this study related to novel professional publications contributing to the evidence base rather than pure information sharing. Data were collated and analyzed using Excel (Microsoft 2007). Statistical analysis was performed to identify patterns of authorship, including coauthorship and productivity, at the institutional, intranational, and international levels. A number of bibliometric indicators have been developed that allow analysis of specific factors, including the collaboration index (CI), the average number of authors per article; degree of collaboration (DC), the proportion of multiauthored articles; and collaboration coefficient (RCC), which provides a more representative numerical picture of collaboration, with fractionalized calculation of authors at this level. The analysis followed the method described by Liao and Yen [9] and provides the most effective evaluation of coauthorship. Categorization of article type followed the Cumulated Index to Nursing and Allied Health Literature (CINAHL) criteria used by Fayland [10] in her review of the nursing literature as (1) research (original research or systematic review), (2) journal article (nonsystematic review, discussion, or directed reading), (3) clinical literature (clinical innovation, case study, guidelines, or interventions), or (4) opinion piece (guest editorial, letter, or short communication). The number and nationalities of authors, together with the article subjects, were also collected, with whole counting of authors. Subject analysis enabled comparison of research and publication trends at the journal, author, and country levels.
Results
Given the two radiography disciplines, diagnostic and therapy, journals were limited to those whose aims and objectives were inclusive to both in order to identify changes in professional practice, role, and output across the whole profession. Limitations were also set in terms of English language and peer review. No single index covers all radiography journals, but a wider search elicited four journals for inclusion in this discussion: 1. Journal of Medical Imaging and Radiation Sciences (JMIRS) 2. Radiography 38
3. The Radiographer 4. The South African Radiographer (SAR)
A total of 835 articles met the inclusion criteria, with 1,999 contributing authors (Table 1). The majority of articles were published in the UK journal Radiography (447/835; 53.5%). Unfortunately, because there was no consistency across the journals in the reporting of author qualifications or job title, only their affiliation, the contribution of nonradiographers to publication is unknown. Although there were 1,999 contributing authors, this represented only 1,306 unique author names. Of these, 77.5% of authors were associated with a single article (1,012/1,306) with a maximum contribution to 19 articles by a single individual.
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Table 1 Overview of the Four Radiography Journals from 2004 to 2011 Journal
Country
Issues/year (No.)
Articles/year (Mean)
Total articles
Total authors
Journal of Medical Imaging and Radiation Sciences Radiography The South African Radiographer The Radiographer Total
Canada UK South Africa Australia
4 4* 2 4
23 55.9 7.9 17.6
184 447 63 141 835
433 1,116 102 348 1,999
*
Plus supplements.
A 42% increase in published articles was seen between 2004 and 2011, however, the number of articles published in The Radiographer and SAR remained relatively unchanged, with JMIRS and Radiography articles increasing over time (Figure 1). Within the eight-year review period, 36.9% (308/835) of the articles had a single author, although the proportional figures demonstrate an overall reduction in sole authorship over the period studied, from a high of 53.7% in 2005 (51/95) to only 20.0% in 2011 (23/115) (Figure 2). The data also demonstrated an increase in the total number of authors contributing to individual articles, with resultant larger collaborative groups. This increase in collaboration was further explored with calculation of the CI, DC, and RCC (Table 2). Across the journals the average number of authors (CI) per article was 2.4 with almost 85% of articles having multiple authors (DC). Variation was, however, noted between the journals over time, with the CI of The Radiographer, JMIRS, and SAR increasing by 57%, 64%, and 112%, respectively, over the eight years, whereas Radiography CI increased from 2.205 to 2.492, a modest 13% increase. In relation to collaborators, there was a tendency for authors to write with colleagues from the same institution, whether a hospital or university, but limited international collaboration was evident, although again there was variation evident between journals (Table 2). Forty-three countries were represented by the 1,999 contributing authors. Because a number of the 835 articles were international collaborations, with more than one country involved, a total of 896 separate country contributions were noted (Table 3). Differences in the type of articles were also evident, with research predominating.
