Hey there, listeners. This is Rod Gerardo, research resident at Cincinnati Children's Hospital. Today, we're starting off a new series where we review Journal of Pediatric Surgery articles, and by we, I mean that I'm joined by Another research resident. Hey, this is Ellen and Cisco, another research resident at Cincinnati Children's Hospital. I think one of the most difficult parts of matching into fellowship is the numbers, right? Yeah, I mean, there are a lot of factors that go into whether or not you match and, and how you're considered in the application process, but, um, but one of those is definitely related to the numbers and specifically the number of publications and and presentations that you do. A dog eat dog world out there, I feel like. Yeah, definitely. Which is why we wanted to talk about this article that came across our desks recently. It was a recent publication out of the Journal of Pediatric Surgery. I actually forgot what it was called. It's called Shifting Paradigms, the Top 100 Most Disruptive Papers in core Pediatric Surgery Journals. I'd say this article took a previously described formula for calculating the disruptive score. Of an article, and we'll go through that more later, but it applied that to pediatric surgery papers over several years. We thought it was pretty interesting. Our boss, Todd Ponsky, thought it was interesting enough to write a commentary, but actually we sat down and talked to him about this article, and here's what he said. I thought it was really cool, but I don't get exactly when you would use it. But interestingly enough, Todd isn't the one who like decided that we should make a podcast on it. Um, who did? Doctor Mark Davenport, one of the editors of the Journal of Pediatric Surgery. Yeah, he's over in Europe, in England, and here were his thoughts on the article. Well, let's start by looking at the abstract, they're gonna calculate a so-called disruption score, this is a bibliometric tool, and they're gonna use it to characterize essentially pediatric surgery publications. All right, let's break it down, let's give this a little bit of context. You should all be familiar with the citation count, that's pretty easy, um, a journal publishes a paper and other journals cite it, count them up and you've got the citation count. But that's for the article itself. If you want to measure how productive a specific author is, there's another measurement for that. Uh, it's called the Hirsch index or H index. It was really made to represent. The the influence or the impact of a particular author, the higher it is, the better. So for instance, let's take this man. Is that Doctor Holcomb, I don't know. Yeah, that's, that's Doctor Witt Holcomb, he's the editor in chief of JPS and his H index is 51, he's published an awful lot over his surgical career. If you look at the senior author of this particular paper. The senior author's age index on this paper, Doctor Shaw. And hers is 8. And that's pretty typical of a fairly average pediatric surgeon. Another way which is sort of gathering momentum uh is to use a family of I think what are termed alt metric score and draws in uh more recent media, social media even. The disruptive score is this new thing. Follow the link in the description, you could see the article and then look at the equation itself. But to break it down, here's Doctor Davenport. The implication is that if those future papers, Are only citing you. Then you're a more disruptive publication. If they cite you and all the rest, then you're less disruptive and as they term it more developmental. The actual score itself varies from -1 to +1. Hmm, OK, maybe we need a little bit more detail. Here are the authors. My name is Ami Shah. I'm an associate professor of surgery and pediatrics at Rush University in Chicago. She's the senior author. And hi, I'm Wynn Sullivan, and I'm a research fellow now through Northwestern and the SOPA Program. And she's the first author of the article. So, Wynn, go ahead, break it down, explain it to us like we're 5. It ranges from -1 to 11 being the most destructive you can be, um, and -1 being papers that are considered developmental in nature. So the way we calculate that. Great point, Wynn. It is a calculation. So really quick, it's X or the disruption equals a minus B over A + B + C. What are all those variables? Let's break it down. Because essentially it ends up being a ratio of how much a paper itself is cited, whereas its own references aren't actually cited in addition. Let's try an example. So we can have a paper that's cited 100 times, 100 of those 100 citations, 90 didn't include any of the index papers reference. That's A. And then we've got 10 papers that included both the papers index and the references. That's B, um, with an additional 20 papers that were cited in any one of the index paper citations but not the index paper itself. And that's C. This ends up resulting in a score in a score of 0.66. So despite explaining it to Todd two times, we had to do it a third time. And here's what Rod had to say for how to interpret this score again. The most disruptive is that how many times it's been cited and that it was the first. Your dad and Gauerer cited all of these articles when they wrote their paper. OK. After your dad's article, everybody was just citing your dad's article and Gerer. They weren't citing all those other articles before, so the ratio is skewed. So now everybody is citing. Your dad and Gower, and not those people before them, meaning that they did something that was disruptive disruptive. So that's why that one has like the highest score because now