|Year : 2013 | Volume
| Issue : 4 | Page : 395-399
Publication trends of cardiology articles in a biomedical journal from India
K. V. S. Hari Kumar1, K Aravinda2
1 Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh, India
2 Department of Oral Medicine and Radiology, CPGIDS&H, Lucknow, Uttar Pradesh, India
|Date of Web Publication||17-Sep-2013|
K. V. S. Hari Kumar
Department of Endocrinology, Command Hospital, Lucknow, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Background: The details about the research productivity in the cardiology specialty from India are lacking. Aim : The aim of this study was to analyze the publishing trends and the research productivity of cardiology articles in the Journal of the Association of Physicians of India (JAPI). Materials and Methods : We carried the bibliometric analysis of cardiology articles from JAPI published between 2000 and 2011. Data were derived from the journal's website and the articles were analyzed for type (Original Article, Case Reports etc.), disease (ischemic, congenital etc.) place of origin and timelines for publication. Results : Out of 2977 articles published, 215 (7%) articles belong to cardiology. Original articles (42.8%) and Case Reports (33.5%) are common than Correspondence (9.3%) and Images (14.4%). Ischemic heart disease (IHD) and hypertension (51%), cardiomyopathy and valvular diseases (23%) account for the majority of research productivity. Mumbai (19%), Delhi (14%), and Chennai (8%) are the top three contributors. Original Articles and Case Reports took about 14 months for publication, when compared to 6-9 months for an image or Letter to the Editor (P = 0.0011). Conclusion : Cardiology specialty contributes an average 15% of articles per annum in JAPI. Metro cities contribute the majority of articles pertaining to the clinical research on IHD and hypertension.
Keywords: Biomedical journals, cardiology, India, publication trends, research productivity
|How to cite this article:|
Kumar KH, Aravinda K. Publication trends of cardiology articles in a biomedical journal from India. Med J DY Patil Univ 2013;6:395-9
| Introduction|| |
Cardiology as a subspecialty is the foremost branches to span out from general medicine. The changes in life-style, urbanization, and stressful situations have led to a rapid increase in the number of patients suffering from cardiology disorders.  Simultaneously, the specialty also grew rapidly in leaps and bounds with the addition of interventional cardiology and nuclear cardiology.  Patients with heart ailments constitute a majority in the clinical practice. Most of them are treated as outdoor patients although a few receive in hospital therapy depending on the severity and the need for intervention. Ischemic heart disease (IHD) remains the giant killer amongst the non-communicable diseases and the numbers are increasing every decade.  Cardiology as a specialty, practice evidence based medicine and has a number of landmark trials that have defined the way we treat our patients. Research work in cardiology is often difficult to undertake for the procedures involved and the duration of observation. However, the quality research work finds its way into one of the leading biomedical journals. The need to publish or perish is felt by most of the academicians and academic institutes in India. 
Disorders of the cardiovascular system are more often tackled by the primary care physicians and complicated cases reach the doors of the tertiary care or research centers. Hence, research productivity related to the cardiology subspecialty is seen in both Medicine and Cardiology Journals. Association of Physicians of India was formed in 1944 and has over 15,000 participants as its members.  The official journal of the association is called as the Journal of Association of Physicians of India (JAPI). JAPI is published every month with a readership of over 250,000 and is extremely popular among the medical fraternity. The journal is published in both print form and released online every month. It covers all aspects of medicine and various subspecialty subjects. There is no formal assessment of the published literature of cardiology subspecialty in India. Hence, this work was carried out by the authors with the aim to analyze the nature and characteristics of cardiology related articles published in JAPI.
| Materials and Methods|| |
JAPI issues of the last 12 years (Jan 2000-Dec 2011) available online were taken for analyzing the publication trends of articles related to cardiovascular disorders in the journal. The data were derived from the website of the journal, which gives links to previous issues.  The flow diagram of the study is given in [Figure 1]. Research work carried out by individuals and institutions is presented usually as original articles.  However, space constraints in a journal lead to publication of the same data in a concise form as correspondence (also known as Letters to Editor). Individual case reports and reporting an interesting image also constitute the early steps towards the research activities. Hence, the following types of articles were included in the final analysis regarding the research productivity pertaining to cardiology in JAPI: Original Articles, Case reports, Images and Letters to Editor. The articles published were analyzed for type, subspecialty and place of the institution from where the work originated.
The following articles were excluded from the analysis as they do not report data derived from original research: Editorials, Update Articles, Review Articles, Philately, Miscellaneous Articles, Postgraduate Clinic, Guidelines, Announcements, Corrigendum. Correspondence pertaining to the published articles and comments unrelated to research work were also excluded from the analysis. Articles published in the special issues and topic supplements were excluded.
For the purpose of analysis the cardiovascular disorders were subdivided into 6 broad groups: Group 1 (IHD and hypertension), Group 2 (congenital heart disease), and Group 3 (structural heart disease including valvular diseases and cardiomyopathies), Group 4 (electrical or arrhythmic disorders), Group 5 (infectious disorders) and Group 6 (miscellaneous). The institution of the first author is taken as the place and department of study for the articles involving multiple authors from different institutes and departments. The duration between initial submission and revision, time taken for acceptance and publication is counted using the dates given in the article files. The 1 st day of every month is taken as the date of publication of all articles given in that issue (for example 1 st September 2010 is taken as the date of publication for the articles in September 2010 issue). The data were obtained independently by both the authors and discrepancy if any was resolved by accessing the information jointly from the JAPI website.
