Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
BMJ Open. 2019 Mar 23;9(3):e027308. doi: 10.1136/bmjopen-2018-027308.
To analyse trends in the academic literature applying complexity science to healthcare, focusing specifically on bibliometric characteristics and indicators of influence.
This study reports a bibliometric analysis via a systematic search of the academic literature applying complexity science to healthcare.
A search of four academic databases was performed on 19 April 2018. Article details were downloaded and screened against inclusion criteria (peer-reviewed journal articles applying complexity science to healthcare). Publication and content data were then collected from included articles, with analysis focusing on trends over time in the types and topics of articles, and where they are published. We also analysed the influence of this body of work through citation and network analyses.
Articles on complexity science in healthcare were published in 268 journals, though a much smaller subset was responsible for a substantial proportion of this literature. USA contributed the largest number of articles, followed by the UK, Canada and Australia. Over time, the number of empirical and review articles increased, relative to non-empirical contributions. However, in general, non-empirical literature was more influential, with a series of introductory conceptual papers being the most influential based on both overall citations and their use as index references within a citation network. The most common topics of focus were health systems and organisations generally, and education, with recent uptake in research, policy, and change and improvement.
This study identified changes in the types of articles on complexity science in healthcare published over time, and their content. There was evidence to suggest a shift from conceptual work to the application of concrete improvement strategies and increasingly in-depth examination of complex healthcare systems. We also identified variation in the influence of this literature at article level, and to a lesser extent by topic of focus.
分析将复杂性科学应用于医疗保健的学术文献的趋势，重点关注文献计量学特征和影响力指标。
本研究通过对应用复杂性科学于医疗保健的学术文献进行系统搜索，报告了一项文献计量分析。
于 2018 年 4 月 19 日在四个学术数据库中进行了搜索。下载文章详细信息并根据纳入标准（应用复杂性科学于医疗保健的同行评审期刊文章）进行筛选。然后从纳入的文章中收集出版和内容数据，分析重点是文章类型和主题随时间的变化，以及文章的出版地点。我们还通过引文和网络分析分析了这部分工作的影响力。
在 268 种期刊上发表了关于医疗复杂性科学的文章，但只有一小部分期刊对这一文献的大部分内容负责。美国发表的文章数量最多，其次是英国、加拿大和澳大利亚。随着时间的推移，实证和综述文章的数量相对于非实证文章有所增加。然而，一般来说，非实证文献的影响力更大，一系列介绍性的概念论文根据总引文和它们在引文网络中的索引引用的使用情况，是最有影响力的。最常见的关注主题是一般的卫生系统和组织，以及教育，最近在研究、政策、变革和改善方面的应用增多。
本研究确定了随时间推移发表的关于医疗复杂性科学的文章类型及其内容的变化。有证据表明，从概念性工作向具体改进策略的应用以及对复杂医疗保健系统的日益深入检查的转变。我们还发现，这方面文献的影响力在文章层面上存在差异，在关注的主题上则略有差异。
