The 60 most highly cited articles published in the Journal of Telemedicine and Telecare and Telemedicine Journal and E-health

Introduction

There have been major advances in telemedicine and a growth in the number of studies carried out in this field. Thus there is a need for measures of scientific quality in the resulting publications. One index of quality is the number of citations to published articles. A citation occurs when one scientific article (the citing article) uses another (the cited article) as a reference. ¹ The number of citations received by an article is an indicator of its scientific impact ² and provides a reliable approach for ranking articles. ³ The more times a paper is cited, the more valuable is that paper.

Highly cited papers (HCPs) have been evaluated in different fields, such as ophthalmology, ⁴ anaesthesia, ⁵ emergency medicine, ⁶ orthopaedics, ⁷ urology, ⁸ rehabilitation, ⁹ obstetrics and gynaecology. ¹⁰ The aims of an analysis of HCPs are: (1) identifying what research has been done in the field and where it is developing, (2) demonstrating the progress of the literature over time, (3) identifying which areas are recognized as having greater impact, (4) assisting researchers and PhD students to identify new areas of work, (5) identifying authors who have made substantial contributions to the field, (6) determining frequently cited institutions.^11–14 It would be useful to know about the characteristics of HCPs in the telemedicine field.

The aim of the present study was to analyse some characteristics of the 60 most cited papers published in the Journal of Telemedicine and Telecare (JTT) and Telemedicine Journal and E-health (TJEH). The JTT and TJEH are the only two specialist telemedicine journals which are indexed in the Web of Knowledge.

Methods

Articles were extracted from the Science Citation Index Expanded (Institute for Scientific Information Web of Knowledge) on 15 September 2012. The two journal names were searched separately in the Web of Science under “Publication Name” and the results were sorted in order of “Times Cited”. In each journal, the 60 articles which had the most citations were identified as HCPs.

The HCPs were analysed using a standard package (SPSS version 18) with regard to number of citations, citation rates, year of publication, number of authors, country of origin and category. Citation rate was defined as the number of citations/number of years in print until 2012. Category was determined after evaluating the field of study for each HCP, see Table 1. In articles from multicentre groups, the first author's information was used to define the country of origin.

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Table 1.

Categories of the highly-cited articles in the two journals.

Number of HCPs
General	15
Telehome care	12
Telegeriatrics	5
Teledermatology	4
Telemental health	4
Telemonitoring	3
M-health	2
Tele-ophthalmology	2
Telepaediatrics	2
Teleradiology	2
Telerehabilitation	2
Telecardiology	1
Telelaparoscopy	1
Telepathology	1
Telepharmacy	1
Telepulmonary care	1
Teletrauma	1
Telewound care	1

We examined the trend in citations per year by calculating a regression coefficient for each journal for the period 1998–2008, i.e. the dependent variable was the total number of citations in a year.

Results

The total number of articles listed in the Web of Science was 1810 for the JTT and 1550 for TJEH. The evaluated articles were from the period 1998–2012 for the JTT and 2000–2012 for TJEH. The 60 most cited articles from the two journals are listed in Tables 2 and 3. In the JTT, the mean number of citations was 43 (SD 13), range 30–89. In TJEH the mean number of citations was 30 (SD 11), range 19–68. The average number of citations for the JTT was significantly higher than for TJEH (P < 0.001).

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Table 2.

The 60 most cited articles published in the Journal of Telemedicine and Telecare.

