WHO Global Coordination Mechanism on Non-Communicable Diseases, World Health Organization, Geneva, Switzerland.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BMJ Open. 2017 Nov 12;7(11):e014715. doi: 10.1136/bmjopen-2016-014715.
Low-income and lower middle-income countries (LLMICs) bear a disproportionate burden of non-communicable diseases (NCDs). WHO has repeatedly called for more research on poverty and NCDs in these settings, but the current situation remains unquantified. We aimed to assess research output on poverty and NCD risk factors from these countries in relation to upper middle-income and high-income countries.
Bibliometric analysis of primary research published between 1 January 1990 and 4 May 2017. We searched 13 databases, combining terms for poverty and NCD behavioural risk factors (tobacco, alcohol, diet and physical activity). Independent dual review was used to screen titles, abstracts and full papers. Two-tailed t-testing and multiple linear regression analyses were used to compare differences in means.
(1) Proportion of lead authors affiliated with institutions based in high and upper middle-income countries vs LLMICs. (2) Mean number of citations for publications from each region. (3) Mean journal impact factor for studies from each region.
Ninety-one (67%) of the 136 included studies were led by scientists affiliated with LLMIC-based institutions. These authors represented 17/83 LLMICs (20%), and their studies garnered 4.8 fewer citations per paper than studies led by high-income and upper middle-income-affiliated authors; however, this finding was non-significant (P=0.67). Papers led by authors based in high-income and upper middle-income countries were published in journals with a mean impact factor 3.1 points higher than those from LLMICs (4.9 vs 1.7) adjusting for year of publication and number of citations (P<0.001).
Most poverty and NCD risk factor research is led by authors from a small number of LLMICs. These studies are being published in relatively low-impact journals, and the vast majority of LLMICs are not producing any research in this area that is vital to their social and economic development. The paucity of domestic evidence must be addressed to inform global policy.
低收入和中低收入国家（LMICs）承担着不成比例的非传染性疾病（NCDs）负担。世界卫生组织一再呼吁在这些国家开展更多关于贫困和 NCD 的研究，但目前的情况仍未得到量化。我们旨在评估这些国家与中上收入和高收入国家在贫困和 NCD 风险因素方面的研究产出。
对 1990 年 1 月 1 日至 2017 年 5 月 4 日期间发表的初级研究进行文献计量分析。我们搜索了 13 个数据库，将贫困和 NCD 行为风险因素（烟草、酒精、饮食和身体活动）的术语结合起来。采用独立的双审查来筛选标题、摘要和全文。使用双尾 t 检验和多元线性回归分析来比较平均值的差异。
（1）主要作者隶属于高收入和中上收入国家与 LLMICs 的机构的比例。（2）每个地区出版物的平均引用次数。（3）每个地区研究的平均期刊影响因子。
91 项（67%）纳入研究由隶属于 LLMIC 机构的科学家领导。这些作者代表了 17/83 个 LLMICs（20%），他们的研究每篇论文的引用次数比高收入和中上收入相关作者的研究少 4.8 次；然而，这一发现没有统计学意义（P=0.67）。由高收入和中上收入国家的作者领导的论文发表在期刊上的平均影响因子比来自 LLMICs 的论文高 3.1 分（4.9 比 1.7），这是在调整出版年份和引用次数的情况下（P<0.001）。
大多数贫困和 NCD 风险因素研究由少数 LLMICs 的作者领导。这些研究发表在相对低影响力的期刊上，绝大多数 LLMICs 没有在这一对其社会和经济发展至关重要的领域开展任何研究。必须解决国内证据不足的问题，为全球政策提供信息。
