SciFed Journal of Orthopedics & Rheumatology

Arthritis Research in India: A Scientometric Assessment of Publications Output during 2007-16

Research Article

Received on: September 25, 2017

Accepted on: October 09, 2017

Published on: October 25, 2017

1Gupta BM, 2Mueen Ahmed KK, *3Ritu Gupta

*Corresponding author: Ritu Gupta, 1K/A Arjun Nagar, Safdarjang Enclave, New Delhi 110029. E-mail: ritu7648@gmail.com

Abstract

Abstract

        The paper examines 3064 Indian publications on arthritis research, as covered in Scopus database during 2007-16, experiencing an annual average growth rate of 7.12% and qualitative citation impact averaged to 8.92 citations per paper. India's share in global output was 3.54% during 2007-16, which increased from 2.96% to 4.09% from 2007-11 to 2012-16. Top 12 most productive countries in arthritis research accounted for 83.27% global publication share during 2007-16, which increased to 82.67% to 83.82% from 2007-2011 to 2012-2016. The top 12 most productive countries in arthritis research individually contributed global share from 2.69% to 26.29% with largest global publication share coming from USA (26.29%), U.K. (10.02%), Germany, Japan, Italy and France (from 5.16% to 6.72%), Netherlands, China and Canada (from 4.37% to 4.81%), Spain, India and Australia (from 2.69% to 3.77%) during 2007-2016. The international collaborative share of India?s publications in arthritis research was 10.77% during 2007-16, which increased from 10.38% to 11.04% from 2007-2011 to 2012-2016. Medicine has, among subjects, contributed the highest publications share (66.09%) in India?s output followed by pharmacology, toxicology & pharmaceutics (33.09%), biochemistry, genetics & molecular biology (17.43%), immunology & microbiology (10.18%) and chemistry (3.36%) during 2007-16. Rheumatoid arthritis has, among different types of arthritis, contributed the largest share of 49.35%, followed by adjuvant arthritis (10.70%), tuberculosis arthritis (8.39%), osteoarthritis (7.96%), bacterial arthritis (7.83%), lupus arthritis (7.64%), juvenile arthritis (7.60%), psoriatic arthritis (3.85%), hand arthritis (2.84%), polyarthritis (2.81%), gout arthritis (2.74%) and septic arthritis (2.20%) during 2007-16. The top 15 most productive organizations and authors together contributed 27.02% and 13.71% respectively as their share of global publication output and 44.76% and 17.36% respectively as their share of global citation output during 2007-16. Among the total journal output of 3021 papers (98.06% of total output), the top 15 journals contributed 27.61% share to the global journal output during 2007-16 which decreased from 27.94% to 27.38% from 2007-11 and 2012-16. Of the total arthritis research output, the top 25 highly cited publications registered citations from 100 to 1112 and they together received 6410 citations, with 256.4 citations per paper. These 25 highly cited papers were published in 22 journals, of which 4 papers were published in the Lancet and 1 paper each in other journals.

