Missing in action: A bibliometric analysis of military research in the medical literature since 1950

Deacon Lile; Alon Bergman; James Rolfing; Rhonda J Allard; Thomas A Davis; Kirby R Gross; Eric A Elster; C William Schwab; Jeremy W Cannon

doi:10.1097/TA.0000000000004376

Missing in action: A bibliometric analysis of military research in the medical literature since 1950

J Trauma Acute Care Surg. 2024 May 16. doi: 10.1097/TA.0000000000004376. Online ahead of print.

Authors

Deacon Lile¹, Alon Bergman, James Rolfing¹, Rhonda J Allard², Thomas A Davis³, Kirby R Gross⁴, Eric A Elster, C William Schwab¹, Jeremy W Cannon

Affiliations

¹ Division of Traumatology, Surgical Critical Care & Emergency Surgery, Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
² James A. Zimble Learning Resource Center, Uniformed Services University of the Health Sciences, Bethesda, MD.
³ Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
⁴ Department of Surgery, Cooper Medical School of Rowan University, Camden, NJ.

PMID: 38750632
DOI: 10.1097/TA.0000000000004376

Abstract

Background: Top-tier general and specialty scientific journals serve as a bellwether for national research priorities. We hypothesize that military-relevant publications are underrepresented in the scientific literature and that such publications decrease significantly during peacetime.

Methods: We identified high impact journals in the fields of Medicine, Surgery and Critical Care and developed Boolean searches for military-focused topics using National Library of Medicine Subject Headings terms. A PubMed search from 1950 to 2020 returned the number of research publications in relevant journals and the rate of military-focused publications by year. Rates of military publications were compared between peacetime and wartime. Publication rate trends were modeled with a quadratic function controlling for the start of active conflict and total casualty numbers. Baseline proportions of military physicians relative to the civilian sector served to estimate expected publication rates. Comparisons were performed using Pearson's Chi Square and Mann-Whitney U test, with p < 0.05 considered a significant difference.

Results: From 1950 to 2020, a total of 716,340 manuscripts were published in the journals queried. Of these, military-relevant manuscripts totaled 4,052 (0.57%). We found a significant difference in the rate of publication during times of peace and times of war (0.40% vs. 0.69%, p < 0.001). Subgroup analysis found significantly reduced rates of publication in medical and critical care journals during peacetime. For each conflict, the percentage of military-focused publications peaked during periods of war but then receded below baseline levels within a median of 2.5 years (interquartile range 1.5-3.8 years) during peacetime. The proportion of military-focused publications never reached the current proportion of military physicians in the workforce.

Conclusion: There is marked reduction in rates of publication for military-focused articles in high impact journals during peacetime. Military-focused articles are underrepresented in high-impact journals. Investigators of military-relevant topics and editors of high-impact journals should seek to close this gap.

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