Disruption: Changing Paradigms in Vascular Surgery Publications

A novel disruption index designed to measure the impact of scientific research has been developed and previously used to assess various surgical subspecialties to identify seminal publications. However, this metric has not yet been applied to vascular surgery literature. We hypothesized that disruptive articles in vascular surgery would increase over time with the advent of new surgical and technological advancements. The Journal of Vascular Surgery was queried from 1984 to 2014 to identify the top 100 most disruptive publications. Disruptive articles are those that launch new streams of research and provide novel information. Disruption index (DI) was calculated using a previously described algorithm based on a ratio of the number of future publications that cite the focal article and the papers cited by the focal article. DI ranges from −1 to 1, where negative scores represent developmental publications, and positive scores indicate disruptive publications. The most impactful papers were identified by being in both the 100 most cited and disruptive lists of publications. Presented are the 100 most cited and 100 most disruptive publications since the inception of the Journal of Vascular Surgery. When the top 100 most cited publications were categorized by vascular disease, aortic research was the most common category of publication (42%). Low correlation was found between disruption index and citation controlling for time after publication (P = .776). Among the 100 most disruptive papers, publications discussing the field of vascular surgery as a unique subspecialty were the most common category of publication (24%). Narrowing down the 100 most disruptive publications with 50 or more citations (n = 30), aortic (37%) and venous (20%) publications were the most common. Among this group of publications, aortic papers were most disruptive between 1993 to 1997, and venous papers were most disruptive in the more recent years between 2001 to 2005. There were eight most impactful papers including topics of publication of aortic (n = 4), venous (n = 2), carotid (n = 1), and endovascular (n = 1) research with an average disruption index of 0.14 and citation count between 174 and 712. This is the first application of the DI to the field of vascular surgery. While citation count is a vital metric, there remains limitations in its ability to measure impact. The DI should be used in conjunction with citation count to provide holistic analysis of publication impact. Additionally, the DI can identify shifting paradigms and innovations unique to vascular surgery and help guide education on impactful studies.TableDetails of the eight most impactful publications in the Journal of Vascular Surgery (1984-2014)TitleReporting standards in venous disease: an update. International Consensus Committee on Chronic Venous DiseaseTransfemoral endovascular repair of abdominal aortic aneurysm: results of the North American EVT phase 1 trial. EVT InvestigatorThoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patientsImpact of exclusion criteria on patient selection for endovascular abdominal aortic aneurysm repairRevision of the CEAP classification for chronic venous disorders: consensus statementShould patients with challenging anatomy be offered endovascular aneurysm repair?Endovascular repair of abdominal aortic aneurysms and other arterial lesionsCorrelation of North American Symptomatic Carotid Endarterectomy Trial (NASCET) angiographic definition of 70% to 99% internal carotid artery stenosis with duplex scanningFirst authorJ.M. PorterW.S. MooreE.S. CrawfordJ.P. CarpenterB. EklofR.K. GreenbergJ.C. ParodiG.L. MonetaSenior authorG.L. MonetaR.B. RutherfordD.H. GlaeserR.M. FairmanT.W. WakefieldK. OurielJ.C. ParodiJ.M. PorterYear of publication19951996198620012004200319951993AffiliationOregon Health Sciences University, Portland, OR, USAUCLA Center for the Health Sciences, Los Angeles, CA, USABaylor College of Medicine, Houston, TX, USAUniversity of Pennsylvania School of Medicine, Philadelphia, PA, USAUniversity of Lund, Helsingborg, SwedenThe Cleveland Clinic Foundation, Cleveland, OH, USAInstituto Cardiovascular de Buenos, ArgentinaOregon Health Sciences University, Portland, OR, USADisruption Index0.091805430.097359740.127410470.12959720.135350320.139860140.192307690.22525253Citation count594221519174712186296229 Open table in a new tab