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Evolution of military medicine literature: a scientometric study of global publications on military medicine between 1978 and 2017
  1. Engin Şenel
  1. Department of Dermatology and Venereology, Hitit University Faculty of Medicine, Çorum 19200, Turkey
  1. Correspondence to Dr. Engin Şenel, Department of Dermatology and Venereology, Hitit University Faculty of Medicine, Çorum 19200, Turkey; enginsenel{at}enginsenel.com

Abstract

Objectives Scientometrics is a popular statistical discipline providing data relevant to publication patterns and trends in a certain academic field. There are no scientometric analyses of publications produced in military medicine literature. The present study aims to perform a holistic analysis of military medicine literature.

Methods All data of this study were collected from the Web of Science Core Collection. All indexed documents between 1978 and 2017 were included. Countries, authors, institutions, citations and keywords relevant to the military medicine literature were comprehensively analysed. An infomap revealing global productivity and infographics of scientometric networks were generated.

Results A total of 48 240 published items were found, 82.29% of which were original articles. USA, covering 56.66% of all literature dominated the military medicine field followed by the UK, China, Canada and Israel. We found that 18 of 20 most productive institutions in the world were from USA and the US Department of Defense was the most contributing institution in the literature with 9664 documents. The most used keywords over a 40-year period were ‘military’, ‘veterans’, ‘posttraumatic stress disorder’ and ‘military personnel’. A scientometric network of keywords showed a complicated ‘starburst pattern’.

Conclusion All most contributing countries except Turkey, China and Israel were developed nations. Only one institution (Tel Aviv University) from developing countries was noted in the list of 20 most productive institutions. The researchers from developing and the least developed countries should be encouraged and supported to carry out novel studies on military medicine.

  • military medicine
  • bibliometrics
  • scientometrics
  • publication patterns
  • publication trends

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Key messages

  • The present study aims to perform the first scientometric analysis of military medicine literature.

  • All indexed documents between 1978 and 2017 were included.

  • A total of 48 240 published items were found and 82.29% of which were original articles.

  • The United States of America (USA) covering 56.66% of all literature dominated the military medicine field followed by the UK, China, Canada and Israel.

  • Only one institution from developing countries was noted in the list of twenty most productive institutions.

  • The researchers from developing and the least developed countries should be encouraged supported to carry out novel studies on military medicine.

Introduction

Bibliometrics evaluates publications produced in a certain field of academic literature and clarifies publication patterns and trends. Scientometrics also known as ‘science of science’ is a novel and popular statistical discipline investigating all aspects of scientific literature.1 Scientometric researches provide more comprehensive assessment and examine characteristics of the authors, countries and organisations producing academic documents in the literature.2 Although the number of bibliometric and scientometric studies has been rising in the last decades, there has been no recent scientometric analysis of publications published in military medicine literature. This study aims to present a holistic analysis of academic literature relevant to military medicine. To the best of our knowledge, this is the first report in this field.

Methods

All data of this study were retrieved from Web of Science (WoS) Core Collection (Thomson Reuters, New York, New York, USA). As the data source we chose WoS since it provides data analysis for publications and citations and allows sorting the results by times cited. Also, WoS citation data are considered more reliable and reproducible than other databases and WoS is used by official organisations as the standard.3 We used a search query including keywords of (‘medical’ OR ‘medicine’ OR ‘health’) AND (‘military’ OR ‘army’). All documents produced between 1978 and 2017 were retrieved from the WoS database and included in the analyses. A free web source titled GunnMap was used to create an infomap revealing the production of world countries.4 Scientometric network analysis was performed by using VOSviewer freeware.5 We grouped countries according to the United Nations (UN) country classification system.6 For analytical and statistical purposes, World Economic Situation and Prospects 2019, a joint product of the UN Department of Economic and Social Affairs, the UN Conference on Trade and Development and the five UN regional commissions (Economic Commission for Africa, Economic Commission for Europe, Economic Commission for Latin America and the Caribbean, Economic and Social Commission for Asia and the Pacific and Economic and Social Commission for Western Asia) classifies all world countries into three broad categories: developed economies, economies in transition and developing economies. A list of the least developed countries was also decided by the UN Economic and Social Council.6

Results

General features of the literature

A total of 48 240 published documents was retrieved during the period 1978–2017, 82.29% of which were original articles (table 1). The most popular research areas of the literature were internal medicine, occupational health, healthcare sciences, behavioural sciences and psychology (36.25%, 30.78%, 25.02%, 22.49% and 22.31%, respectively; table 2). The peak year of production was 2017 with 3178 items. The predominant language of the literature was English (91.99%) followed by Russian, French, Korean and Spanish (3.42%, 1.53%, 1.17% and 1.16%, respectively).

