What factors predict original research citation rates? Analysis of media reports, editorials, guidelines and reviews of Rituximab for non-Hodgkin's lymphoma (NHL; 1997-2003)

Article type
Authors
Kho M1, Brouwers M1
1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON
Abstract
Background: As new healthcare technologies emerge, information sources such as media reports, editorials, guidelines, or reviews may influence decision-makers perceptions of the efficacy of a new treatment. Objectives: To understand citation relationships between original research of Rituximab for NHL and these information sources. Methods: We searched American Society of Hematology conference abstracts, MEDLINE, and EMBASE (1997 2003) for original research reports of Rituximab for NHL, regardless of study design. We also sought review articles, guidelines, editorials and media reports of Rituximab for NHL, and identified direct citations to the research cohort. Using multivariable regression analysis, we hypothesized the following predicted higher citation frequency: earlier publications, randomized controlled trial (RCT) study design (vs. non-RCT), peer-review publication (vs. conference abstract), documents listing any author affiliated with industry, and studies with larger sample sizes. Results: We identified 317 original research reports and 440 related documents. The research reports included 12.9%(n = 41) RCTs, 36.3%(n = 115) peer-review publications, and 21.1%(n = 67) listing any author affiliated with industry. The median (interquartile range) number of evaluated patients was 27 [9 to 53]. The 440 related documents included 36.3%(n=160) reviews, 2.0%(n=9) guidelines, 13.4%(n = 59) editorials, and 48.2%(n = 212) media reports; 51.3% (n = 226) cited no original research in the cohort, the majority, media reports (86.3%(n = 195)). The 214 documents represented 1,571 direct citations (90.1% reviews, 1.6% guidelines, 6.9% editorials, 1.1% media reports). The multivariable analysis was statistically significant (p & 0.001), with all hypothesized predictors except RCT study design independently associated with higher citation frequency. Conclusions: Rituximab RCT study design did not predict higher citation frequency, and few media reports cited original research evidence. Evidence consumers need to be vigilant about the types of original research evidence cited to support clinical or policy decisions. We need more research to understand the content and quality of cited studies.