A 10-point increase above the mean in reported success rates of atrial fibrillation ablation studies was independently associated with an 18.6% increase in citation count (95% CI, 7.6-29.6%; P<0.0001).
Systematic Review (n=36,289)
Does a higher reported success rate in studies of radiofrequency catheter ablation for atrial fibrillation increase the citation count of the study?
Studies of radiofrequency catheter ablation for atrial fibrillation with higher reported success rates receive significantly more citations, suggesting a citation bias that may exaggerate perceived effectiveness.
Effect estimate: 18.6% increase (95% CI 7.6-29.6%)
p-value: p=<0.0001
BACKGROUND: The preferential citation of studies with the highest success rates could exaggerate perceived effectiveness, particularly for treatments with widely varying published success rates such as radiofrequency catheter ablation for atrial fibrillation. METHODS AND RESULTS: We systematically identified observational studies and clinical trials of radiofrequency catheter ablation of atrial fibrillation between 1990 and 2012. Generalized Poisson regression was used to estimate association between study success rate and total citation count, adjusting for sample size, journal impact factor, time since publication, study design, and whether first or last author was a consensus-defined pre-eminent expert. We identified 174 articles meeting our inclusion criteria (36 289 subjects). After adjustment only for time since publication, a 10-point increase above the mean in pooled reported success rates was associated with a 17.8% increase in citation count at 5 years postpublication (95% confidence interval, 7.1-28.4%; P<0.001). After additional adjustment for impact factor, sample size, randomized trial design, and pre-eminent expert authorship, the association remained significant (18.6% increase in citation count; 95% confidence interval, 7.6-29.6%; P<0.0001). In this full model, time since publication, impact factor, and pre-eminent expert authorship were significant covariates, whereas randomized control trial design and study sample size were not. CONCLUSIONS: Among studies of radiofrequency catheter ablation of atrial fibrillation, high success rate was independently associated with citation count, which may indicate citation bias. To readers of the literature, radiofrequency catheter ablation of atrial fibrillation could be perceived to be more effective than the data supports. These findings may have implications for a wide variety of novel cardiovascular therapies.
Perino et al. (Mon,) conducted a systematic review in Atrial Fibrillation (n=36,289). Reported success rate was evaluated on Total citation count (18.6% increase, 95% CI 7.6-29.6%, p=<0.0001). A 10-point increase above the mean in reported success rates of atrial fibrillation ablation studies was independently associated with an 18.6% increase in citation count (95% CI, 7.6-29.6%; P<0.0001).