Perhaps unsurprisingly, the four publishing countries were the most productive, but differences in the percentage of articles were noted, with 61.5% of Radiography articles having a UK-based author(s) (275/447) compared with 82.5% of SAR articles having a South Africa–based author(s) (52/63), 83.2% of JMIRS articles a Canadian contributor (153/184), and 92.6% of The Radiographer articles having an author(s) with an Australian address (132/141). In terms of discipline, the majority of articles related to diagnostic radiography (503/835; 60.2%), but this was not consistent across the journals (Table 4). The proportion of research articles was not significantly different between disciplines (z ¼ 0.99; P ¼ .320), with 49.3% of diagnostic-based (248/503) and 53.6% of therapeutic-based articles (96/179) presenting the findings of research. Overall research articles comprised almost half of the articles published (410/835; 49.1%); however, the proportion of research articles varied across the journals, with The Radiographer publishing the most (79/141; 56.0%), followed by Radiography (234/447; 52.3%), and SAR (23/36; 41.3%), with JMIRS publishing the least over the study period (71/184; 38.6%). The number of research articles has increased by 90% over time, from 45.7% in 2004 (37/81) to a high of 60.9% in 2011 (70/ 115), with the trend being consistent across all journals. In relation to subject, just over half of the articles were focused on a clinical practice topic (427/835; 51.1%) (Table 4), with the majority presenting research findings (228/427; 53.4%) or a discussion of practice (93/427; 21.8%). Although 18.7% of all clinical practice articles were case reports (80/427), numbers varied across journals, with 48.8% of clinical articles in the SAR comprising case reports (21/43) in comparison with 20.9% in Radiography
Figure 1. Comparison of the increase in the number of articles across the journals.
Figure 2. Number of authors contributing to each article by year as a percentage.
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
39
Table 2 Comparison of Collaboration Across the Journals Collaboration Metrics Collaboration index (CI) Degree of collaboration (DC) Revised collaboration coefficient (RCC) Author Sole author Institutional Intranational International Total
Journal of Medical Imaging and Radiation Sciences
Radiography
The South African Radiographer
The Radiographer
Total
2.353 0.822 0.371 No. (%) 53 (37.6) 52 (36.9) 29 (20.6) 7 (5.0) 141
2.497 0.880 0.438 No. (%) 135 (30.2) 145 (32.4) 131 (29.3) 36 (8.1) 447
1.619 0.578 0.203 No. (%) 43 (68.3) 7 (11.1) 11 (17.5) 2 (3.2) 63
2.468 0.848 0.406 No. (%) 77 (41.8) 61 (33.2) 34 (18.5) 12 (6.5) 184
2.394 0.846 0.399 No. (%) 308 (36.9) 265 (31.7) 205 (24.6) 57 (6.8) 835
Table 3 Productivity by Author Nationality Country
Research No. (%)
Opinion No. (%)
United Kingdom Australia Canada South Africa Eire United States New Zealand Nigeria Hong Kong Malta Norway Finland India Japan Kuwait Pakistan Uganda Morocco Portugal Singapore Sweden Turkey France Ghana Greece Indonesia Italy Korea Malaysia Austria Brazil China Czech Republic Fiji Germany Iran Kenya Lithuania Poland Slovenia Taiwan Trinidad & Tobago Tunisia Total
140 113 68 17 20 8 7 13 5 4 6 5 2 4 2 4 4
20 (7.0) 3 (1.5) 4 (2.4) d 1 (2.6) d 2 (13.0) d 1 (9.1) d d d d d 1 (25.0) d d d d d d d d d d d d d d d d d d d d d d d d d d d d 32 (3.6)
40
1 2 3 2 1 2 2 1 2 1 1 1 1
1 1 1 1 1 410
(49.0) (57.4) (40.0) (31.5) (51.3) (36.4) (46.7) (86.7) (45.5) (57.1) (85.7) (83.3) (33.3) (66.7) (50.0) (100.0) (100.0) d (33.3) (66.7) (100.0) d (100.0) (50.0) d (100.0) (100.0) (50.0) (100.0) d (100.0) (100.0) d (100.0) (100.0) d d d (100.0) (100.0) (100.0) (100.0) (100.0) (45.8)
Clinical No. (%) 43 35 16 22 2 6 2 1
2 2
3 1 3
2
1 1
1
139
(15.0) (18.0) (9.4) (41.0) (5.1) (27.0) d (13.0) (9.1) d d d (33.3) (33.3) d d d (100.0) d (33.3) d (100.0) d d (100.0) d d (50.0) d (100.0) d d d d d d (100.0) d d d d d d (16.0)
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
Journal No. (%) 83 46 82 15 16 8 6 4 3 1 1 2 1
2
1
1
1 1
254
(29.0) (23.4) (48.2) (27.8) (41.0) (36.4) (40.0) d (36.4) (42.9) (14.3) (16.7) (33.3) d (25.0) d d d (66.7) d d d d (50.0) d d d d d d d d (100.0) d d (100.0) d (100.0) d d d d d (28.3)
Total 286 (31.9) 197 (22.0) 170 (19.0) 54 (6.0) 39 (4.4) 22 (2.5) 15 (1.7) 15 (1.7) 11 (1.2) 7 (0.8) 7 (0.8) 6 (0.7) 6 (0.7) 6 (0.7) 4 (0.4) 4 (0.4) 4 (0.4) 3 (0.3) 3 (0.3) 3 (0.3) 3 (0.3) 3 (0.3) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 2 (0.2) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 1 (0.1) 896
Table 4 Comparison of Article Discipline and Subject Focus by Journal Article Discipline focus Diagnostic Therapy Generic Subject Clinical practice Dose/QA Roles/skill mix Education Research methods History Profession/policy Total
