Social media platforms and news outlets are important avenues for dissemination of research output to more broadly inform the public of medical advances and to promote health. The relative distribution of focus areas of public interest and engagement is quantifiable using the Altmetric score, which captures the attention an article receives through weighted measures of each electronic source. We aimed to identify and describe the articles in 4 major cardiovascular journals that garnered the most digital attention in 2017.
Methods ∣
From June 1 to August 31, 2018, we tabulated the number of articles published in the following 4 select journals in 2017: Circulation, European Heart Journal, the Journal of the American College of Cardiology, and JAMA Cardiology. We identified the 10% of articles with the highest Altmetric scores within each journal in 2017 using Dimensions, an online searchable platform that aggregates data on more than 91 million publications.1 We extracted data regarding overall Altmetric score and its components, the number of citations at the time of the search query (August 2018), and open access status. We evaluated the abstracts and full-text articles to obtain data regarding article type, topic, and study design. As these article metrics were publicly available and did not contain patient information, institutional review board approval was not required.
We used the Spearman rank correlation coefficient to assess the correlation between Altmetric score and number of citations. Both Altmetric scores and number of citations were log-transformed given skewed distributions. Analyses were carried out using R, version 3.5.0 (R Foundation for Statistical Computing). All P values were from 2-sided tests and results were deemed statistically significant at P < .05.
Results ∣
In 2017, there were 3108 articles published in the 4 journals in our study (Circulation, 858; European Heart Journal, 834; Journal of the American College of Cardiology, 1043; and JAMA Cardiology, 373). The top 10% of articles in each journal resulted in 310 total manuscripts (Table). The median Altmetric score was 188 (interquartile range, 118-357), attracting a median of 80 Twitter participants across a median of 5 continents. Nearly half of articles (144 [46.5%]) were not original investigations. Median Altmetric scores were highest for research letters (280), editorials (226), and guidelines and scientific statements (204). The median number of citations per article was 11 (interquartile range, 4-22). Overall, 97 articles (31.3%) were open access; there was no difference in Altmetric score between articles that were open access and those that were not (198 [interquartile range, 118-369] vs 186 [interquartile range, 118-357]; P = .85). Approximately one-fifth (63 [20.3%]) of articles pertained directly to nutrition and lifestyle. Observational studies accounted for most original investigations and research letters. There was a weak but significant correlation between log-transformed Altmetric scores and log-transformed number of citations (rs = 0.16; P = .006) (Figure).
Table.
Characteristics of Top 10% of Articles Published in Each Journal in 2017 by Altmetric Score
| Characteristic | No. (%) (N = 310) |
|---|---|
| Journal | |
| Circulation | 86 (27.7) |
| European Heart Journal | 83 (26.8) |
| Journal of the American College of Cardiology | 104 (33.5) |
| JAMA Cardiology | 37 (11.9) |
| Altmetric score, median (IQR) | 188 (118-357) |
| News outlets, median (IQR), No. | 14 (2-35) |
| Twitter demographics, median (IQR). No. | |
| Participants | 80 (34-182) |
| Continents | 5 (4-6) |
| Mendeley readers, median (IQR), No. | 26 (12-44) |
| Article type | |
| Original investigation | 166 (53.5) |
| Research letter | 18 (5.8) |
| Review | 28 (9.0) |
| Editorial | 25 (8.1) |
| Viewpoint | 22 (7.1) |
| Guideline or scientific statement | 51 (16.5) |
| Citations, median (IQR), No. | 11 (4-22) |
| Open access | 97 (31.3) |
| Article topic | |
| Nutrition and lifestyle | 63 (20.3) |
| Electrophysiology | 61 (19.7) |
| Coronary artery disease | 60 (19.4) |
| Heart failure or cardiomyopathy | 43 (13.9) |
| Lipids | 34 (11.0) |
| Valve disease | 23 (7.4) |
| Healthcare quality | 18 (5.8) |
| Hypertension | 15 (4.8) |
| Vascular medicine | 14 (4.5) |
| Procedure or drug safety | 3 (1.0) |
| Adult congenital heart disease | 3 (1.0) |
| Other | 25 (8.1) |
| Study design | |
| Clinical observational | 156 (50.3) |
| Clinical trial | 18 (5.8) |
| Basic science | 10 (3.2) |
Abbreviation: IQR, interquartile range.
