Gastroesophageal reflux disease in surgical versus clinical literature: clinicians do not read surgical journals

Abstracts

RACIONAL: Várias doenças podem ser tratadas médica ou cirurgicamente; no entanto, a terapêutica clínica ou cirúrgica não é muitas vezes usada como diferente opção para o mesmo paciente, mas sim como diferente filosofia médica na abordagem. OBJETIVO: Verificar se os principais periódicos cirúrgicos e clínicos fazem referências aos seus congêneres, tendo a doença do refluxo gastroesofágico como um modelo de doença clínico/cirúrgica. MÉTODO: Foram revistos os cinco primeiros periódicos classificados na área de gastroenterologia, cirurgia geral e medicina geral e um jornal neutro. Os números do ano 2008 dos periódicos selecionados foram pesquisados no como lidar com a doença do refluxo gastroesofágico. RESULTADOS: Foram selecionados 49 trabalhos, 36 (74%) em revistas clínicas, 5 (10%) em revistas de cirurgia, 2 (4%) em revistas de medicina geral e 6 (12%) no jornal neutro. Trinta e um (63%) tiveram origem clínica, 13 (26%) cirúrgica, e 5 (10%) a origem foi neutra. Revistas cirúrgicas publicaram apenas artigos cirúrgicos e revistas de medicina geral, publicaram apenas trabalhos clínicos. Revistas e jornais de medicina clínica geral mostraram maior proporção de referências clínico/cirúrgicas em relação às revistas de cirurgia (p<0,001) e do jornal neutro (p<0,001). Não houve diferenças na proporção de referências clínico/cirúrgicas quando revistas cirúrgicas e a neutra foram comparadas (p= 0,06). Revistas clínicas e de medicina geral mostraram semelhante proporção de referências clínico/cirúrgicas (p=0,06). CONCLUSÃO: Os clínicos fazem referências significativamente menores para revistas cirúrgicas do que os cirurgiões fazem para as revistas clínicas.

Cirurgia; Gastroenterologia; Refluxo gastroesofágico

ORIGINAL ARTICLE

^IDepartment of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, São Paulo, SP, Brazil

^IIDepartment of Surgery, University of Chicago, Chicago, Il, USA

Correspondence

ABSTRACT

BACKGROUND: Several diseases may be treated either medically or surgically; however, clinical and surgical therapies are often not treated as different options for the same patient but rather as different medical philosophies.

AIM: To assess whether the main surgical and medical journals make references to their counterparts, with gastroesophageal reflux as a model of clinical/surgical disease.

METHOD: It was reviewed the leading medical journals in order to verify if surgeons and clinicians make references to their counterparts on their work using gastroesophageal reflux disease as a model of a clinical/surgical disease. It was reviewed the five top-ranked journals in the field of gastroenterology, general surgery and general medicine and a neutral journal. The issues of the year 2008 of the selected journals were searched for papers dealing with gastroesophageal reflux disease.

RESULTS: The search in the selected journals retrieved 49 papers, 36 (74%) in clinical journals, 5 (10%) in surgical journals, 2 (4%) in general medicine journals, and 6 (12%) in the neutral journal. Thirty one (63%) had a clinical origin, 13 (26%) a surgical origin, and 5 (10%) a neutral origin. Surgical journals published only surgical papers and general medicine journals published only clinical papers. Clinical journals and general medicine journals showed a higher proportion of clinical/surgical references compared to surgical journals (p<0.001) and the neutral journal (p<0.001). There was no differences in the proportion of clinical/surgical references when surgical and the neutral journal were compared (p=0.06). Clinical journals and general medicine journals showed a similar proportion of clinical/surgical references (p=0.06).

CONCLUSION: Clinicians make significantly less references to surgical journals than surgeons do to clinical journals.

Headings: Surgery. Gastroenterology. Gastroesophageal reflux.

INTRODUCTION

The dissimilarities between surgeons and clinicians go well beyond their beauty⁸. Several diseases may have either a clinical or surgical therapy as an acceptable treatment. In many cases; however, medical and surgical therapy are not treated as different options for the same patient but rather as two different medical philosophies. Furthermore, it seems that often surgeons and clinicians do not discuss the same papers and they are not aware of each others research.

The aim of this article is to review the leading medical journals in order to verify if surgeons and clinicians make references to their counterparts on their work using gastroesophageal reflux disease as a model of a clinical/surgical disease.

METHODS

It was reviewed the five top-ranked journals in the field of gastroenterology, general surgery and general medicine. Journals were selected based on the number of citations according to the ISI Web of Knowledge impact factor for 2007. Highly specialized journals, such as those devoted solely to hepatology, endoscopy, vascular surgery, etc., were excluded from the analysis. In addition, a specialized journal that is edited by surgeons and clinicians was included as a neutral journal. The selected journals are listed in Table 1.

