Catalá-López Ferrán, Alonso-Arroyo Adolfo, Page Matthew J, Hutton Brian, Tabarés-Seisdedos Rafael, Aleixandre-Benavent Rafael
Department of Medicine, University of Valencia/INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain.
Fundación Instituto de Investigación en Servicios de Salud, Valencia, Spain.
PLoS One. 2018 Jan 3;13(1):e0189091. doi: 10.1371/journal.pone.0189091. eCollection 2018.
The management of comorbidity and multimorbidity poses major challenges to health services around the world. Analysis of scientific research in comorbidity and multimorbidity is limited in the biomedical literature. This study aimed to map global scientific research in comorbidity and multimorbidity to understand the maturity and growth of the area during the past decades.
This was a cross-sectional analysis of the Web of Science. Searches were run from inception until November 8, 2016. We included research articles or reviews with no restrictions by language or publication date. Data abstraction was done by one researcher. A process of standardization was conducted by two researchers to unify different terms and grammatical variants and to remove typographical, transcription, and/or indexing errors. All potential discrepancies were resolved via discussion. Descriptive analyses were conducted (including the number of papers, citations, signatures, most prolific authors, countries, journals and keywords). Network analyses of collaborations between countries and co-words were presented. During the period 1970-2016, 85994 papers (64.0% in 2010-2016) were published in 3500 journals. There was wide diversity in the specialty of the journals, with psychiatry (16558 papers; 19.3%), surgery (9570 papers; 11.1%), clinical neurology (9275 papers; 10.8%), and general and internal medicine (7622 papers; 8.9%) the most common. PLOS One (1223 papers; 1.4%), the Journal of Affective Disorders (1154 papers; 1.3%), the Journal of Clinical Psychiatry (727 papers; 0.8%), the Journal of the American Geriatrics Society (634 papers; 0.7%) and Obesity Surgery (588 papers; 0.7%) published the largest number of papers. 168 countries were involved in the production of papers. The global productivity ranking was headed by the United States (37624 papers), followed by the United Kingdom (7355 papers), Germany (6899 papers) and Canada (5706 papers). Twenty authors who published 100 or more papers were identified; the most prolific authors were affiliated with Harvard Medical School, State University of New York Upstate Medical University, National Taiwan Normal University and China Medical University. The 50 most cited papers ("citation classics" with at least 1000 citations) were published in 20 journals, led by JAMA Psychiatry (11 papers) and JAMA (10 papers). The most cited papers provided contributions focusing on methodological aspects (e.g. Charlson Comorbidity Index, Elixhauser Comorbidity Index, APACHE prognostic system), but also important studies on chronic diseases (e.g. epidemiology of mental disorders and its correlates by the U.S. National Comorbidity Survey, Fried's frailty phenotype or the management of obesity).
Ours is the first analysis of global scientific research in comorbidity and multimorbidity. Scientific production in the field is increasing worldwide with research leadership of Western countries, most notably, the United States.
共病和多重共病的管理给全球卫生服务带来了重大挑战。生物医学文献中对共病和多重共病的科学研究分析有限。本研究旨在梳理共病和多重共病领域的全球科学研究，以了解该领域在过去几十年中的成熟度和发展情况。
这是一项对科学网进行的横断面分析。检索从起始时间至2016年11月8日。我们纳入了不受语言或出版日期限制的研究文章或综述。由一名研究人员进行数据提取。两名研究人员进行了标准化过程，以统一不同术语和语法变体，并消除排版、转录和/或索引错误。所有潜在差异均通过讨论解决。进行了描述性分析（包括论文数量、引用次数、署名、发文最多的作者、国家、期刊和关键词）。展示了国家间合作和共词的网络分析。在1970 - 2016年期间，3500种期刊发表了85994篇论文（2010 - 2016年占64.0%）。期刊的专业领域差异很大，最常见的是精神病学（16558篇论文；19.3%）、外科学（9570篇论文；11.1%）、临床神经病学（9275篇论文；10.8%）以及普通内科和内科（7622篇论文；8.9%）。《公共科学图书馆·综合》（1223篇论文；1.4%）、《情感障碍杂志》（1154篇论文；1.3%）、《临床精神病学杂志》（727篇论文；0.8%）、《美国老年医学会杂志》（634篇论文；0.7%）和《肥胖外科学》（588篇论文；0.7%）发表的论文数量最多。168个国家参与了论文发表。全球生产力排名首位的是美国（37624篇论文），其次是英国（7355篇论文）、德国（6899篇论文）和加拿大（5706篇论文）。确定了20位发表100篇或更多论文的作者；发文最多的作者隶属于哈佛医学院、纽约州立大学上州医科大学、国立台湾师范大学和中国医科大学。被引用次数最多的50篇论文（“引用经典”，至少被引用1000次）发表在20种期刊上，其中以《美国医学会杂志·精神病学》（11篇论文）和《美国医学会杂志》（10篇论文）为首。被引用次数最多的论文在方法学方面（如查尔森共病指数、埃利克斯豪尔共病指数、急性生理与慢性健康状况评分系统）有贡献，但也包括关于慢性病的重要研究（如美国国家共病调查的精神障碍流行病学及其相关因素、弗里德衰弱表型或肥胖管理）。
我们的研究是对共病和多重共病领域全球科学研究的首次分析。该领域的科研产出在全球范围内不断增加，西方国家尤其是美国在研究方面占据领先地位。