Journal of Medical Imaging and Radiations Sciences No. (%)
Radiography No. (%)
The South African Radiographer No. (%)
The Radiographer No. (%)
Total No. (%)
63 (34.2) 74 (40.2) 47 (25.5)
321 (71.8) 45 (10.1) 81 (18.1)
50 (79.4) 8 (12.7) 5 (7.9)
69 (48.9) 52 (36.9) 20 (14.2)
503 (60.2) 179 (21.4) 153 (18.3)
105 (57.1) 10 (5.4) 11 (6.0) 19 (10.3) 14 (7.6) 1 (0.5) 24 (13.0) 184
211 (47.2) 27 (6.0) 70 (15.7) 49 (11.0) 27 (6.0) 19 (4.3) 44 (9.8) 447
43 5 3 4
68 (48.2) 9 (6.4) 17 (12.1) 16 (11.3) 8 (5.7) 2 (1.4) 21 (14.9) 141
427 51 101 88 49 22 97 835
(44/211), 14.7% in The Radiographer (10/68), and only 4.8% in JMIRS (5/105). In relation to the articles on a clinical practice topic, the most common diagnostic themes were modality or equipment related, in particular general radiography, magnetic resonance imaging, computed tomography, and ultrasound, with other popular topics being gastrointestinal or vascular imaging. This compares to therapeutic articles where the most popular subjects were patient support or counselling, image-guided radiotherapy, planning, and intensity-modulated radiotherapy. Further analysis of content related to skill mix and role development was undertaken, which identified that the majority of articles were on skill mix in diagnostic or therapy-based articles, with 68.8% (11/16) relating to advanced and consultant practice concepts, and only a small number of diagnostic articles discussing assistant or support worker roles’ or broadbased reviews. Diagnostic articles on role development (including image interpretation) included a number related to discussions around opportunities, standards, or education for roles (15/55; 27.3%). The remainder were focussed toward a modality, with the greatest attention being general radiography (n ¼ 18 of 40; 45.0%) and breast (14/40; 35.0%). In contrast, only a small number of role development articles were specific to the therapeutic topics of image-guided radiotherapy or planning (2/7; 28.6%) and patient support (1/7; 14.3%), with the remainder discussing broad issues or education. Discussion This study used bibliometric methods to analyze publication patterns across four international radiography journals over an eight-year period (2004–2011). The bibliometric review of publications in this manner is relatively novel in radiography, but can provide a useful benchmark on which to evaluate trends and explore opportunities within a profession or subject [11]. The scope of this study only included those journals that included both diagnostic and therapeutic articles, and it is recognized that there are a number of other
(68.3) (7.9) (4.8) (6.4) d d
8 (12.7) 63
(51.1) (6.1) (12.1) (10.5) (5.9) (2.6) (11.6)
journals within the radiography field that are focussed toward a single discipline or modality, which will also influence the overall picture. Further, the sharing of knowledge, whether research or opinion based, is also facilitated through books and conference presentations, although analysis of the latter is often limited because of the inconsistency of indexing or recording of information [11, 12]. Unfortunately, there is no single simple mechanism for creating a bibliometric database for radiographic publications, as the traditional method for collating publication data is via online through individual publisher’s resources or journal collections such as Web of Science [3], MEDLINE, or CINAHL [13]. As the radiography journals examined involve a number of publishers with no single database excerpt available, and are not included in the Web of Science or MEDLINE because they are not impact factored, and are not complete in CINAHL, data collection required that a hand search be performed. This method has a number of limitations, including time required, lack of citation data, risks with data cleanliness, and inability to map author networks. It does, however, allow for custom-made data gathering at the macro or micro level. The results demonstrate an increase in articles published over the study period, although this growth was not consistent across the journals. This could be influenced by the relative size of the radiographic population within the individual countries or may be related to page (and financial) constraints. The latter may limit the potential for growth within individual journals; however, the opportunity to expand online-only content and special virtual editions can successfully increase capacity without the associated printing costs. Both SAR and The Radiographer are open access journals and freely available electronically, whereas JMIRS and Radiography are both published by Elsevier and available only to individual professional society members (including reciprocally) or through institutional subscription to Scopus. This lack of open access does not appear to have deterred submissions, as these journals demonstrated the greatest increase in published articles over the study period.
