|Year : 2017 | Volume
| Issue : 1 | Page : 23-29
Medical speciality research in Saudi Arabia: A bibliometric assessment of productivity and worldwide ranking
Abdulhakim B Jamjoom
Department of Surgery, Section of Neurosurgery, King Khalid National Guards Hospital, Jeddah, Saudi Arabia
|Date of Web Publication||20-Jan-2017|
Abdulhakim B Jamjoom
Section of Neurosurgery, King Khalid National Guards Hospital, P.O. Box 9515, Jeddah 21423
Objectives: The objective of this study was to identify the medical specialities that had a positive relative contribution to scientific productivity in the Kingdom of Saudi Arabia (KSA) over the last two decades and to determine the influence of their contribution on KSA worldwide ranking in these specialities.
Methods: SCImago Journal and Country Rank was used to determine KSA's ranking in 46 medical specialities during 1996-2014 based on four productivity indices. Relative Specialisation Index (RSI) was calculated for each speciality. Specialities with RSI >0 were defined as the positive relative contribution specialities in KSA. They were compared with the remaining specialities using a number of parameters that were examined statistically.
Results: The median KSA ranking in 46 specialities was 42 for total documents, 43 for total cites, 79 for citations per document and 44 for h-index. Fourteen (30%) specialities were designated as the positive relative contribution specialities in KSA. These were ophthalmology, medicine (miscellaneous), paediatrics, complementary medicine, clinical genetics, clinical biochemistry, transplantation, surgery, infectious disease, nephrology, pulmonology, epidemiology, otolaryngology and anaesthesiology. Being a positive relative contribution speciality in KSA was not influenced by the nature of speciality or by having its own Saudi journal; however, it was associated with a significantly higher KSA ranking based on total documents, total cites and h-index but not based on citations per document.
Conclusions: Medical speciality contribution to research productivity in KSA was not influenced by the speciality having a Saudi journal. Positive relative contribution specialities had a significant impact on KSA ranking in three out of the four indices. KSA's medical specialities were ranked relatively low based on citations per document. KSA researchers of all medical disciplines should be encouraged to publish quality research in local and international journals.
Keywords: Bibliometrics, medical speciality research, Saudi Arabia, scientific productivity, worldwide ranking
|How to cite this article:|
Jamjoom AB. Medical speciality research in Saudi Arabia: A bibliometric assessment of productivity and worldwide ranking. J Health Spec 2017;5:23-9
|How to cite this URL:|
Jamjoom AB. Medical speciality research in Saudi Arabia: A bibliometric assessment of productivity and worldwide ranking. J Health Spec [serial online] 2017 [cited 2019 May 22];5:23-9. Available from: http://www.thejhs.org/text.asp?2017/5/1/23/198795
| Introduction|| |
Bibliometrics encompass a set of statistical methods that are used to quantitatively analyse the academic literature. It has a number of validated tools that can be utilised in the assessment of research performance in various disciplines and by different countries. In recent years, there has been an increasing interest in the objective evaluation of global scientific productivity and worldwide ranking for the medical specialities and subspecialities such as cardiovascular medicine, rheumatology, endocrinology and metabolism, plastic and reconstructive surgery, spine, foot and ankle research  and arthroscopy. Such data are useful in providing points of reference for comparison. It is also valuable in decision-making in relation to the development of research programmes and in the allocation of resources.
The first medical journal from the Kingdom of Saudi Arabia (KSA), the Saudi Medical Journal, was established in 1979, and over the years, KSA researchers had contributed to the national and international literature., A number of bibliometric studies that evaluated KSA's input to the medical and neurosurgical journals have been published in the past few years. These include analysis of the most cited articles in the Saudi medical literature, appraisal of the most cited Saudi neurosurgical publications in the worldwide literature, survey of the h-index for neurosurgeons in KSA, assessment of the rate of full publication of presentations from the Saudi Association of Neurological Surgery meetings, grading of the level of evidence of clinical neurosurgery research in KSA  and review of the Saudi publications in the highest impact medical journals. Furthermore, a bibliometric assessment of KSA's scientific output and worldwide ranking in clinical neuroscience was the subject of a recent publication. The impact of the contribution of KSA researchers on global medical sciences during the period 1996-2012 had also been examined in the past. However, a comparative assessment of research productivity between the various medical disciplines in KSA has never been undertaken. The objective of this study was to identify the medical specialities that were considered to have had a positive relative contribution to scientific productivity in KSA over the last two decades and to determine the influence of their contribution on KSA's worldwide ranking in these specialities.
