A bibliometric analysis of obstetrics and gynecology articles with highest relative citation ratios, 1980-2019

Abstract Objective The relative citation ratio (RCR) is a novel bibliometric tool that quantifies the impact of research articles. The objectives of this study were to identify the 100 obstetrics and gynecology (OBGYN) articles with the highest RCR, evaluate how characteristics of these articles changed over time, and compare characteristics of these articles with top-cited OBGYN articles. Design We undertook a cross-sectional bibliometric study to examine the 100 OBGYN articles with the highest RCR and the 100 top-cited articles in the NIH Open Citations Collection (OCC) from 1980-2019. Methods We identified every OBGYN article published from 1980-2019 that was indexed in the NIH OCC. The top-100 articles with the highest RCR and the 100 top-cited articles were selected for further review. Each article was evaluated using metrics of influence, translation, and other characteristics. We compared the top-100 articles with highest RCR published in 1980-1999 versus 2000-2019, and characteristics of the top-100 articles with highest RCR versus the 100 top-cited articles (after excluding those on both lists). Means, standard deviations (SD), and mean differences (MD) with corresponding 95% confidence intervals (CI) were calculated. Associations were expressed as relative risks (RR) (95% CI). Results A total of 323,673 OBGYN articles were published between 1980-2019. Among the top-100 articles with highest RCR, most were observational studies (36%), reviews (26%), and consensus statements (21%). There were only 5 randomized clinical trials. Compared to highest RCR articles published from 1980-1999, articles published from 2000-2019 were more likely to about benign gynecology (RR 1.3, 95% CI 0.6, 2.8) and less likely be about gynecology oncology (RR 0.6 95% CI 0.2, 1.9) and urogynecology (RR 0.6, 95% CI 0.1, 3.3). The articles after 2000 were more likely to be systematic reviews (RR 7.7, 95% CI 1.0, 58.3) and consensus statements (RR 5.1, 95% CI 1.6, 16.3), and to be published open-access (RR 1.3, 955 CI0.9, 2.0). There were 60 articles in common between the top-100 articles with highest RCRs and the 100 top-cited articles. When compared to articles that were top-cited (after excluding articles on both lists), articles with highest RCR received fewer mean [SD] citations (266.9 [135.3] versus 514.3 [54.6]; MD 247.4, 95% CI 201.5, 293.3), but had higher numbers of citations per year (37.5 [4.1] versus 31.6 [8.1]; MD -5.9, 95% CI -14.6, -2.7). Compared to articles with highest RCR, top-cited articles were more likely to address gynecology topics (RR 1.6, 95% CI 1.1, 2.5), less likely to be RCTs (RR 0.7, 95% CI 0.1, 3.8), and less likely to be published open-access (RR 0.52, 95% CI 0.31, 0.86). Conclusions The RCR is a novel bibliometric tool that does not rely on absolute citation rates and provides unique insight into the dissemination of knowledge in OBGYN. Nearly half of the influential OBGYN articles identified with this metric would not have been recognized as citation classics by conventional bibliometric analysis.