B.A. Snaith/Journal of Medical Imaging and Radiation Sciences 44 (2013) 37-43
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Along with the growth in publication, the number of contributing authors has also increased, demonstrating more collaboration and a corresponding decrease in single-person authorship. Of the articles reviewed, 36.9% had a single author, compared with 31.4% in a longitudinal review of Radiography [8]. The proportion of sole-authored articles has fallen over the eight-year period, with only 20% of articles being attributable to one author in 2011, closer to the figure of 16.0% in a recent nursing study [14]. There is overt similarity between the Canadian, Australian, and UK journals, with most articles being collaborative. Whereas in the JMIRS or The Radiographer, institutional collaboration is in the majority, and this is not replicated in Radiography, where coauthorship is almost as likely to be intranational as institutional. No attempt was made to ascertain the basis for the variation in this study, but previous research [8] may provide evidence that this may represent the growth in Radiography clinical academic coauthorship. Development of the evidence base is reliant on contribution from both clinical and academic research to initiate changes in clinical practice and also academic curricula, thereby influencing the next generation of practitioners [1]. The reasons for the increase in the number of publishing authors remain unclear, but various initiatives have been identified as influencing participation, such as full-time or parttime faculty appointment [15, 16], academic progression [14], and involvement in writing groups [17, 18]. There does, however, appear to be a persistent problem with maintaining practitioner engagement in research and scholarship, with over three-quarters of authors contributing only a single article to any of the four journals over the eight-year period. Some of these contributions may be from individuals within other professions; however, because author role or discipline was not universally collected, this cannot be confirmed. The number of radiographers in the four countries exceeds 45,000 [19–21] and although there are other journals, these publications represent the primary professional body publication within each of the home countries and should be considered as key journals for author submission. Therefore, the number actually contributing to the published evidence base appears to represent a very small percentage of the radiography profession, and contributing more than one article is extremely limited. There were clear differences in the international origin of publications within individual journals. The author affiliation at time of publication was used within this study, but a small number of authors were observed to move country during the study period, thereby creating an opportunity to influence their new location with future activity and publications. Although a large number of countries were represented by authors in the four journals, there were single-article contributions from 14 of the 43 countries. Radiography proved to be the most international journal over the eightyear period, with 38.5% of articles having a non-UK–based author. Although similar proportions of international authors were evident in the JMIRS and SAR (16.8% and 17.5%, 42
respectively), the number of non-Australian authors publishing in The Radiographer was small (7.4%). No previous study has analyzed international authorship in radiography; however, given that the lowest contributions came from Europe and Asia, this may be influenced by language barriers or differences in education, role, or status as has been observed elsewhere [22]. The relatively low number of articles published by authors from the United States may appear surprising, given its numbers of radiographers; however, there are active diagnostic and therapy journals in the United States, which may contribute to the relatively low submission levels to the publications studied. Despite differences in international contribution, it is reassuring to note that research articles predominate, accounting for almost half of the articles published, acknowledging the growing strength of radiography research. A requirement of a minimum of five research papers per issue has been suggested to achieve an impact factor, the ultimate aim of a peer-review journal [1], but the lack of an impact factor is not unique to radiography, and many nursing [11] and most physiotherapy [12] journals