Table 1

Document types published in military medical literature between 1978 and 2017

Table 2

Most study research areas of military medical literature between 1978 and 2017

The most contributing authors, journals, meetings and institutions

The most prolific author was Wessely S with 188 articles in this area (table 3). The most contributed source title was found to be Military Medicine with 4786 articles followed by Aviation, Space, and Environmental Medicine, Voenno-Meditsinskii Zhurnal and Journal of the Royal Army Medical Corps (n=1442, 985 and 442 items, respectively; table 4). The most contributing meetings were noted to be the National Aerospace Electronics Conferences in this field. We found that 18 of 20 most productive institutions in the world were from USA and the US Department of Defense was the most contributing institution in the literature with 9664 documents followed by its subordinate military departments, the US Army and the US Navy (table 5).

Table 3

The 20 most prolific authors of military medicine literature between 1988 and 2017

Table 4

The 10 most productive source titles in military medical literature between 1978 and 2017

Table 5

The 20 most productive institutions in military medical literature between 1978 and 2017

Global productivity

USA dominated the military medical literature and covered 56.66% of all productivity with 27 331 items. The UK ranked #2 with 2935 documents followed by China, Canada and Israel (n=1352, 1284 and 1245 items, respectively; figure 1). Almost all world but some countries in Africa produced publications in this field (figure 2).

Figure 1

The 10 most contributing countries in military medicine literature.

Figure 2

Publication density of world countries in military medicine.

Citation and keyword analysis by decades

Since the citation report feature of the WoS database is not available from a search containing more than 10 000 records, we had to analyse citations and keywords by decades.

1978–1987

A total of 303 articles was indexed in WoS Core Collection during the period 1978–1987, 58.09% of which were original articles. The peak year for productivity was 1982 with 50 items. The US Department of Defense was the most contributing institution with 71 documents (23.43%) followed by the US Army and the US Navy (13.2% and 3.3%, respectively). Macher AM was the most prolific author with 12 articles (3.96%) in this decade. Military Medicine covered 29.04% of all literature with 88 items followed by Medécine & Armées and New England Journal of Medicine (21.12% and 6.93%, respectively). USA ranked first with 155 articles (51.15%) in the literature followed by France, the UK and the Federal Republic of Germany (formerly known as West Germany) (11.88 and 2.31, respectively). In this decade, only 15 countries in the world produced publications in this area (table 6). The h-index of the literature was measured as 10 and the total citation number was 429. An original article titled ‘Cigarette-Smoking, Oral Hygiene and Periodontal Health in Swedish Army Conscripts’ published in the Journal of Clinical Periodontology in 1980 was the most cited document in this period.

Table 6

The top 20 countries publishing in military medical literature by decades between 1988 and 2017 (source: Web of Science Core Collection database)

1988–1997

Between 1988 and 1997, 1702 articles were produced in military medical literature and 80.43% of all documents were original articles. The production of the items gradually raised by year and peaked in 1997 with 305 documents. Gunby P was the most prolific author and the US Department of Defense was the biggest contributor with 435 articles (25.56%). USA was the leading country with 435 papers followed by Israel and France (63.33%, 3.64% and 3.58%, respectively; table 6). Military Medicine was the most productive source title with 443 articles (26.03%) followed by Journal of The American Medical Association and Aviation, Space, and Environmental Medicine (3.7% and 2.64%, respectively). The h-index of the literature in this decade was 79, the total number of citations was 32 642 (32 310 without self-citations) and the average citations per item was 19.18. The most cited document was an original article titled ‘A survey of augmented reality’ by Azuma RT published in Presence: Teleoperators and Virtual Environments in 1997 (table 7). The most common keywords of the literature in this period were ‘military medicine’, ‘epidemiology’, ‘military personnel’ and ‘PACS (Picture Archiving and Communication System)’ (table 8). Scientometric network analysis of the most used keywords revealed two main circles with the keyword ‘military medicine’ at the intersection (figure 3).

Figure 3

Scientometric network of the most used keywords in military medicine literature between 1988 and 1997.

Table 7

Most cited articles in military medical literature by decades

Table 8

The most used keywords of military medical literature by decades

1998–2007

During the period 1998–2007, 4561 documents were indexed by WoS Core Collection and most of them were original articles (75.99%). The peak year was 2007 with 662 items and the US Department of Defense was the most contributing institution with 1225 articles. The most prolific author was found to be Wessely S with 52 papers. The most contributed source titles were Military Medicine, Aviation, Space, and Environmental Medicine and Journal of The American Medical Association (19.71%, 3.05% and 2.37%, respectively). USA ranked first with 2933 articles (64.31%) in this period followed by the UK, Israel, Germany and Turkey (5.52%, 3.57%, 3.4% and 2.63%, respectively; table 6). The h-index of the literature was calculated as 132 in this decade and the total number of citations was 117 600 (113 750 without self-citations). The most cited paper of this decade was an original article titled ‘A survey on sensor networks’ published in 2002 (table 7). The most used keywords in indexed publications were ‘military medicine’, ‘military personnel’, ‘veterans’ and ‘epidemiology’ (table 8). A ‘starbust pattern’ around centred keywords of ‘military medicine’ and ‘military’ was found in scientometric network analysis (figure 4).