Figure. Correlation Between Altmetric Score and Number of Citations.
Each data point represents a single article. Both Altmetric scores and number of citations were log-transformed to account for skewed distributions.
Discussion ∣
Our study highlights several findings regarding the top performing contemporary articles in major cardiovascular journals by Altmetric score. First, the top 10% of research articles have an impressive median Altmetric score (188), well within the top 5% of all scientific output, defined by an Altmetric score greater than 20.1 Second, nearly half of the most disseminated articles were not original investigations. These data suggest that guideline documents, scientific statements, editorials, and viewpoints garner significant digital attention. Third, nutrition and lifestyle was the primary subject matter among one-fifth of articles. The highest-scoring article in each of the journals in 2017 was related to nutrition and lifestyle,2-5 suggesting that these topics are of higher interest to media outlets. Fourth, although open access status may improve visibility among the academic community, it does not appear to influence media attention. Finally, in our study examining a broad range of research output in 2017, Altmetric scores and number of citations were weakly correlated, consistent with findings from prior work restricted to original investigations from 2014.6 This finding raises concern that articles achieving digital attention may not be of equivalent interest among the academic community. Our study is limited by the recent publication of articles, which may not allow for sufficient accrual of citations. Future research is needed to understand better the effect of targeted social media engagement in disseminating and advancing science in cardiovascular medicine.
Acknowledgments
Conflict of Interest Disclosures: Dr Patel reported being supported by the National Heart, Lung, and Blood Institute T32 postdoctoral training grant (T32HL069771). DrVaduganathan reported being supported by the KL2/Catalyst Medical Research Investigator Training award (an appointed KL2 award) from Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award KL2 TR002542), and serving on advisory boards for Bayer AG and Baxter Healthcare. DrBhatt reported serving on advisory boards for Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, and Regado Biosciences; serving on the board of directors for the Boston Veterans Affairs Research Institute, Society of Cardiovascular Patient Care, and TobeSoft; serving as chair of the American Heart Association Quality Oversight Committee; serving on the data monitoring committees for Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic, Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi Sankyo), and Population Health Research Institute; receiving honoraria from the American College of Cardiology (Senior Associate Editor, Clinical Trials and News, ACC.org; Vice-Chair, ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim), Belvoir Publications (Editor in Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees), HMP Global (Editor in Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (Guest Editor; Associate Editor), Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national co-leader, funded by Bayer), Slack Publications (Chief Medical Editor, Cardiology Today's Intervention), Society of Cardiovascular Patient Care (Secretary/Treasurer), and WebMD (CME steering committees); serving as the Deputy Editor of Clinical Cardiology; serving as chair of NCDR-ACTION Registry Steering Committee; serving as chair of VA CART Research and Publications Committee; receiving research funding from Abbott, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, Eisai, Ethicon, Forest Laboratories, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, Regeneron, Roche, Sanofi Aventis, Synaptic, and The Medicines Company; receiving royalties from Elsevier (Editor, Cardiovascular Intervention: A Companion to Braunwald's Heart Disease); serving as site coinvestigator for Biotronik, Boston Scientific, St Jude Medical (now Abbott), and Svelte; serving as trustee for the American College of Cardiology; and performing unfunded research for FlowCo, Merck, Novo Nordisk, PLx Pharma, and Takeda. No other disclosures were reported.
Footnotes
Disclaimer: Dr Bonow is Editor of JAMA Cardiology, but he was not involved in any of the decisions regarding review of the manuscript or its acceptance.
Contributor Information
Ravi B. Patel, Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Muthiah Vaduganathan, Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts.
Deepak L. Bhatt, Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts.
Robert O. Bonow, Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, JAMA Cardiology.
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