Keywords

           Arthritis Research; Publications; India; Bibliometrics; Scientometric

FullText

Introduction
        "Arthritis" literally means joint inflammation. Although joint inflammation is a symptom or sign rather than a specific diagnosis, the term arthritis is often used to refer to any disorder that affects the joints. Joints are places in the body where bones come together, such as the knees, wrists, fingers, toes, and hips. These disorders fall within the broad category of rheumatic diseases. These are diseases characterized by inflammation (signs include redness or heat, swelling, and symptoms such as pain) and loss of function of one or more connecting or supporting structures of the body. They especially affect joints, tendons, ligaments, bones, and muscles. Common signs and symptoms are pain, swelling, and stiffness. Some rheumatic diseases also can involve internal organs. There are more than 100 rheumatic diseases that collectively affect more than millions of people worldwide [1, 2, 3].Arthritis affects 15% of Indian population (about 180 million people). There are several diseases where joint pain is primary, and is considered the main feature. Generally when a person has "arthritis" it means that they have one of these diseases, which include: Osteoarthritis, rheumatoid arthritis, gout and pseudo-gout, septic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis and still's disease. Joint pain can also be a symptom of other diseases. In this case, the arthritis is considered to be secondary to the main disease; these include: Psoriasis (Psoriatic arthritis), reactive arthritis, etc. [4]. In osteoarthritis, there is damage to the cartilage, which begins to fray and may wear away entirely. There is also damage to the bond stock of the joint. Osteoarthritis can cause joint pain and stiffness. Disability results most often when the disease affects the spine and the weight-bearing joints (the knees and hips)[5]. Rheumatic Arthritis is the inflammatory disease of the immune system and it targets first the synovium or lining of the joint, resulting in pain, stiffness, swelling, joint damage, and loss of function of the joints. Inflammation most often affects joints of the hands and feet and tends to be symmetrical [5].
1.1 Literature Review
        Only one study by Lewison and Devey [6] has so far been published in the past on quantitative analysis of arthritis research, which used bibliometric methods to evaluate the magnitude and quality of publications in arthritis research in the UK and also compared this with that of other countries. Outputs from 13 countries between 1988 and 1995 were analyzed by number, research level (from clinical to basic) and potential impact on other researchers (from low to high). The UK has a strong presence in arthritis research and the highest relative commitment of all the countries studied. Few other studies focused on evaluation of rheumatic diseases (including arthritis) research based on publications output. Among these studies, Mela and Cimmino[7] evaluated the distribution and scope of papers (2331) that were published by authors from the European Union (EU) in 17 rheumatological journals during 1995 and the impact of rheumatological research in the EU in comparison with that produced elsewhere. Of the 2331 papers, 1316 (56.5%) came from the EU (29.4% from the UK, 17.4% from France, 11.5% from Germany, and 10.8 % from Italy) and 544 (23.3%) from the USA. The mean average impact factor (IF) per paper of EU papers were approximately 2 in comparison with 3.5 for the USA and 2.4 for other countries. Less than a quarter of them were cited more than twice. Go, Liu and Zhang et al [8] evaluated the global rheumatic research output, with particular reference to China's output. China has occupied third place regarding the number of rheumatic disease's publications. Nevertheless, most of these articles were not associated with high impact factors or frequent citations, let alone great influence.
2. Objectives
        The main objectives of this study are to study the performance of India's arthritis research during 2007-16, based on publications output covered in Scopus database. In particular, the study focuses on the following objectives: (i) To study the growth India's research output in arthritis research and its citation impact; (ii) To study the India's international collaboration share and share of leading collaborating countries; (iii) To study the Indian research output by broad subject areas and the types of arthritis research; (iv) To study the publication productivity and citation impact of top 15 most productive organizations and authors; (vi) To study the modes of communication and identification of most productive journals; and (v) To study the characteristics of top 15 highly cited papers. 
3. Methodology
        The study retrieved and downloaded 10-year publication data of the world output in arthritis research from the Scopus database [9] (http://www.scopus.com) covering the period 2007-2016. Keywords, such as "arthritis" were incorporated in the search string and qualified these keywords with "keyword tag", "Article Title tag" and "Source Title tag", and in addition incorporated in this search string the period "2007-16" within "date range tag". Finally this search string was applied for searching Indian publication data for arthritis research. The search string was subsequently refined by "subject area tag", "country tag", "source title tag", "journal title name" and "affiliation tag", to get data/information on the distribution of publications output by subject, collaborating countries, author-wise, organization-wise and journal-wise, etc. For citation data, citations to publications were also collected from the date of publication till March 2017.
(KEY (arthritis) OR TITLE (arthritis)) AND PUBYEAR > 2006 AND PUBYEAR < 2017
(KEY (arthritis) OR TITLE (arthritis)) AND PUBYEAR > 2006 AND PUBYEAR < 2017 AND (LIMIT-TO (AFFILCOUNTRY,"India"))
4. Analysis
        The total research output of the world and India in the field of arthritis cumulated to 86491 and 3064 publications in 10 years during 2007-16. The annual output of the world and India in arthritis research increased from 7795 and 167 in the year 2007 to 6666 and 268 publications in the year 2016, registering -1.18% and 7.12% growth per annum. The cumulative world and Indian output in arthritis research in 5 years 2007-11 increased from 41967 and 1243 to 44524 and 1821 publications during succeeding 5-year period 2012-16, registering 6.09% and 46.50% quinquennial growth. Of the total Indian publications output on arthritis, 64.95% (1990) was published as articles, 21.61% (662) as reviews, 6.46% (198) as letters, 2.15% (66) as editorials, 1.80% (55) as conference papers, 1.70% (52) as notes and the rest asshort surveys (23), book chapters (13), erratum (3) and articles in press (2). The citation impact of Indian publications on arthritis research averaged to 8.92 citations per publication (CPP) during 2007-16; five-yearly impact averaged to 13.73 CPP for the period 2007-11 which declined to 5.64 CPP in the succeeding five-year 2012-16 (Table 1). 
Table 1: World and India's Output in Arthritis Research, 2007-16  
                          
