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Scientific publications in cardiology and cardiovasology journals from Chinese authors in various parts of North Asia:10-year survey of literature

Liang-Hao Hu 1,Zhuan Liao 1,Rui Gao 1,Zhao-Shen Li ?

Department of Internal Medicine,Changhai Hospital,Second Military Medical University,168Changhai Road,Shanghai,200433,China

Received 3June 2008;accepted 16November 2008

Abstract

Background:People of Chinese ethnicity make up one of the largest populations in the world.Heart and vessel diseases remain the leading cause of morbidity and mortality in China.The research status in cardiology and cardiovasology among Chinese individuals in the three major regions of China —Mainland (ML),Hong Kong (HK)and Taiwan (TW)—are unknown.The outputs of cardiology and cardiovasology articles published in international journals from the three regions were compared in this study.

Methods:Articles published in 83journals related to cardiology and cardiovasology originating from the ML,TW and HK from1998–2007were retrieved from the PubMed database.The number of total articles,clinical trial,randomized controlled trial,case reports,impact factors (IF),citations,and articles published in top general medicine journals were conducted for quantity and quality comparisons.

Results:The total number of articles from the three regions increased significantly from 1998to 2007(from 154to 591).There were 2801articles from ML (883),TW (1404)and HK (514)in the past ten years.The number of articles published per year from the ML (297)have exceeded those from TW (235)and HK (59)in 2007.The accumulated impact factor of the articles from TW (4082.736)was much higher than ML (2221.699)and HK (1673.049).HK had the highest average IF of cardiology and cardiovasology articles and the most articles published in top general medicine journals among the three regions.

Conclusion:The total number of articles from the three major regions of China increased significantly from 1998to 2007.The number of articles published per year from the ML have exceeded those from TW and HK.However,the quality of articles from TW and HK is better than that from ML.

?2008Elsevier Ireland Ltd.All rights reserved.

Keywords:Research;Randomized controlled trial (RCT);Impact factor (IF);Science citation index expanded (SCIE);Journal citation reports (JCR)

1.Introduction

People of Chinese ethnicity are one of the groups at most risk of heart and vessel diseases in the world.Coronary artery disease remains the leading cause of morbidity and mortality in China [1,2].Cardiovascular disease is the major cause of mortality in China,with stroke accounting for over 40%of deaths [3,4].Although it was suggested that China ranked the sixth in the top 20countries sorted by articles in all fields from Essential Science Indicators (January 1997–August 31,2007)

[5],the scientific publications in cardiology and cardiovasol-ogy field by Chinese authors were not reported.We therefore intended to reveal the contribution of Chinese authors in major regions of China —the Mainland (ML),Hong Kong (HK)and Taiwan (TW)—to the research in the field of cardiology and cardiovasology.2.Methods 2.1.Search strategy

A total of 84journals related to cardiology and cardiova-sology were selected from the “cardiac and cardiovascular systems ”category of Science Citation Index Expanded (SCIE)

International Journal of Cardiology xx (2008)xxx –xxx

IJCA-11389;No of Pages 5

https://www.doczj.com/doc/d914531231.html,/locate/ijcard

Corresponding author.Tel.:+862125070552;fax:+862155621735.E-mail address:zhaoshenli@https://www.doczj.com/doc/d914531231.html, (Z.-S.Li).1

Dr.Liang-Hao Hu,Dr.Rui Gao and Dr.Zhuan Liao contributed equally 0167-5273/$-see front matter ?2008Elsevier Ireland Ltd.All rights reserved.doi:10.1016/j.ijcard.2008.11.086

ARTICLE IN PRESS

subject categories by the Institute for Scientific Information

(ISI)[6].The category covers resources dealing with the

diagnosis and treatment of heart disease and focuses on

cardiac disease prevention,pharmacology,surgery,trans-

plantation,and research.Acta cardiologica sinica was not

indexed by PubMed,so it was excluded.A computerized

literature search was conducted in the PubMed database in

April20,2008.[7].Articles published from the ML,TWand

HK from January1998to December2007in these journals

were elicited,respectively.The ISSN(Print)was used to

perform searches in PubMed.The search terms used were:“0001-5385OR0065-2326OR0002-8703OR0002-9149 OR1175-3277OR1076-7460OR0363-6135OR1302-

