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Defending psychiatry or defending the trivial effects of therapeutic interventions? A citation content analysis of an influential paper.

ABSTRACT: AIMS:Leucht et al. in 2012 described an overview of meta-analyses of the efficacy of medication in psychiatry and general medicine, concluding that psychiatric drugs were not less efficacious than other drugs. Our goal was to explore the dissemination of this highly cited paper, which combined a thought provoking message with a series of caveats. METHODS:We conducted a prospectively registered citation content analysis. All papers published before June 1st citing the target paper were independently rated by two investigators. The primary outcome coded dichotomously was whether the citation was used to justify a small or modest effect observed for a given treatment. Secondary outcomes regarded mentioning any caveats when citing the target paper, the point the citation was making (treatment effectiveness in psychiatry closely resembles that in general medicine, others), the type of condition (psychiatric, medical or both), specific disease, treatment category and specific type. We also extracted information about the type of citing paper, financial conflict of interest (COI) declared and any industry support. The primary analysis was descriptive by tabulating the extracted variables, with numbers and percentages where appropriate. Co-authorship networks were constructed to identify possible clusters of citing authors. An exploratory univariate logistic regression was used to explore the relationship between each of a subset of pre-specified secondary outcomes and the primary outcome. RESULTS:We identified 135 records and retrieved and analysed 120. Sixty-three (53%) quoted Leucht et al.'s paper to justify a small or modest effect observed for a given therapy, and 113 (94%) did not mention any caveats. Seventy-two (60%) used the citation to claim that treatment effectiveness in psychiatry closely resembles that in general medicine; 110 (91%) paper were about psychiatric conditions. Forty-one (34%) papers quoted it without pointing towards any specific treatment category, 28 (23%) were about antidepressants, 18 (15%) about antipsychotics. Forty (33%) of the citing papers included data. COIs were reported in 55 papers (46%). Univariate and multivariate regressions showed an association between a quote justifying small or modest effects and the point that treatment effectiveness in psychiatry closely resembles that in general medicine. CONCLUSIONS:Our evaluation revealed an overwhelmingly uncritical reception and seemed to indicate that beyond defending psychiatry as a discipline, the paper by Leucht et al. served to lend support and credibility to a therapeutic myth: trivial effects of mental health interventions, most often drugs, are to be expected and therefore accepted.Protocol registration: https://osf.io/9dqat/.

SUBMITTER: Cristea IA

PROVIDER: S-EPMC6998859 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Defending psychiatry or defending the trivial effects of therapeutic interventions? A citation content analysis of an influential paper.

Cristea I A IA Naudet F F

Epidemiology and psychiatric sciences 20171129 3

<h4>Aims</h4>Leucht et al. in 2012 described an overview of meta-analyses of the efficacy of medication in psychiatry and general medicine, concluding that psychiatric drugs were not less efficacious than other drugs. Our goal was to explore the dissemination of this highly cited paper, which combined a thought provoking message with a series of caveats.<h4>Methods</h4>We conducted a prospectively registered citation content analysis. All papers published before June 1st citing the target paper ...[more]

PMID: 29183418

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Project description:BackgroundThe undergraduate program of psychiatry has been widely established in recent years to improve the education and recruitment of psychiatrists in China. We aim to investigate the career choice of medical students majoring in psychiatry in China and the influential factors.MethodThis multicenter study was conducted in 26 medical schools in China from May to October of 2019. Participants included 4610 medical students majoring in psychiatry and 3857 medical students majoring in clinical medicine. Multivariable logistic regression was used to investigate the influential factors of students' choices of psychiatry at matriculation and as a career.Results44.08% of psychiatry majored students gave psychiatry as a first choice at matriculation, and 56.67% of them would choose psychiatry as a career, which was in sharp contrast to the proportion of clinical medicine majored students who would choose psychiatry as a career (0.69%). Personal interest (59.61%), suggestions from family members (27.96%), and experiencing mental problems (23.19%) were main reasons for choosing psychiatry major at matriculation. Personal interest (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.87-2.40), experiencing a psychiatry clerkship (OR = 1.99, 95% CI = 1.28-3.08), being female (OR = 1.50, 95% CI = 1.30-1.68), experiencing mental problems (OR = 1.33, 95% CI = 1.28-1.56), and suggestions from family members (OR = 1.25, 95% CI = 1.08-1.46) correlated positively with students' choice of psychiatry as career. Students who lacked psychiatry knowledge (OR = 0.49, 95% CI = 0.29-0.85) or chose psychiatry because of lower admission scores (OR = 0.80, 95% CI = 0.63-0.97) were less likely to choose psychiatry as a career.ConclusionMore than half of psychiatry majored medical school students planned to choose psychiatry as their career, whereas very few students in the clinic medicine major would make this choice. Increasing students' interest in psychiatry, strengthening psychiatry clerkships, and popularizing psychiatric knowledge are modifiable factors to increase the psychiatry career intention. The extent to which medical students' attitudes toward psychiatry can be changed through medical school education and greater exposure to psychiatry will need further investigation.