| Methods|| |
This study was carried out at King Khalid National Guard Hospital (KKNGH), Jeddah, KSA. It was a review based on routinely available data with open access; hence, it did not require an ethical approval by KKNGH. The SCImago Journal and Country Rank (SCR) is a portal that incorporates journal and country scientific indicators obtained from Scopus database. The website gives lists of country rankings based on six individual features: Total documents, total cites, h-index, citable documents, citations per document and self-citations. The findings differ according to the searched area, category, region and year. The SCR website was searched on 15th January 2016 utilising the parameters: 'Medicine', '1996-2014', 'all regions' and 'each of the listed 48 specialities in the site'. The subject categories 'Drug Guides' and 'Medical Reviews and References' were excluded due to limited participation by KSA researchers. Using SCR, we determined KSA's worldwide ranking in each of the 46 specialities based on four productivity indices (total documents, total cites, citations per document and h-index). We also calculated the Relative Specialisation Index (RSI) for each of the 46 subject categories. RSI is an established quantitative bibliometric indicator that determines whether a country has a relatively higher or lower share in world publications in a speciality than its overall share in the world total publications. It was proposed by Schubert and Braun in 1986 and had been utilised in numerous publications afterwards.,,, RSI is derived from the Thematic Specialisation Index (TSI) which is a measure closely related to the relative activity index that was originally introduced by Frame in 1977. The TSI and RSI are calculated using the following bibliometric formulae:,
RSI has values that range from −1 to +1. An RSI >0 indicates an above world average productivity in the speciality while an RSI <0 indicates a below world average. Hence, in this study, KSA medical specialities that had RSI >0 were labelled as the positive relative contribution specialities while those with RSI ≤0 were referred to as the other specialities. An online search was carried out to identify all KSA journals which focused on one or more of the 46 subject categories. Medical and health sciences journals with a title that did not contain a particular speciality were excluded. The KSA medical journals and their allocated specialities are listed in [Table 1]. As the majority of these journals do not have a recorded impact factor (IF), this parameter was not included in the assessment. The positive relative contribution specialities were compared to the other specialities with regard to the nature of the speciality, whether clinical or nonclinical, and whether it had a speciality Saudi journal. Furthermore, the median KSA worldwide ranking for the 46 specialities was determined for each of the four productivity indices. Utilising the median rank as a cut-off point, the KSA worldwide ranking of the positive relative contribution specialities was compared to the ranking of the other specialities using the following parameters: Total documents rank (<42 vs. ≥42), total cites rank (<43 vs. ≥43), citations per document rank (<79 vs. ≥79) and the h-index rank (<44 vs. ≥44). All comparative data were examined by the Fisher's exact test, and significance was achieved when P < 0.05. The Social Sciences Statistics Site  was used for the statistical analysis.
