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International Publication Trends and Accountable Care Articles in Plastic Surgery: A Ten Year Analysis in Trends of Global Contribution and Evidence-Based Articles in the Plastic Surgery Literature

Subhas Gupta, Emily Kobayashi, Isha Gupta

Background: As globalization and worldwide economic development progress, the boundaries that previously prevented the exchange of goods, services and information have blurred. A second trend in the literature is an increased interest in accountable care. This study analyzed trends in both contribution and accountable care articles in the five highest impact factor plastic surgery journals over the past decade.

Methods: A review of publications in the top five highest impact factor plastic surgery journals from 2003 through 2012 was conducted and articles catalogued according to country of publication and subspecialty within plastic surgery. Over 15,000 articles were reviewed and 14,479 eligible articles were categorized and presented in this study. Next, a review was performed for accountable care articles in the Plastic Surgery literature. More than 10,000 articles were screened by title and journal, then by content with a total of 211 publications from the top five impact factor plastic surgery journals were found to be applicable, of which 189 qualified for analysis after removing letters and editorials.

Results: After compilation of all five journals, North America was the largest contributor and demonstrated a trend of increasing publication rates in both percentage and number of articles published. Though individual region contributions changed as a percentage, the absolute number of articles from North America, Europe, Oceana, Latin America and East and Southeast Asia increased over our study period. The only contributor showing a declining trend was the Middle East, with other regions remaining fairly stable from 2003-2012 in total number of articles published. In regards to accountable care articles, an increase was found in the number of primary articles regarding cost, efficiency, evidencebased practice and outcomes since 2000. This trend appears to be steeper than that seen in the literature of other medical specialties.

Conclusions: The stage for plastic surgery research has become international over the last ten years, a shift reflected in the observed publication trends. Most regions of the world demonstrated increasing or steady numbers of publications. In addition, the persistent variability in clinical practice found in our specialty has fueled a steadily increasing demand for evidence of clinical effectiveness. Consequently, a body of literature regarding safety, effectiveness, appropriate indications and cost-effectiveness has been developing at an increasing pace in the main Plastic Surgery journals. The creation of the EBM Special Topic section in the PRS journal in 2010 has had a clear impact on the number of evidence-based studies published in our specialty. We expect this trend may extend to our other specialty journals.