8723OR1082-720X OR0003-4975OR0003-9683OR

0066-782X OR0300-8428OR0007-0769OR0828-282X

OR0008-6312OR0733-8651OR1047-9511OR0174-

1551OR0897-5957OR0920-3206OR1054-8807OR

0008-6363OR1530-7905OR1522-1946OR0009-7322

OR1346-9843OR0009-7330OR0160-9289OR1861-

0684OR0268-4705OR0146-2806OR0742-2822OR

1099-5129OR0195-668X OR1520-765X OR1010-7940

OR1741-8267OR1525-2167OR1388-9842OR1355-

6037OR0147-9563OR0910-8327OR1382-4147OR

1547-5271OR1098-3511OR0340-9937OR1349-2365

OR0167-5273OR1569-5794OR1071-9164OR0886-

0440OR1932-7501OR1053-0770OR1045-3873OR

1097-6647OR1558-2027OR0889-4655OR0160-2446

OR1074-2484OR0021-9509OR0022-0736OR1053-

2498OR0966-8519OR1383-875X OR0022-2828OR

1071-3581OR0735-1097OR0894-7317OR0022-5223

OR0022-9040OR1743-4297OR0939-4753OR0147-

8389OR0172-0643OR0033-0620OR0954-6111OR

1530-6550OR0300-8932OR1401-7431OR0730-2347

OR0171-6425OR1050-1738”AND“Hong Kong[ad]”,“Taiwan[ad]”,and“China[ad]NOT Hong Kong[ad]NOT Taiwan[ad]”.Articles that showed the first author's affilia-tion(ad)with the three regions were considered as research output from the regions.The number of articles in the fields of clinical trials,randomized controlled trials(RCT)and case reports were generated,respectively,according to the publication types by PubMed.

To compare the quality of the research articles,three

methods were used.First,the accumulated impact factors(IF)

and the average IF were generated according to Journal

Citation Reports(JCR)2006established by the ISI[8].

Second,citation reports of articles having an affiliation with a

Chinese institution were conducted.Third,articles published

in top general medicine journals(The New England journal of

medicine[NEJM],JAMA,Lancet,British Medical Journal

[BMJ]and Annals of internal medicine[AIM])were also

generated.Articles related to cardiology and cardiovasology

were extracted first independently and subsequently in

consensus if a disagreement existed between the reviewers

(Liang-Hao Hu and Zhuan Liao)by viewing the titles,

abstracts and full text if necessary.Articles published on the

top-10high impact cardiology and cardiovasology journals were also generated.Further more,we determined the top-10 popular cardiology and cardiovasology journals of the three regions according to the published article numbers.

2.2.Statistical analysis

Statistical analyses were performed using STATA8.0[9]. The nonparametric test for trend was performed to determine any significant change of the total numbers over the period of time.Kruskal-Wallis test was used for detecting the difference among the three regions,and rank-sum test between two when necessary.The test for significance was two-tailed and the value of P b0.05was considered significant.

3.Results

3.1.Total number of articles and trends

A total number of159,410articles were published in the selected83journals from1998to2007worldwide.There were2801articles(2801/159,410,1.8%)from ML(883/ 2801,31.5%),TW(1404/280150.1%)and HK(514/2801, 18.4%).The numbers increased significantly from1998to 2007in the three regions(from24to297,P b0.001for trend,100to235,P b0.001,30to59,P=0.014,respectively, Fig.1).From2004onwards,the number of articles published from the ML exceeded that from HK and in 2007ML exceeded TW.The share of articles increased significant in the ML(P b0.001)and TW(P=0.040),but not in HK(P=0.813,Fig.2).

3.2.Clinical trial,randomized controlled trial and case report

There was no difference among the three regions(ML vs. TW vs.HK,P=0.058)with regards to clinical trials(Fig.3). However,the same result was found for RCT(ML vs.

TW Fig.1.The trend of the number of articles from Mainland,Taiwan,and Hong Kong during the past ten years.

2L.-H.Hu et al./International Journal of Cardiology xx(2008)xxx–xxx

vs.HK,P =0.492),from 2003onwards,the numbers of RCT per year from ML have exceeded those from TW or HK,and even exceeded the total number of RCT published from TW and HK in 2005.

Interestingly,TW published 337case reports between 1998and 2007,much more than the ML (67,P b 0.001)and HK (71,P b 0.001),and the difference between ML and HK was not significant (P =0.323;Fig.2).3.3.Impact factors

According to the JCR 2006,74journals of cardiac and cardiovascular systems had IF in 2006[8].9journals in our study had no IF.After excluding these journals,it was expected that the accumulated IF of articles from TW (4082.736)was much higher than ML (2221.699)and HK (1673.049,P =0.002).However,HK had the highest average IF of 3.255,and followed by TW of 2.908,ML of 2.516(P =0.004,Table 1).