are similarly positioned. Journal articles, which include nonsystematic reviews and discussion pieces, are the second most common article type (28.3%); this compares favourably to a radiology study where review articles were the most popular article type [23]. Their benefit is to collate research evidence, provide debate on a subject, and draw conclusions or identify the need for future study, and these articles tend to be highly cited [24]. Interestingly, few opinion articles were published, and the majority of these were from UK authors. Given that opinion pieces include guest editorials, it is likely that this may represent a journal’s specific structure and articles solicited from authors known to the editor or editorial board. There were few letters and commentaries published in any journal, and the reasons for this are unclear but may include disinterest or a lack of confidence to challenge published work or authors. Variations in the subject basis of articles published by each of the journals were evident, with all publishing more on clinical practice than any other type. The JMIRS published the least number of case reports, whereas SAR did not published any articles on research methods or radiography history. Clinical practice topics followed modality or equipment developments in both branches, which probably fits with the greatest innovation and analyzes undertaken in the clinical workplace. Role development and skill mix articles were more likely to be published in the UK and Australian journals, possibly representing the advancement in role seen in these countries [25]. The topics appear to represent the areas with greatest advancement internationally, with a long history of general radiography and breast role developments in the diagnostic branch and patient support roles in therapeutic radiography. It will be interesting to see if there are significant changes in these in the future. It is perhaps unsurprising that diagnostic radiography articles predominate, given the significantly larger number of diagnostic radiographers. This is particularly evident in
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Radiography and SAR, the former possibly relating to a separate UK-based radiotherapy journal, although the reason for the latter being unclear. The higher proportion of therapy articles in JMIRS and The Radiographer was unanticipated; however, this may relate to the maturity of the therapy discipline in research terms in these countries, but it is worthy of further research. It also raises questions regarding the ability of a single journal to represent the broad interests of a profession, as is the aim of each of these publications. But whether there is the appetite for or financial incentive to increase the number of relevant journals in the future is unclear, and it is expected that radiographers will continue to publish in other journals as befits the subject matter they wish to convey. The variations in publication practices across the journals are likely to be multifactorial, influenced by profession size, current academic, and role development, together with external academic pressure and institutional reward. However, it is clear from the continued growth in publication and still limited author numbers that there remains significant opportunity for further development of the professional evidence base within these and other radiography journals. The question is whether there is an appetite for research engagement from the individual academic and clinician communities to develop more proactive author networks to advance the current pace of change. Conclusion The derived data suggest that radiography evidence-based practice through journal publication is active internationally with many cross-fertilized links. Some journals appear to maintain a single country focus, whether this is deliberate or related to poor promotion overseas is beyond the scope of this article, but may merit further evaluation. Research-focused and clinical practice articles predominate, which is reassuring both for the professional communities and journal editorial boards. Yet it is important that radiography not become complacent, as the number of authors publishing just one article remains high and reasons for nonreturn to authorship need to be examined. This group does, however, present an opportunity for journals and authors to reengage individuals in future research and writing activity. References [1] French, J. (2007). The last piece in the puzzledthe importance of publishing and establishing the professional status of medical radiation technologists. Canadian J Med Radiat Technol 3, 23–36. [2] Pritchard, A. (1969). Statistical bibliography or bibliometrics? J Document 25, 348–349.