Project description:BackgroundDisparities in health outcomes across countries/areas are a central concern in public health and epidemiology. However, few authors have discussed legends that can be complemental to choropleth maps (CMs) and merely linked differences in outcomes to other factors like density in areas. Thus, whether health outcome rates on CMs showing the geographical distribution can be applied to publication citations in bibliometric analyses requires further study. The legends for visualizing the most influential areas in article citation disparities should have sophisticated designs. This paper illustrates the use of cumulative frequency (CF) map legends along with Lorenz curves and Gini coefficients (GC) to characterize the disparity of article citations in areas on CMs, based on the quantile classification method for classes.MethodsBy searching the PubMed database (pubmed.com), we used the keyword "Medicine" [journal] and downloaded 7042 articles published from 1945 to 2016. A total number of 41,628 articles were cited in Pubmed Central (PMC). The publication outputs based on the author's x-index were applied to plot CM about research contributions. The approach uses two methods (i.e., quantiles and equal total values for each class) with CF legends, in order to highlight the difference in x-indices across geographical areas on CMs. GC was applied to observe the x-index disparities in areas. Microsoft Excel Visual Basic for Application (VBA) was used for creating the CMs.ResultsResults showed that the most productive and cited countries in Medicine (Baltimore) were China and the US. The most-cited states and cities were Maryland (the US) and Beijing (China). Taiwan (x-index?=?24.38) ranked behind Maryland (25.97), but ahead of Beijing (16.9). China earned lower disparity (0.42) than the US (0.49) and the rest of the world (0.53) when the GCs were applied.ConclusionCF legends, particularly using the quantile classification for classes, can be useful to complement CMs. They also contain more information than those in standard CM legends that are commonly used with other classification methods. The steps of creating CM legends are described and introduced. Bibliometric analysts on CM can be replicated in the future.

Project description:BackgroundThe value of citation searches as part of the systematic review process is currently unknown. While the major guides to conducting systematic reviews state that citation searching should be carried out in addition to searching bibliographic databases there are still few studies in the literature that support this view. Rather than using a predefined search strategy to retrieve studies, citation searching uses known relevant papers to identify further papers.MethodsWe describe a case study about the effectiveness of using the citation sources Google Scholar, Scopus, Web of Science and OVIDSP MEDLINE to identify records for inclusion in a systematic review.We used the 40 included studies identified by traditional database searches from one systematic review of interventions for multiple risk behaviours. We searched for each of the included studies in the four citation sources to retrieve the details of all papers that have cited these studies.We carried out two analyses; the first was to examine the overlap between the four citation sources to identify which citation tool was the most useful; the second was to investigate whether the citation searches identified any relevant records in addition to those retrieved by the original database searches.ResultsThe highest number of citations was retrieved from Google Scholar (1680), followed by Scopus (1173), then Web of Science (1095) and lastly OVIDSP (213). To retrieve all the records identified by the citation tracking searching all four resources was required. Google Scholar identified the highest number of unique citations.The citation tracking identified 9 studies that met the review's inclusion criteria. Eight of these had already been identified by the traditional databases searches and identified in the screening process while the ninth was not available in any of the databases when the original searches were carried out. It would, however, have been identified by two of the database search strategies if searches had been carried out later.ConclusionsBased on the results from this investigation, citation searching as a supplementary search method for systematic reviews may not be the best use of valuable time and resources. It would be useful to verify these findings in other reviews.

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Defending psychiatry or defending the trivial effects of therapeutic interventions? A citation content analysis of an influential paper.

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Defending psychiatry or defending the trivial effects of therapeutic interventions? A citation content analysis of an influential paper.

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