4.1. Top 12 Most Productive Countries in Global Arthritis Research
      The global research output in the field of arthritis research had originated from more than 100 countries during 2007-16. Top 12 most productive countries in arthritis research had contributed 2330 to 22728 publications each during 2007-16(Table 2). Top 12 most productive countries in arthritis research accounted for 83.27% global publication share during 2007-16, which increased from 82.67% to 83.82% from 2007-11 to 2012-16. Each of top 12 countries accounted for 2.69% to 26.29% global publication share during 2007-16, with USA accounting for the highest publication share (26.29%), followed by U.K. (10.02% share), Germany, Japan, Italy and France (from 5.16% to 6.72%), Netherlands, China and Canada (from 4.37% to 4.81%), Spain, India and Australia (from 2.69% to 3.77%0 during 2007-16.The global publication share in five years increased by 3.38% in China, followed by 1.13% in India, Italy and Australia (0.50% each), Japan (0.31%) and Spain (0.01%), as against decrease by 2.05%in USA, 1.43% in Germany, 0.63% in U.K., 0.37% in France, 0.11% in Canada and 0.09% in Netherlands from 2007-11 to 2012-16.
Table 2: Global Publication Share of Top 12 Most Productive Countries in Arthritis Research during 2007-16
4.2 India's International Collaboration
       The international collaborative share of India's publications in arthritis research was 10.77% during 2007-16, which increased from 10.38% to 11.04% from 2007-11 to 2012-16. Among the foreign countries, USA contributed the largest share of 45.15% to India's international collaborative papers in arthritis research, followed by U.K. (19.70%), France (9.70%), Canada (8.18%), Australia and Japan (8.88% each), Japan (7.88%), Germany (7.58%), Sweden (7.27%), Netherlands and Saudi Arabia (6.67% each) during 2007-16. The share of international collaborative papers increased by 4.58% in Netherlands, followed by 4.03% in Australia, 3.53% in Germany, 2.75% in Japan, 1.76% in Sweden, 0.71% in Canada and 0.65% in France, as against decrease by 3.30% in U.K. and 0.51% in Saudi Arabia from 2007-11 to 2012-16 (Table 3). 
Table 3: The Share of Top 10 Foreign Countries in India?s International Collaborative Papers during 2007-16
4.3 Subject-Wise Distribution of Research Output
      The global arthritis research output published during 2007-16is distributed across five sub-fields (as identified in Scopus database classification), with medicine science accounting for the highest publications share (66.09%), followed by pharmacology, toxicology &pharmaceutics (33.09%), biochemistry, genetics &molecular biology (17.43%), immunology & biology (10.18%) and chemistry (3.36%) during 2007-16. The activity index, which computes change in research activity in a discipline over time 2007-11 to 2012-16 (world average activity index of a given subject is taken as 100), witnessed increase in medicine (from 99.82 to 100.12), pharmacology, toxicology & pharmaceutics (from 96.27 to 102.55), biochemistry, genetics & molecular biology (from 87.24 to 108.71) and immunology & microbiology (from 94.81 to 103.54), as against decline of research activity in chemistry (from 102.91 to 98.02) from 2007-11 to 2012-16. In terms of citation impact per paper, chemistry tops the list with CPP of 26.66, followed by biochemistry, genetics & molecular biology (12.95), immunology & microbiology (12.80), pharmacology, toxicology & pharmaceutics (10.06) and medicine (7.78) during 2007-16. 
Table 4: Subject-Wise Breakup of Indian Publications in Arthritis Research during 2007-16 
         
4.4 Type of Arthritis
        Among the different types of arthritis research, the largest share of papers (49.35%) was published in rheumatoid arthritis, followed by adjuvant arthritis (10.70%), tuberculosis arthritis (8.39%), osteoarthritis (7.96%), bacterial arthritis (7.83%), lupus arthritis (7.64%), juvenile arthritis (7.60%), psoriatic arthritis (3.85%), hand arthritis (2.84%), polyarthritis (2.81%), gout arthritis (2.74%) and septic arthritis (2.20%) during 2007-16. Except for rheumatoid arthritis, psoriatic arthritis and septic arthritis, the research activity has declined in all other types of arthritis from 2007-11 to 2012-16. Bacterial arthritis registered the highest citation impact per paper (19.81), followed by osteoarthritis (16.36), lupus arthritis (12.70), tuberculosis arthritis (10.86), adjuvant arthritis (10.48), gout arthritis (9.61), rheumatoid arthritis (9.44), juvenile arthritis (6.25), psoriatic arthritis (5.40), polyarthritis (5.16) and hand arthritis (3.39) during 2007-16.
 