[3] Chew, F. S., & Relyea-Chew, A. (1988). How research becomes knowledge in radiology: an analysis of citations to published papers. Am J Roentgenol 150, 31–37. [4] Nightingale, J., & Marshall, G. (2012). Citation analysis as a measure of article quality, journal influence and individual researcher performance. Radiography 18, 60–67. [5] Chew, F. S. (1988). Coauthorship in radiology journals. Am J Roentgenol 150, 23–26. [6] Burnham, J. F. (1997). Mapping the literature of radiologic technology. Bull Med Libr Assoc 85, 289–292. [7] Mohanti, B. K., Bansal, M., Sharma, D. N., Gairola, M., & Majhail, N. S. (2004). Publications by radiation oncologists from India: a brief survey. Natl Med J India 17, 195–197. [8] Snaith, B. (2012). Collaboration in radiography: a bibliometric analysis. Radiography 18, 270–274. [9] Liao, C. H., & Yen, H. R. (2012). Quantifying the degree of research collaboration: a comparative study of collaborative measures. J Infometr 6, 23–33. [10] Fayland, M. J. (2008). Mapping the literature: A bibliometric analysis of evidence based practice literature in English language nursing journals. Louisiana State University. Doctoral thesis. Available at: http://search. proquest.com/docview/304819060 Accessed November 30, 2012. [11] Smith, D. R., & Hazleton, M. (2011). Bibliometric awareness in nursing scholarship: can we afford to ignore it any longer? Nurs Health Sci 13, 384–387. [12] Smith, D. R., & Rivett, D. A. (2009). Bibliometrics, impact factors and manual therapy: balancing the science and art. Man Ther 14, 456–459. [13] Allen, M., Jacobs, S. K., & Levy, J. R. (2006). Mapping the literature of nursing: 1996–2000. J Med Libr Assoc 94, 206–220. [14] Polit, D., & Beck, C. T. (2009). International differences in nursing research. J Nurs Scholarsh 41, 44–53. [15] Harnett, N., Palmer, C., Bolderston, A., Wenz, J., & Catton, P. (2008). The scholarly radiation therapist. Part one: charting the territory. J Radiother Pract 7, 99–104. [16] Smith, T., Brown, L., & Cooper, R. (2009). A multidisciplinary model of rural allied health clinical-academic practice. J Allied Health 38, 236– 241. [17] Jackson, D. (2009). Mentored residential writing retreats: a leadership strategy to develop skills and generate outcomes in writing for publication. Nurs Outlook 29, 9–15. [18] Murray, R., & Newton, M. (2008). Facilitating writing for publication. Physiotherapy 94, 29–34. [19] Canadian Association of Medical Radiation Technologists. Radiologic technologists. Available at: http://www.camrt.ca/abouttheprofession/ abouttheprofession/radiologicaltechnologists/. Accessed November 30, 2012. [20] Health and Care Professions Council. Radiographers. Available at: http://www.hpc-uk.org/aboutregistration/professions/index.asp?id¼12. Accessed November 30, 2012. [21] Australian Institute of Radiography. Discussion paper. A model of advanced practice in diagnostic imaging and radiation therapy in Australia. Available at: http://www.air.asn.au/cms_files/09_AdvancedPractice/ APWG_Final_Report_260609.pdf. Accessed November 30, 2012. [22] Freeman, P., & Robbins, A. (2006). The publishing gap between rich and poor: the focus of AuthorAID. J Public Health Policy 27, 196–203. [23] Johnson, C. A., & Toms, A. P. (2009). The impact of European research ethics legislation on UK radiology research activity: a bibliometric analysis. Clin Radiol 64, 983–987. [24] Marshall, G. (2007). Writing review articles. Radiography 13, 2–3. [25] Cowling, C. (2008). A global overview of the changing roles of radiographers. Radiography 14, e28–e32.
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