The issues of the year 2008 of the selected journals were searched for papers dealing with gastroesophageal reflux disease. Letters to the editor, editorials, case reports, and meeting abstracts were excluded from analysis. The origin of the paper was classified as "clinical" or "surgical" based on the department that originated the research. Neutral origin denoted a paper originated from diverse departments, such as pathology or a conjoined work by surgeons and clinicians. The references of these papers were classified as "clinical", "surgical", or "neutral" according to the journal where it was published. Clinical journals were defined as those classified as gastroenterology & hepatology at the Journals Citation Report by ISI Web of Knowledge. Similarly, surgical journals were defined as those classified as surgery. Other journals or those figuring in both classifications were defined as neutral.

Ethics approval was not required for this study.

Fisher's test was used for statistic comparison among groups.

RESULTS

The search in the selected journals retrieved 49 papers, 36 (74%) in clinical journals, 5 (10%) in surgical journals, 2 (4%) in general medicine journals, and 6 (12%) in the neutral journal. According to the origin, 31 (63%) had a clinical origin, 13 (26%) a surgical origin, and 5 (10%) a neutral origin. Surgical journals published only surgical papers and general medicine journals published only clinical papers (Table 2).

Selected papers' references are depicted in Table 3. Clinical journals and general medicine journals showed a higher proportion of clinical/surgical references compared to surgical journals (p<0.001) and the neutral journal (p<0.001). There was no differences in the proportion of clinical/surgical references when surgical and the neutral journal were compared (p=0.06). Similarly, clinical journals and general medicine journals showed a similar proportion of clinical/surgical references (p=0.06).

DISCUSSION

Journals are considered one of the most important sources in the transmission of research findings and as a guide to clinical practice for clinicians³ and surgeons^1,7. It is intuitive to believe that clinicians are more inclined to read clinical journals and surgeons to read surgical journals. This can be explained by personal interests and the accessibility to the journals given that they are usually available to members of professional organizations and societies. However, readership level is not synonym to ranking of importance¹. Furthermore, scientific reports must be free of bias and prejudices. Previous surveys showed that surgeons read medical journals^1,4,7 but the interest of clinicians in surgical journals has not been investigated.

Here, it was investigated the references of clinical and surgical papers to determine if surgeons and clinicians make references to their counterparts.

Gastroesophageal reflux disease was used as a model in this research due to the fact that clinical and surgical treatments of the disease are widely available, acceptable and efficient⁵. Furthermore, surgeons are familiar with basic research and pathophysiologic studies, and actually perform diagnostic testing, medical management, and endoscopic therapeutic interventions in addition to surgery².

Our review showed that clinicians make significantly less references to surgical journals than surgeons do to clinical journals. Interestingly, general medicine journals showed a similar behaviour compared to clinical journals. The neutral journal is more open-minded to clinical and surgical papers and references.

CONCLUSION

Surgeons should be encouraged to publish in clinical journals in order to disseminate surgical research⁶. Neutral journals may be an unbiased manner of publication.

REFERENCES

• 1. Jones TH, Hanney S, Buxton MJ. The journals of importance to UK clinicians: a questionnaire survey of surgeons. BMC Med Inform Decis Mak. 2006;6:24.
• 2. Luketich JD, Pennathur A. How to Keep the Treatment of Esophageal Disease in the Surgeon's Hands. Ann Thorac Surg 2008; 85:S760-3.
• 3. McKibbon KA, Haynes RB, McKinlay RJ, Lokker C. Which journals do primary care physicians and specialists access from an online service? J Med Libr Assoc. 2007;95(3):246-54.
• 4. Mcleod DAD. BMJ is second most popular journal among surgeons. BMJ 1998; 316:1164.
• 5. Moayyedi P, Talley NJ. Gastro-oesophageal reflux disease. Lancet. 2006 ;367(9528):2086-100.
• 6. Schein M, Fingerhut A. Where can surgeons publish? Br J Surg. 2000;87(3):261-4.
• 7. Schein M, Paladugu R, Sutija VG, Wise L. What American surgeons read: a survey of a thousand Fellows of the American College of Surgeons. Curr Surg. 2000 ;57(3):252-258.
• 8. Trilla A, Aymerich M, Lacy AM, Bertran MJ. Phenotypic differences between male physicians, surgeons, and film stars: comparative study. BMJ. 2006 333(7582):1291-3.

Gastroesophageal reflux disease gical versus clinical literature: clinicians do not read surgical journals

Fernando A M Herbella^I; Daniel Szor^I; Guilherme F Takassi^I; Jose C Del Grande^I; Marco G Patti^II

Publication Dates

• Publication in this collection
  19 Jan 2011
• Date of issue
  Dec 2010

History

• Received
  14 July 2010
• Accepted
  25 Oct 2010