Summary data are presented as mean values ± SD and comparison between groups was done by one way ANOVA with Bonferroni's multiple comparison test. The data regarding the timelines is derived from the articles and days were calculated using day's 360 formulas embed in Microsoft Excel (Microsoft, USA). P values were reported for all statistical tests and a value <0.05 was considered to be significant.
| Results|| |
Over the past 12 years, JAPI published 12 volumes (volume numbers 48-59) with a total of 144 issues. A total of 10 issues were not considered as they published proceedings of the APICON and details about May 2005 issue were not available on the website. A total of 215 articles related to cardiology were available for final analysis. The distribution of the types of articles is given in [Figure 2]. Original Articles (42.8%) and Case Reports (33.5%) are the major types of research articles accounting for 3/4 th of all published articles. Remaining 1/4 th is shared by Correspondence (9.3%) and Pictorial Images (14.4%). Cardiology as a subspecialty contributed about 11-18% of articles published in JAPI. The total number of cardiology related articles and its share in JAPI is given in [Figure 3]. The number of articles per year is increasing each year with an up sloping trend line [Figure 3]. The current year (2011) had a maximum percentage (18%) when compared to previous years.
|Figure 2: Distribution of cardiology related research articles in the Journal of the Association of Physicians of India\|
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|Figure 3: Trends of cardiology related publications over the last decade|
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[Table 1] gives the details about the disease wise distribution of the articles. IHD and hypertension (51%) and structural heart diseases such as cardiomyopathies and valvulaar heart disorders (23%) are responsible for 3/4 th of research productivity. The remaining articles are shared equally by arrhythmic/congenital and infectious disorders. Original Articles constitute the majority of articles related to the IHD, whereas case reports constitute the majority regarding the articles pertaining to structural diseases. Other specialties also have more number of articles as Case Reports and Letters to Editor. There was not a single Original Research Article in the field of congenital heart disease and the majority from this are published as pictorial images.
|Table 1: Top diseases contributing to the research productivity in cardiology |
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Mumbai (19%), Delhi (14%), and Chennai (8%) contributed the majority of cardiology related research articles followed by Ajmer and Jaipur (6% and 4% respectively). The contributions from other cities of India remain a small percentage individually as shown in [Figure 4]. Only six publications related to cardiology were submitted from foreign countries.
[Table 2] gives the details about the timelines between submission and publication. The time taken from initial submission to acceptance varied between 9 months and 10 months and another 4-5 months for publication. Hence, the average time taken by articles from submission to publication is about 13-15 months. Original Articles and Case Reports took more time in the pre-publication process than Pictorial Images and Letters to Editor (P = 0.0011). The timelines were significantly less for Images and Letters to Editor at all stages of the pre-publication process.
|Table 2: Comparison of publication timelines between four types of articles |
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| Discussion|| |
In this study, we analyzed the publication trends of cardiology related research articles in one of the most popular journal of India. The total number of articles related to cardiology subspecialty published per volume varied between 11% and 18% over the past 12 years. The peak contribution was seen in the years 2011 and 2007. Original Articles and Case Reports take a major share of published articles. This indicates that the specialty is conducting more number of research projects and also has a lot of interesting cases for the general practitioner. The contribution from the cardiology specialty is increasing in the past decade coinciding with the rise in the epidemic of non-communicable diseases in India. , India has the dubious distinction of being the diabetes capital of the world and diabetes is the leading cause of cardiovascular and renal disorders.  Hence, the research productivity of the cardiology is growing in parallel to the rise in number of patients with IHD, diabetes and hypertension. , The observed rate of growth pertaining to articles from cardiovascular diseases is similar to other major specialties such as endocrinology, neurology, and infectious diseases. 
IHD exists across a wide spectrum ranging from asymptomatic nature to sudden cardiac death. The IHD in Indians is characterized by young onset, multivessel disease, and non-obese phenotype with unique risk factors.  The other common disorders seen in cardiology out-patient department are structural heart disorders including valvular heart disorders and cardiomyopathies. India still is grappling with rheumatic heart disease and infectious endocarditis.  Congenital heart diseases are in minority and hence they are reported more as Case Reports and Pictorial Images. The research productivity of cardiology also captures the similar trend with about 75% of articles contributed from IHD and structural heart diseases as shown in [Table 1].
In view of a large number of patients available of IHD and a wide spectrum of disease, more number of researchers has studied the disease. Disorders pertaining to rhythm abnormalities and infectious diseases are less in numbers leading to a decline in the research productivity of these branches of cardiology. The factors responsible for this decline are : s0 pecialized nature of the studies, small number and not relevant to the general practitioner.  Most of the contributions to the JAPI in the field of cardiology have come from the three metros (Mumbai, Delhi, and Chennai). This is closely followed by Ajmer and Jaipur [Figure 4]. This is explained by the fact that corporate hospitals and academic institutes imparting medical education are located in these cities. Kolkata surprisingly did not feature in the top five places regarding cardiology related research productivity. This could be due to less prevalence of the disease coupled with investigators selecting more diverse research topics other than IHD.  The practitioners and institutes from other cities have contributed sporadically with case studies and research articles. Very few reports have been contributed from foreign countries and this could be due to poor visibility of the JAPI coupled with lack of online submission facilities. 
The articles take an average time of more than a year from the date of submission to acceptance. The timelines are different between types of articles, images and letters taking less time when compared to other types of articles [Table 2]. This could be due to delay in peer review process for the lack of complete details and delay in publishing after acceptance of the articles which consume more space in the journal. Though we analyzed all the online available data in this study, exclusion of some articles for lack of details is a limitation of our study. The publication trends of newly qualified versus old cardiologists could not be analyzed for the lack of relevant details in the articles database.
| Conclusions|| |
Our analysis showed that cardiology as a subspecialty contributed to 15% of articles in JAPI every year. Original Articles and Case Reports are the majority and Mumbai contributed the maximum number of articles in this subject. IHD and hypertension are the most favorite research topics followed by cardiomyopathy and valvular heart disease.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2]