everyone who does it, who does, you know, feeding tube stuff, they're gonna cite that, but they don't care about any of the other stuff before them because that's all irrelevant now. There's no need to cite that anymore. That is so cool. Yeah, yeah, it's really cool, but it's like a lot of math, it's kind of confusing. So why did Wyn and Dr. Shah even want to look at this in pediatric surgery? You know, it's hard sometimes to get papers published, but I think a lot of the innovation in pediatric surgery comes from doing a lot of cases and going out to these places and doing all these things. How do we measure how academically productive someone is? When when producing that volume of papers, what's the actual value in it? So, the results are pretty interesting. Yeah, I agree. So here's Doctor Davenport explaining some of the results. So let's now cut to the results. Uh, so, uh, they do a top 100, I've just taken the top 10 here for illustrative purposes. So what's number 1, I hear you will ask. Well, I wouldn't have a real problem with this one, this is, uh, Michael Gower's paper, um, describing percutaneous endoscopic gastrostomies. You'll see the second author there is quite familiar, it's got a quite familiar name, that's Todd's dad. Well, well, well, very interesting. Todd's dad, Jeff Ponsky, was the most disruptive of all time. If you want to learn about this article that made the number 1, I made a podcast about that several months ago, check it out, it's the History of the peg. But I digress, carry on, Doctor Davenport. Number 2, it's a big series of interception. Number 3, fairly big series of fundoplications. OK, so a lot of them are pretty important papers, but are all of them? But some of them you think, why are they on this list? Number 6, internet use of in families and children requiring cardiac surgery. Not sure why that's there, fibrous fusion between the liver and the lung. This is a case report, it was only cited 17 times, but yet it's number 7 on the list. Yeah, it's weird. I mean, some of these Doctor Davenport said he didn't even read or even heard of. So Ellen asked. Shaw about that. Were you guys surprised by the results? I was, because I was like, what about this paper? What about this paper? Like, this is the basis of how we do ped surgery. Right, like a lot of seminal work was left off and then some other things on there, I'm kind of like, what's going on here? Wynn had some thoughts. Different areas within pediatric surgery that have a high focus of um studies that came out that were more Developmental in nature rather than destructive. So they ended up categorizing these. So take for example, something like neuroblastoma. We do so much, what you would call developmental research on this, you know, because it's surgical oncology. But things that in fields that have a little bit more innovation to them like trauma, um, had a lot of articles that were included in this list. And they had a lot of different tables breaking it down in very specific ways. So if you want to read the whole thing. It's linked underneath the podcast and if you want to read it for yourself, you'll find it there. But the last thing that we talked to Doctor Shaw and Todd about is the fact that they stopped looking at articles at like, you know, like 2014 or something like that. So, That brings me to a point that there's a little bit of a lag time for it, which I think is true for all of the scores. We don't know exactly how long it would take for us to decide collectively that a paper is disruptive. There's no way to know what's the holy grail is to know when important paper comes out right when it's released. No one knows does it go viral? Does it go viral? This equation isn't an answer for does it go viral. This is an equation that's for, does it change the game. So to conclude, and do remember these views are my own personal opinion and don't represent necessarily the views of the editors or indeed the journal itself. Let's ask ourselves three questions. Is this article original? And of course you have to answer yes, it is original. Is it useful? I don't really think it stands up by comparison to the more conventional aspects of how we view the medical literature, the citation scores seems to be still uh the key method of assessing the impact of a particular uh paper. Is the disruptive score disruptive in and of itself? Well, only time will tell. Hmm, seems a little bit skeptical. Here's Todd. What happens in the next several years? If people start actually making the effort to use this metric, uh, it may very well become something that is being used. However, I do think that the point that Doctor Shaw made, this may be something that people could start putting on their CVs. That would actually be Very interesting to someone looking at the CV where they say, what's this? And they say, well, this is the disruption score. That's gonna be on the part of the, of the, of the young authors and the young academicians to start actually putting this on their CV. And probably podcasts like this are a way to start getting visibility about this. Yeah, and that's not a biased opinion at all. Just kidding. We have like so many podcasts. So if you wanna learn more about pediatric surgery, different procedures, different groundbreaking research articles, this is the podcast that you gotta listen to. But If you want even more than that, you can tune in for our update course, August twenty-seventh, coming up soon. Download the app. I'm Rod Gerardo and I'm Ellen and Cisco. And remember, knowledge should be free. Nice.
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