Table 5: Types of Arthritis Research as reflected in the Indian Output during 2007-16
4.5 Profile of Top 15 Most Productive Indian Organizations
      The productivity of 15 most productive Indian organizations (as shown in Table 6) in Indian arthritis research varied from 27 to 136 publications and together they contributed 27.02% publication share and 44.76% citation share to its cumulative publications output during 2007-2016. Four organizations registered publications output greater than the group average of 55.20: All India Institute of Medical Sciences, New Delhi (136 papers), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow (122 papers), Postgraduate Institute of Medical Education & Research, Chandigarh (112 papers) and Christian Medical College, Vellore (65 papers) during 2007-15. Five organizations registered citation impact per paper above the group average of 14.78: Chhatrapati Shahuji Maharaj Medical University, Lucknow (38.93), National Institute of Pharmaceutical Education & Research, Mohali (24.85), Postgraduate Institute of Medical Education & Research, Chandigarh (22.73), All India Institute of Medical Sciences, New Delhi (21.33) and Jamia Hamdard University, Delhi (17.6) during 2007-2016. Seven organizations contributed international collaborative publications share above the group average of 11.59%:Christian Medical College, Vellore (23.08%), Jamia Hamdard University, Delhi (21.15%), Nizam?s Institute of Medical Sciences, Hyderabad (19.51%), Chhatrapati Shahuji Maharaj Medical University, Lucknow (16.67%), Vellore Institute of Technology, Vellore (12.5%), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow (12.3%) and Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry (11.90%) during 2007-2016. Five organizations registered the relative citation index above the group average (1.66): Chhatrapati Shahuji Maharaj Medical University, Lucknow (4.36), National Institute of Pharmaceutical Education & Research, Mohali (2.79),Postgraduate Institute of Medical Education & Research, Chandigarh (2.55), All India Institute of Medical Sciences, New Delhi (2.39) and Jamia Hamdard University, Delhi (1.97) during 2007-2016.
Table6: Scientometric Profile of Top 15 Most Productive Indian Organizations in Arthritis Research during 2007-16
 
4.6 Profile of Top 15 Most Productive Authors
      The research productivity of top 15 most productive authors(as shown in Table 7) in Indian arthritis research varied from 15 to 80 publications and together they contributed 13.71% global publication share and 17.36% citation share during 2007-16. Four authors registered publications output above the group average of 28.0: A.A.Aggarwal (80 papers), R.Misra (46 papers), V.Agarwal and A.Chopra (34 papers each) during 2007-16. Six authors registered impact above the group average of 11.30 citations per publication: O.Silakari (19.35), A.A.Aggarwal (17.31), A.Chopra (15.24), M.Rasool (15.20), R.Misra(15.13) and R.Gupta (11.31) during 2007-16. Seven authors registered h-index above the group average of 9.53: A.A.Aggarwal (20), O.Silakari (17), R.Misra (15), A.Chopra (12), M.Rasool, A.Kumar and V.Agarwal (10 each) during 2007-2016. Nine authors contributed international collaborative publications share above the group average of 8.10%:A.Kumar(16), A.N.Malaviya (15.79), A.Chopra (14.71), S.Agrawal (13.33), R.Gupta and A.Sharma (12.50% each), M.Rasool (10.0%), A.A.Aggarwal (8.75%) and S. Singh (8.33%) during 2007-2016. Five authors registered the relative citation index above the group average (1.27):S. Singh (2.17), O.Silakari (1.94), M.Rasool (1.71), A.A.Aggarwal and V.Dhir (1.70) during 2007-2016.
 
Table 7: Scientometric Profile of Top 15 Most Productive Authors in Arthritis Research during 2007-16
 