3.4.Citation reports of articles published on the cardiology and cardiovasology journals

The ISI has not set up a function for finding a citation report of articles by limiting the department of the first author [6],so in this citation reports the articles included were affiliated with a Chinese institution,more than the previous search results in PubMed.In this analysis,TW has the highest total citations of 11840(2080articles),and followed by HK with 7068total citations (977articles),and the ML,which had 6165citations in 1949articles (P =0.0192,Fig.4).3.5.High impacted cardiology and cardiovasology journals and top general medicine journals

A total number of 442articles from the three regions were published in the 10top-ranking cardiology and cardiovasol-ogy journals.46.4%(205/442)were in Circulation,Journal of the American College of Cardiology and American Journal of Physiology-Heart and Circulatory Physiology .TW published 211articles in the high impacted

cardiology

Fig.2.The share of articles from Mainland,Taiwan,and Hong Kong during the past ten

years.

Fig.3.Number of articles on clinical trial,randomized controlled trial,and case report from Mainland,Taiwan and Hong Kong.Table 1

The accumulated and average impact factor of articles from Mainland (ML),Taiwan (TW),and Hong Kong (HK)Year

Accumulated impact factor Average impact factor ML

TW HK ML TW HK 199856.856338.09591.623 2.369 3.381 3.054199946.152361.19166.616 2.564 3.376 3.471200068.379291.658143.567 3.108 3.352 3.339200187.108366.4875.266 2.354 3.425 2.428200293.601350.345169.079 2.600 2.920 3.0742003147.904367.794187.391 2.641 2.990 2.9742004164.341476.258163.738 2.251 3.175 3.2752005298.385402.491252.003 2.446 2.382 3.7062006497.404536.606216.063 2.512 2.605 3.2252007761.569591.819207.703 2.564 2.518 3.520Total

2221.699

4082.736

1673.049

2.516

2.908

3.255

Fig.4.Total citations of articles from Mainland,Taiwan,and Hong Kong published on the cardiology and cardiovasology journals from 1998to 2007.

3

L.-H.Hu et al./International Journal of Cardiology xx (2008)xxx –xxx

and cardiovasology journals,while HK and ML had100and 131articles,respectively,in the top10journals(Table2).

A total number of226articles(ML41,TW58,and HK 127)were published in the five top general medicine journals, NEJM,Lancet,JAMA,BMJ,and AIM.12articles in cardiology and cardiovasology field were selected by two reviewers. HK had the most articles of7(RCT1,case report1,others 5;JAMA4,Lancet3),ML had4articles(RCT1,case report1, others2;NEJM1,JAMA1,Lancet2),and TW had only one prospective study in Lancet.

3.6.Popular cardiology and cardiovasology journals

The most popular journals in the three regions were listed in Table3.International Journal of Cardiology was the most popular journal in ML and TW,while Annals of Thoracic Surgery in HK.International Journal of Cardiology,Annals of Thoracic Surgery and the Journal of Thoracic and Cardiovascular Surgery appeared in all10-top journals in

the three regions.

4.Discussion

To the best of our knowledge,this is the first report to

reveal the contribution of Chinese authors in major regions

of China—ML,HK and TW—to the research in the field of

cardiology and cardiovasology.In the present study,it seems

exciting that ML has improved the research in cardiology

and cardiovasology field,and the articles in international

journals increased significantly during the past ten years.

From2004onwards,the number of articles published from

the ML exceeded that from HK and in2007ML exceeded

TW.

HK and TW have been for many years been at the fore-

front of scientific and medical research,and investigations

from these regions having contributed some of the best

scientific papers in cardiology and cardiovasology.When

impact factors(IF),citation reports,and articles published in

top general medicine journals were conducted for quality

comparisons,the gap of cardiology and cardiovasology

research articles among WL,TW and HK was still appears to

be considerable.HK had the highest average IF of3.255,and

followed by TW of2.908,ML of2.516.The major con-

sideration is that publications in the medical and scientific

field that reach an international audience are virtually all in

the English language.This has given a major advantage to “English-speaking”countries,and during various phases of their socioeconomic development,has proven a challenge for

investigators in non-English speaking countries.It's reported

that number of articles published from the ML in cardiova-

sology field ranked15worldwide in total[10],although a

substantial number of high-quality articles by Chinese

authors were published in journals in Chinese[1].

Although there was no difference among the three regions

with regards to RCT in last decade,the numbers of RCT per

year from ML have exceeded those from TWor HK from2003

onwards,and even exceeded the total number of CRT

published from TWand HK in2005.There are several reasons:

first,China with1.3billion population has a huge number of

subjects.Second,Chinese people are more compliant than the

Table2

Articles published on the10most impacted journals from Mainland(ML),Taiwan(TW)and Hong Kong(HK)