Figure 4

Keyword network of military medicine literature between 1998 and 2007.

2008–2017

A total of 13 536 publications was produced between 2008 and 2017 in military medicine literature and 77.63% of all papers were original articles. The peak year was 2017 with 2075 documents. The US Department of Defense was the most productive organisation with 2151 items (15.9%). Wessely S was the most prolific author with 118 papers (0.87%) as in the previous decade. Military Medicine was the most contributing source title with 1178 articles (8.7%) followed by the Chinese Journal of Traumatology and Journal of The Royal Army Medical Corps (1.85% and 1.68%, respectively). USA covered 55.64% of all literature with 7532 items followed by the UK, China and Germany (7.4%, 5.24% and 3.33%, respectively; table 6). The h-index of the literature was 105 in this period and the total number of citations was 117 393 (95 366 without self-citations). An original article titled ‘Mild traumatic brain injury in US Soldiers returning from Iraq’ published in the New England Journal of Medicine in 2008 was the most cited document (table 7). The most common keywords in the literature in this decade were ‘military’, ‘veterans’, ‘posttraumatic stress disorder’ and ‘mental health’ (table 8). Scientometric network analysis revealed centred keywords of ‘military’, ‘veterans’, ‘epidemiology’, ‘health’, ‘combat’, ‘PTSD (Post-traumatic stress disorder)’ and ‘trauma’ (figure 5).

Figure 5

Scientometric network of the most used keywords of military medicine field between 2008 and 2017.

1978–2017

The most used keywords over a 40-year period were ‘military’, ‘veterans’, ‘Posttraumatic stress disorder’ and ‘military personnel’ (table 8). The scientometric network of keywords showed a complicated ‘starburst pattern’. USA was found to be the most collaborative country with 10 539 documents and 209 367 citations followed by the UK, Germany, Canada, France and Australia (figure 6). Uniformed Services University and Boston University were the most collaborative institutions (figure 7).

Figure 6

Scientometric network of the most collaborative countries in military medicine literature.

Figure 7

Scientometric network of the most collaborative institutions in military medicine literature.

Discussion

Scientometric analyses provide qualitative and quantitative evaluation of academic literature and clarify the most popular, active and trending fields.7 Scientometric studies reveal publication trends and productivity of the countries, authors and organisations in a certain area.8 Although an increasing popularity of scientometrics has been noted recently in the academic literature, there have been limited articles focusing on military medicine.

In a recent report, Vickers et al performed a bibliometric study investigating publications on military trauma and found a total of 5496 documents. The top contributing institutions were reported to be Washington DC military institutions (National Navy Medical Centre Bethesda, Uniformed Services University of Health Sciences, Walter Reed Army Institute of Research and Walter Reed National Military Medical Centre), San Antonio military institutions and UK institutions. The most productive country was USA as found in our study. The authors noted that USA was followed by the UK, Germany and Israel.9

In our decade analysis of the literature relevant to military medicine, we detected that USA was dominated literature overall and covered more than 50% of all global productivity in all decades. Although China was not among the first 20 countries producing publications between 1978 and 1997, it was the third most contributing country between 2008 and 2017. China also left behind many other productive countries such as Canada, Israel and France and ranked third in an overall evaluation of 40 years (figure 1 and table 6).

Between 1998 and 2007, medical problems during the wars in Iraq and Afghanistan became the major topics in the literature as seen in the most cited articles (table 7). Only in this decade, a term of ‘Persian Gulf syndrome’ was among the most used keywords. The Persian Gulf War or The First Gulf War code named Operation Desert Shield was a military action by a US-led coalition force against Iraq as a result of the crisis that began with the invasion of Iraq by Kuwait on 2 August 1990. Gulf War Illness (GWI) formerly known as Persian Gulf syndrome is a chronic multisymptomatic disease affecting 25%–32% of veterans of The First Gulf War for over two decades.10 The reported symptoms of GWI include headache, fatigue, musculoskeletal pain, cognitive dysfunction, and gastrointestinal and dermatological complaints.10 Also, brain cancer has been reported at increased rates in veterans returned from theatre. Although the actual cause(s) of GWI remains unknown, reported studies support a role of neurotoxicants, that were present in theatre, such as carbamates, organophosphates, sarin nerve agents and pesticides.11

Conclusions

As we investigated the most contributing countries, all countries except Turkey, Israel and China were developed nations according to the UN classification. Turkey, Israel and China were developing countries according to the UN country classification.6 Only one institution (Tel Aviv University, Israel) from developing countries was noted and 17 of 20 institutions in the list of 20 most productive institutions were from USA. All the most prolific authors were from two developed countries, USA and the UK. Physicians from developing and the least developed countries should be supported to perform novel studies relevant to military medicine.

References

Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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