Article	Rank	No of times cited	Citation rate (per year)*	Country
Elford 15	1	89	6.8	Canada
Miller 16	2	75	6.2	USA
Chen 17	3	74	6.7	Australia
Loane 18	4	73	4.8	Northern Ireland
Jennett 19	5	72	7.2	Canada
Loane 20	6	69	4.6	Northern Ireland
Hailey 21	7	64	7.1	Australia
Piccolo 22	8	58	4.4	Austria
Trott 23	9	57	3.8	Australia
Vassallo 24	10	53	4.4	England
Doze 25	11	51	3.6	Canada
Barlow 26	12	48	8.0	England
Sixsmith 27	13	48	3.6	England
Hawker 28	14	47	3.1	Australia
Lemaire 29	15	46	3.8	Canada
Craig 30	16	46	3.2	Northern Ireland
Mathie 31	17	45	5.0	Australia
Pesamaa 32	18	45	5.0	Finland
Taylor 33	19	45	3.0	England
Taylor 34	20	45	3.0	England
Hersh 35	21	44	4.0	USA
Bergmo 36	22	44	3.3	Norway
Tang 37	23	44	3.3	England
Harrison 38	24	44	2.9	England
Loane 39	25	43	3.5	Australia
Giovas 40	26	43	2.8	Greece
Broens 41	27	42	7.0	Netherlands
Tsang 42	28	42	3.5	China
Ferrer-Roca 43	29	40	4.4	Spain
Chan 44	30	39	3.2	China
Reponen 45	31	39	3.0	Finland
Ball 46	32	39	2.6	England
Lee 47	33	37	4.6	Canada
Simpson 48	34	37	3.0	Canada
Oakley 49	35	37	2.8	New Zealand
Whited 50	36	37	2.4	USA
Brennan 51	37	36	2.5	USA
Mairinger 52	38	36	2.4	Austria
Ryan 53	39	34	4.2	England
Loane 54	40	34	8.5	Australia
Demiris 55	41	34	2.6	USA
Whitten 56	42	34	2.6	USA
Ruggiero 57	43	34	2.2	Italy
DelliFraine 58	44	33	6.6	USA
Frueh 59	45	33	5.5	USA
Martinez 60	46	33	4.7	Spain
Elford 61	47	33	2.7	Canada
Mair 62	48	33	2.5	England
Hailey 63	49	33	2.3	Canada
Whitten 64	50	33	2.2	USA
Maiolo 65	51	32	3.2	Italy
Demichelis 66	52	32	2.9	Italy
Simpson 67	53	32	2.6	Canada
Lamminen 68	54	32	2.4	Finland
Nordal 69	55	31	2.5	Norway
Kunkler 70	56	31	2.0	Scotland
Aas 71	57	30	2.5	Norway
Doolittle 72	58	30	2.3	USA
Doughty 73	59	30	2.3	England
Karlsten 74	60	30	2.3	Sweden

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Table 3.

The 60 most cited articles published in Telemedicine Journal and E-health.

Article	Rank	No of times cited	Citation rate (per year)*	Country
Williams 75	1	68	5.6	England
Krishna 76	2	61	15.2	USA
Noel 77	3	55	6.1	USA
Nelson 78	4	52	5.2	USA
Kobb 79	5	50	5.0	USA
Dansky 80	6	49	4.0	USA
Meystre 81	7	45	5.6	USA
Lymberis 82	8	43	4.3	Belgium
Krupinski 83	9	43	3.9	USA
Ostojic 84	10	42	5.2	Croatia
Rialle 85	11	40	3.6	France
Darkins 86	12	39	7.8	USA
Schofield 87	13	38	4.7	USA
Finkelstein 88	14	35	3.8	USA
Tachakra 89	15	35	3.5	England
Bouchard 90	16	34	3.7	Canada
Whited 91	17	34	3.0	USA
Finkelstein 92	18	32	4.5	USA
Chumbler 93	19	31	3.4	USA
Satava 94	20	31	2.3	USA
Sood 95	21	29	4.8	Mauritius
Brennan 96	22	29	3.2	USA
Grigsby 97	23	29	2.6	USA
Krupinski 98	24	28	2.1	USA
Jan 99	25	27	4.5	Taiwan
Kim100	26	27	2.7	USA
Bynum101	27	27	2.2	USA
Demiris 102	28	27	2.2	USA
Whited 103	29	26	2.6	USA
Abramoff 104	30	25	3.1	USA
Glueckauf 105	31	25	2.7	USA
Aoki 106	32	25	2.5	USA
Bashshur 107	33	25	2.2	USA
Leong 108	34	25	1.9	England
Whitten 109	35	25	1.9	USA
Pare 110	36	24	3.4	Canada
Dang 111	37	24	3.4	USA
Johnston 112	38	24	2.4	USA
Postel 113	39	23	4.6	Netherlands
Whited 114	40	23	2.5	USA
Edwards 115	41	23	2.3	USA
Callas 116	42	23	1.7	USA
Whited 117	43	22	2.7	USA
Winters 118	44	22	2.4	USA
Agha 119	45	22	2.0	USA
Broderick 120	46	22	1.8	USA
Barnard 121	47	22	1.6	USA
Whitten 122	48	21	3.5	USA
Ryan 123	49	21	2.1	USA
Suzuki 124	50	21	1.7	Japan
Angood 125	51	21	1.6	USA
Seto 126	52	20	4.0	Canada
Lamothe 127	53	20	2.8	Canada
Marcin 128	54	20	2.5	USA
Dimmick 129	55	20	2.0	USA
Ricci 130	56	20	2.0	USA
Myers 131	57	19	3.8	USA
Bashshur 132	58	19	2.3	USA
Suzuki 133	59	19	2.1	Japan
Bynum134	60	19	1.9	USA

*

no of citations/years in print until 2012.