Rank Journal2006IF ML(%)TW(%)HK(%)Total 1Circulation10.94018(17)66(62)22(21)106 2Circulation research9.85411(48)9(39)3(13)23 3Journal of the American College of Cardiology9.70111(14)40(53)25(33)76 4European Heart Journal7.2866(27)9(41)7(32)22 5Cardiovascular research 5.82627(38)32(45)12(17)71 6Journal of Molecular and Cellular Cardiology 4.85919(41)12(26)15(33)46 7Trends in cardiovascular medicine 4.7240(0)1(100)0(0)1 8Basic research in cardiology 3.7986(46)7(54)0(0)13 9Heart rhythm 3.7777(50)4(29)3(21)14 10American Journal of Physiology-Heart and Circulatory Physiology 3.72426(37)31(44)13(19)70 Total131(30)211(48)100(23)442 Table3

The10most popular cardiology and cardiovasology journals in Mainland

(ML),Taiwan(TW)and Hong Kong(HK)

Rank ML(n=462)N TW(n=763)N HK(n=454)N

1IJC114IJC125ATS54

2JCP89JCE103PACE42

3ATS63ATS102AJC37

4EJCT34PACE79IJC35

5AC30AJC71RM28

6CJ28Cardiology67JCE27

7CR27Circulation66JACC25

8JTCS27JTCS60Heart23

9AJPHC26EJCT46Circulation22

10Cardiology24CJ44JTCS21

IJC,International Journal of Cardiology,IF=2.234;JCP,Journal of

Cardiovascular Pharmacology,IF=1.635;ATS,The Annals of Thoracic

Surgery,IF=2.342;EJCT,European Journal of Cardio-thoracic Surgery,

IF=2.106;AC,Acta Cardiologica,IF=0.519;CJ,Circulation Journal,

IF=2.135;CR,Cardiovascular Research,IF=5.826;JTCS,The Journal of

Thoracic and Cardiovascular Surgery,IF=3.560;AJPHC,American Journal

of Physiology Heart and Circulatory Physiology,IF=3.724;JCE,Journal of

Cardiovascular Electrophysiology,IF=3.265;PACE,Pacing and Clinical

Electrophysiology,IF=1.095;AJC,The American Journal of Cardiology,

IF=3.015;JACC,Journal of the American College of Cardiology,IF=9.701;

RM,Respiratory Medicine,IF=2.086;Heart,IF=3.708;Circulation,

IF=10.94;Cardiology,IF=1.795.

4L.-H.Hu et al./International Journal of Cardiology xx(2008)xxx–xxx

Western population[11].Third,trials in China are much cheaper to conduct[12].

China in recent years is prospering rapidly economically to become the second-largest economy in the world after the United States[1].The Chinese have medical problems somewhat unique to the Chinese population,but there are many patients whose problems are similar to those in Western countries.These include:obesity,smoking,diabetes,hyper-tension,decreased exercise,pollution,et al[1,13].All of these risk factors obviously will increase the cardiometabolic risk for Chinese patients,the end result being an increase in cardiovascular diseases.There is a price that developing countries must pay for modernization.However,let the price the Chinese pay not exceed the benefits from modernization [14].

International Journal of Cardiology(IJC)has been the most popular journal for the authors from ML and TW.IJC was founded in1981and has an established and proud history of publishing top-class scientific articles in the field.The articles concentrated on Chinese ethnicity or traditional Chinese medicine,which was not only from the Chinese author but also the author of the rest of the world,increased significantly in IJC during the past ten years[1,11,15,16].IJC has promoted the development of cardiovascular research in China,and makes China takes its place in the field of world cardiovasology.

The articles in this study were retrieved using the computer-generated PubMed search system,which is a comprehensive database run by the National Center for Biotechnology Information(NCBI)at the National Library of Medicine in Bethesda,Maryland,containing articles from high-quality medical journals.This study also used data from the JCR.The JCR has been published by the Institute for Scientific Information since1975and represents the most comprehen-sive citation index to the scientific literature,which covers more than6000journals at2006.It also should be mentioned here that although IF is not the optimal parameter for de-termining the quality of articles,since even the main journals may at times publish poor-quality articles,it is at present the best available parameter for determining the quality of studies.

There are some limitations in our study.Although the journals were selected from the cardiac and cardiovascular systems of SCIE,a few journals may cover resources beyond cardiology and cardiovasology,and some journals relation to cardiology and cardiovasology are not included in SCIE.We also limited the author's address by(China,HK or TW),and the articles that only addressed particular Chinese cities or provinces were not included.In fact,there was also Macau included in our study in our previous design.But we later excluded it when we found there were few articles affiliated to it.So there were only three regions in our study,which can also reflect the actuality of the research on cardiology and cardiovasology in the whole China.

In conclusion,the number of articles published from ML, TW,and HK increased significantly during the past ten years.The total number of articles from the three major regions of China increased significantly from1998to2007. The number of articles published per year from the ML have exceeded those from TW and HK.However,the quality of articles from TW and HK is better than that from ML. References

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