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SPECIAL ARTICLE |
1 Division of Geriatric Medicine, Saint Louis University Medical Center, and VA Medical Center (GRECC), St. Louis, Missouri.
2 National Institutes of Health, National Institute on Aging, Baltimore, Maryland.
Address correspondence to John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University Medical Center, 1402 S. Grand Blvd., M238, St. Louis, MO 63104. E-mail: morley{at}slu.edu
THE understanding and future development of a field is dependent on its history (1). History creates the values of a field. History also allows a field to move forward without repeating the mistakes of the past. This is particularly important in modern geriatrics where there are continuous forces touting the science and the pseudoscience of rejuvenation—that is, the anti-aging movement—and others who minimize the importance of science in favor of "high touch" care and undervalue the need for a rigorous scientific training (2–5). Recently, the history of geriatrics has been chronicled (6–8) as has the history of nursing homes (9).
Isaac Asimov in the "Foundation" trilogy predicted that eventually a statistical form of history would allow scientific predictions of the future. This concept was utilized to develop a series of articles in the Journal on the Future History of Geriatrics (10–12). With the development of the ISI indexing system, it is now possible to examine statistically the relevancy of a scientist to a particular field. For scientists, the number of publications, the total and average number of citations, and the h-factor can all be used to determine the impact of a scientist on a field. The h-index is the number of papers a scientist has published that have received at least as many citations as the number of published papers up to that point (13–15). This form of impact assessment is considered to be a more transparent and unbiased measure of scientific productivity than are many other measures, and avoids the possibility that one single, although highly cited paper, could influence excessively the citation score.
In an attempt to examine the productivity of geriatricians, we have utilized the ISI Web of Science online database (http://apps.isiknowledge.com/WoS/CIW.cgi, accessed 1/7/07). As a first approximation list, without any pretense of being exhaustive, we considered all members of the 2006 editorial boards of the Journals of Gerontology: Medical Sciences, Journal of the American Geriatrics Society, Age and Aging, American Journal of Geriatric Psychiatry, and Alzheimer's Disease and Associated Disorders as well as the 2007 expanded editorial board of the Journal of the American Medical Directors Association. The abstracted data allowed a statistical view of papers published by these scientists from 1995 to 2006. It excludes the impact of papers published before this time period and thus gives a modern view of geriatric productivity. Nowadays, these data are widely accessible through a simple Internet search.
Things seem to be in the right place. Five of the top 10 geriatricians with the highest total number of citations came from the editorial board of Alzheimer's Disease and Associated Disorders. The editors-in-chief of three of the journals viz. Journals of Gerontology: Medical Sciences, Journal of the American Medical Director's Association, and Alzheimer's Disease and Associated Disorders were in the top 10 of total citations.
Overall, the most productive area in geriatrics has been dementia research. The other area with the most productivity has been epidemiology, particularly in the areas of disability, frailty, sarcopenia, hormones, nutrition, and cytokines. Other well-defined islands of high productivity, which were limited to a few scientists, are delirium, cardiovascular disease, falls, and depression. Surprisingly, missing from the list are areas of research that are at the core of geriatric medicine, such as some classical geriatric syndromes, nursing home care, home care, and palliative care. These represent areas of opportunity for funding agencies and for the next generation of geriatricians.
Overall, the use of citation counts and the h-factor provides an opportunity to identify "hot" areas in geriatrics and the scientists involved in these areas. This approach is more transparent and less capricious than many other approaches that have been used to define the science of geriatrics. In addition, it allows the young geriatrician to identify successful geriatricians with whom they can interact and also gives a glimpse into newly developing hot areas of geriatrics. Although clearly there are numerous potential problems in utilizing any single approach to defining the value of scientific endeavor, productivity and recognition by other scientists of the importance of scientific findings is probably more objective than the opinions of a group of experts.
F
Decision Editor: Darryl Wieland, PhD, MPH
Received September 17, 2007
Accepted September 24, 2007
References
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