4.7 Medium of Communication 
       Of the total Indian output of arthritis research, 98.60% (3021) appeared in journals. The top 15 most productive journals accounted for 24 to 219 papers each in arthritis research and together accounted for 27.61% share (834 papers) of total journal publication output during 2007-16. The publication share of these top 15 most productive journals decreased from 27.94% to 27.38% from 2007-11 and 2012-16. The top most productive journal (with 219 papers) was Indian Journal of Rheumatology, followed by International Journal of Rheumatic Diseases (219 papers), International Journal of Pharmacy & Pharmaceutical Sciences (67 papers), International Journal of Pharmaceutical Sciences Review & Research (57 papers), etc. during 2007-16.
Table 8: Top 15 Most Productive Journals in Indian Arthritis Research during 2007-16
4.8 Highly Cited Papers
       A total of 25 highly cited papers were identified which received citations from 100 to 1112 during 2007-16. These 25 papers together received 6410 citations, which averaged to 256.4 citations per paper. Among these high cited papers, the largest foreign participation was from USA (8 papers), followed by U.K. (6 papers), Netherlands (5 papers), Canada and Germany (4 papers each), Japan, France, Sweden and Saudi Arabia (3 papers each), etc. .Among the various Indian organizations involved, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow accounted for 4 papers, followed by All India Institute of Medical Sciences, New Delhi , Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh and Jamia Hamdard, Delhi (2 papers each), etc. These 25 highly cited papers were published in 22 journals, of which 4 papers were published in The Lancet and 1 paper each in Advanced Drug Delivery Review, Asia and Pacific Journal of Tropical Medicine, Arthritis Research & Therapy, Bioorganic & Medicinal Chemistry, Biomaterials, Colloids & Surfaces B, Current Problems in Cancer, Cytokine, Current Opinion in Pharmaceuticals, Drug Discovery Today, European Journal of Medicinal Chemistry, European Journal of Pharmaceutical Science, International Journal of Nanomedicine, Journal of American Medical Association, Journal of Rheumatology, Journal of Clinical Pharmacology, Medicinal Research Review, Pharmacological Reports, Seminars in Nuclear Medicine, Systematic Reviews in Pharmacy and Yale Journal of Biology & Medicine.
Summary & Conclusion
       The global arthritis research had originated from more than 100 countries, of which the 12 top most productive countries (with individual publication share from 2.69% to 26.29%) together accounted for 83.27% global publication share during 2007-16, which increased from 82.67% to 83.82% from 2007-11 to 2012-16. USA accounting for the highest publication share (26.29%) followed by U.K. (10.02%), Germany, Japan, Italy and France (from 5.16% to 6.72%), Netherlands, China and Canada (from 4.37% to 4.81%), etc.
       India has published 3064 publications in arthritis research during 2007-16, increasing from 167 to 268 from the year 2007 to the year 2016, registering a 7.12% growth per annum. The average citation impact per paper of Indian publications on arthritis research was 8.92, which decreased from 13.73 to 5.64 from 2007-11 to 2012-16.The international collaborative share of India?s publications in arthritis research was 10.77% during 2007-16, which increased from 10.38% to 11.04% from 2007-11 to 2012-16. USA contributed the largest share of 45.15% to India?s international collaborative papers in arthritis research, followed by U.K. (19.70%), France (9.70%), Canada (8.18%), Australia and Japan (8.88% each), Japan (7.88%), Germany (7.58%), Sweden (7.27%), Netherlands and Saudi Arabia (6.67% each) during 2007-16.Medicine, among subjects, contributed the highest publications share (66.09%) in India?s output followed by pharmacology, toxicology & pharmaceutics (33.09%), biochemistry, genetics & molecular biology (17.43%), immunology & microbiology (10.18%) and chemistry (3.36%) during 2007-16. On classifying arthritis research, it was observed that rheumatoid arthritis contributed the largest share of 49.35%, followed by adjuvant arthritis (10.70%), tuberculosis arthritis (8.39%), osteoarthritis (7.96%), bacterial arthritis (7.83%), lupus arthritis (7.64%), juvenile arthritis (7.60%), psoriatic arthritis (3.85%), hand arthritis (2.84%), polyarthritis (2.81%), gout arthritis (2.74%) and septic arthritis (2.20%) during 2007-16.
The top 15 most productive organizations and authors together contributed 27.02% and 13.71% respectively as their share of global publication output and 44.76% and 17.36% respectively as their share of global citation output during 2007-16. Among the total journal output of 3021 papers (98.06% of total output), the top 15 journals contributed 27.61% share to the global journal output during 2007-16 which decreased from 27.94% to 27.38% from 2007-11 and 2012-16.Only 25 highly cited publications registered citations from 100 to 1112 in arthritis research and they together received 6410 citations, with 256.4 citations per paper. These 25 highly cited papers were published in 22 journals, of which 4 papers were published in The Lancet and 1 paper each in 18 other journals.
        Conclude that India's share in global output is only 3.54%, which needs to be substantially increased over the year. Its citation impact per paper is 8.92 during 2007-16. The increase in research output and citation impact can be achieved in India by identifying arthritis research as a national priority research area by government funding agencies, increasing the investment in R&D, designing suitable training programs for manpower development and boosting the international collaborative efforts with foreign countries active in research in this area.

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