|Table 1: List of Kingdom of Saudi Arabia journals with their speciality and start year|
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| Results|| |
The range (median) values for the four productivity indices in the 46 specialities in KSA were: Total documents: 18-10,361 (441), total cites: 119-61,341 (3610), citations per documents: 4.96-24.06 (11.17) and h-index: 4-75 (29). The range (median) values for the KSA worldwide ranking in the 46 specialities were: Total documents: 26-52 (42), total cites: 27-65 (43), citations per document: 43-192 (79) and h-index: 29-66 (44). The overall total documents relating to the 46 specialities originating from KSA and the whole world during 1996-2014 were 35,406 and 14,378,434 documents, respectively. The RSI range (median) for the 46 specialities in KSA was: −0.600-0.373 (−0.101). [Table 2] lists the 46 specialities based on their total documents and illustrates how the RSI scores were calculated using the previously stated formulae. [Table 3] shows the worldwide rankings in the 46 medical specialities according to four productivity indices. The 14 specialities with RSI >0 that were considered to have had a positive relative contribution to research productivity in KSA over the last two decades and their RSI scores were: Ophthalmology: 0.373, medicine (miscellaneous): 0.211, paediatrics: 0.194, complementary medicine: 0.177, clinical genetics: 0.133, clinical biochemistry: 0.125, transplantation: 0.111, surgery: 0.088, infectious disease: 0.077, nephrology: 0.059, pulmonology: 0.053, epidemiology: 0.043, otolaryngology: 0.040 and anaesthesiology: 0.034. The other 32 specialities with RSI ≤0 are listed in [Table 2].
|Table 2: Total documents and Relative Specialisation Index calculation for the 46 specialities in Kingdom of Saudi Arabia|
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|Table 3: Worldwide rankings based on four indices for 46 medical specialities in Kingdom of Saudi Arabia|
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Thirty-one specialities were clinical while remaining 15 were non-clinical (laboratory, basic sciences and others). Twenty-four specialities had a KSA journal while 22 did not. [Table 4] summarises the comparison between the positive relative contribution specialities and the other specialities based on the nature of the speciality, the presence of a speciality-focused Saudi journal and KSA worldwide ranking in the speciality based on four productivity indices. Not surprisingly, positive relative contribution specialities compared to the others were associated with significantly higher KSA worldwide ranking (above the median) based on total documents (P < 0.001), total cites (P = 0.001) and h-index (P = 0.027). However, there was no significant difference in the rankings between the two groups of specialities when citations per document were used as the index (P = 0.754). Furthermore, the 14 positive relative contribution specialities were diverse in their focus and did not differ significantly from the other 32 specialities in nature (clinical vs. non-clinical) (P = 0.748) or in having a Saudi speciality journal (P = 0.114).
|Table 4: Comparison between the positive relative contribution specialities and the other specialities in Kingdom of Saudi Arabia based on a number of parameters|
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| Discussion|| |
SCR is a free-access portal that uses Scopus indexed journals for quality assessment. It is computed using an algorithm that reflects not only the number of citations but also the prestige of the citation source. SCR has been recognised as a serious alternative to the well-established journal IF and to other scientometric measures.,, Saudi Arabia's research productivity in medical science had increased markedly in recent years., Compared to the latter published studies, the data pool presented here is very large (total of 35,406 KSA documents extracted from 6,450 journals over a 19-year period). The observed wide difference in output between the various medical specialities is not surprising. Specialities differ in their research history and opportunities. They also vary in their number of researchers, number of journals and journals IFs. It is generally accepted that direct comparison between the research productivity of various medical fields may not be informative. It is also documented that the h-index cannot be used to compare scientists belonging to different fields, even closely related specialities. Therefore, to overcome this, the RSI was calculated for each of the 46 specialities and used to compare their relative contribution to research productivity in KSA. RSI is an index that relativises the scientific output of the different specialities with the international productivity. The higher the RSI above 0, the more the relative contribution and impact of the speciality on the country's productivity.
Research productivity appears to be more visible in some medical disciplines compared to others. Using PubMed, Al-Bishri  reviewed KSA's total publications during 2010-2011 and reported that most of the articles were in the fields of community medicine, pathology, medicine and surgery. In this study, 14 of the searched 46 specialities were considered to have had a positive relative contribution to scientific productivity in KSA over the last two decades. These were in the order of their RSI score: Ophthalmology, medicine (miscellaneous), paediatrics, complementary medicine, clinical genetics, clinical biochemistry, transplantation, surgery, infectious disease, nephrology, pulmonology, epidemiology, otolaryngology and anaesthesiology. There are problems facing the execution of quality research in KSA which may be more prominent in some specialities than others. These include lack of experience, time constraints as well as limited logistic support and funding. In addition, the absence of qualified Saudi researchers holding research degrees as well as the dilution of the clinical load due to the non-regionalisation of the services.