In the JTT, the total number of citations for the 60 HCPs was 2584. In TJEH, the total number of citations for the 60 HCPs was 1790. Approximately 18% of the 60 HCPs published in the JTT had more than 50 citations, while 6% of the HCPs in TJEH had more than 50 citations.

The mean citation rate in the JTT was 42 per year (SD 6), range 35–52. The mean citation rate for TJEH was 33 per year (SD 11), range 25–62.

The HCPs in the JTT were from the period 1998–2009. The years with the most HCPs were 1998 and 2000 (23% for each year), see Figure 1. The maximum number of mean citations was in 2003 (mean = 52 per article), see Figure 2. The HCPs in TJEH were from the period 2000–2009. The year with the most HCPs was 2003 (22%), see Figure 1. The maximum number of mean citations was in 2009 (mean = 61 per article), see Figure 2. OPEN IN VIEWER

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Figure 2.

The mean number of citations for the highly cited papers in the two journals.

In the regression models, the coefficient for citations per year was not significant in either journal. In addition, the interaction terms between the name of the journal and year was not significant, which means that the trend of citations in both journals was similar (P = 0.094).

The origins of the 60 HCPs in the two journals are shown in Table 4 and 5. The 60 HCPs in the JTT originated from 16 countries; the most common country of origin was England (18%). The 60 HCPs in TJEH originated from 10 countries; the most common country of origin was the US (75%). Considering both journals together, the majority of HCPs came from the US, UK, Australia and Canada. These four countries have a population of about 450 million, less than 10% of the world population.

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Table 4.

Country of origin of HCPs in the JTT.

Country	Number	Percent
England	11	18
USA	10	17
Australia	9	15
Canada	7	12
Finland	3	5
Italy	3	5
Northern Ireland	3	5
Norway	3	5
Rest of the world	9	15
Total	60	100

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Table 5.

Country of origin of HCPs in TJEH.

Country	Number	Percent
USA	45	75
Canada	4	7
England	3	5
Japan	2	3
Rest of the world	6	10
Total	60	100

In the JTT, the mean number of authors for each HCP was 4.6 (SD 3.1), range 1–18. In TJEH, the mean number of authors for each HCP was 4.5 (SD 2.3), range 1–12. There was no difference between the two journals (P = 0.84). In both journals approximately 58% of the HCPs had 1–4 authors.

The total number of categories of HCPs in the JTT and TJEH were 13 and 18 respectively. The most common category of HCPs in both journals was “General” (approximately 19 in the JTT and 15 in TJEH). The three most common categories of the HCPs published in the two journals are summarised in Table 6.

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Table 6.

The three most common categories of the 60 HCPs in the JTT and TJEH.

JTT	Number	Percent	TJEH	Number	Percent
General	19	32	General	15	25
Teledermatology	10	17	Telehome care	12	20
Telepsychiatry	10	17	Telemental health	4	7

Discussion

The present study identified the 60 most highly cited articles published in the two specialist, peer-reviewed telemedicine journals. The characteristics of the HCPs published in the JTT and TJEH were broadly similar. For example, there was no significant difference in terms of the number of authors. Also in both journals, the majority of HCPs came from the US, UK and Canada. Furthermore, the most frequent category in both journals was the same (General). The number of citations per year did not exhibit any obvious trend. In most years the mean number of citation per year in the JTT was slightly higher than in TJEH (P < 0.001).

The present study had certain limitations. First, citations in textbooks and lectures were not considered. Furthermore, the citation count recorded by the Science Citation Index included self-citations; we do not know whether this is a source of bias. Second, the list of HCPs is not static, and will change with time. Third, we did not consider HCPs published in non-specialist journals. In future, a similar analysis could be carried out more widely to produce further data about highly cited articles in the field of telemedicine.

In summary, although analysis of citations is not a direct method of measuring the quality of published articles, it can identify – for authors and editors of journals, and others – the most highly cited papers in the two journals.^8,135