In this study, the median worldwide ranking for KSA in 46 specialities was 42 based on total documents, 43 based on total cites and 44 based on h-index. Using these three indicators, the author calculated an adjusted worldwide rank for KSA in clinical neuroscience and found it to be 40. The rank was considered low as KSA satisfied a number of the country-specific characteristics that were associated with a higher rank. It is reported that scientific productivity in clinical neurology is strongly influenced by the number of universities a country has among the top 500 in the world and by the number of speciality journals listed in SCR. It is also influenced to a lesser degree by the gross domestic product (GDP) per capita and the percentage of GDP spent on research and development (R and D). The worldwide ranking for KSA in the 46 specialities based on citations per document was fairly low compared to the other three indicators (median 79). This is probably a reflection of the recognised trend for KSA researchers to be published in local journals with low IF. The question of whether KSA researchers should publish their quality articles in international journals or national journals can be a matter of debate. Publications in high IF journals are more likely to be cited and likely to improve the country's worldwide ranking. On the other hand, good publications in Saudi journals will help to improve their IF and likely to prove more beneficial on the long-term.
Ophthalmology was the most productive speciality (RSI score 0.373) and had the highest worldwide ranking among the 46 medical specialities in KSA (four indices median rank was 28). The reasons for the relatively good achievement by KSA ophthalmology researchers could be multifactorial and may involve having a major national tertiary centre (King Khalid Eye Specialist Hospital, Riyadh) that was established 1983. In addition, ophthalmology was one of the earliest specialities in KSA to have its own association and journal (Saudi Association of Ophthalmological Society and Saudi Journal of Ophthalmology which were launched in 1985 and 1986, respectively). Medicine (miscellaneous) was the second most productive speciality (RSI score 0.211). This is expected considering the size of the speciality which encompasses the two oldest Saudi journals, namely, the Saudi Medical Journal and the Annals of Saudi Medicine which were established in 1979 and 1985, respectively. In addition, the contribution to medicine (miscellaneous) may have been inflated by speciality and topic overlap. The SCR website did not provide a clear description of how the scientific publications were distributed between medicine (miscellaneous), internal medicine and their various sub-specialities. It is, therefore, possible that some speciality articles from KSA that were published in a general medical journal may have been misclassified into medicine (miscellaneous).
There are a number of limitations to this study. The positive impact specialities were defined as specialities with a positive RSI score. This could be argued as it resulted in the exclusion of a number of specialities such as cardiology, neurology, public health, oncology and radiology which had an impact on KSA research through their relatively large numbers of total documents. The study was dependent on the accuracy of the website search engine SCR. It is possible that there were errors, particularly with multi-national publications. Furthermore, there may have been some speciality and topic overlap. The influence of the presence of a Saudi speciality association or the starting date of the Saudi speciality journal on scientific productivity was not examined.
| Conclusions|| |
The median KSA worldwide ranking in 46 specialities was 42 for total documents, 43 for total cites, 79 for citations per document and 44 for h-index. Positive contribution to research productivity by the various medical specialities in KSA was not influenced by the speciality's nature or by having a local speciality journal. Specialities with a positive relative contribution had a significant impact on KSA worldwide ranking based on three out of the four indices used. The relatively low ranking for KSA's medical specialities based on citations per document is explained by the trend for KSA researchers to publish in local journals with low IF. KSA researchers of all medical disciplines should be motivated to publish quality papers in national and international journals. International research collaboration should be encouraged. KSA needs to promote 'research culture' and establish clinical academic departments staffed by Saudi PhD-holders. KSA universities need to create strong PhD programmes that are linked to highly ranked international universities.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]