American Association of Plastic Surgeons

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Complementing The H-index: A New Framework For Evaluating The Research Productivity Of Plastic Surgeons
Elijah M. Persad-Paisley, BA, Jay Gopal, BA, Damon RT McIntire, MD, Loree K. Kalliainen, MD, MA.
Warren Alpert Medical School of Brown University, Providence, RI, USA.

PURPOSE: In academic plastic surgery, research output is widely used to assess the quality of residency applicants and to evaluate faculty for promotion. The h index has been used as the benchmark measure of academic productivity. It is defined as an authorís h papers with at least h citations. While the h-index is simple and intuitive, it disfavors junior researchers, favors publication quantity, and undervalues frequently cited works. Given the importance of bibliometrics in plastic surgery, alternative metrics may more accurately measure research productivity. The authors explored the use of time-independent bibliometrics to complement the h-index. Because current national ranking systems for Plastic Surgery training programs lack objectivity, we then used the metrics to generate research profiles and ranks for academic plastic surgeons and their departments.
METHODS: The genders and academic levels and roles of plastic surgeons at integrated residency programs were recorded. Author publications were retrieved from Scopus. Bibliometrics software was used to calculate the following metrics: h-index; e-index, which accounts for the excess citations ďmissedĒ by the h-index; and the g-index, which prioritizes an authorís most cited works. Time-corrected versions of the indices (m-quotient, ec- and gc-index, respectively) were used to correct for years since an authorís first publication to facilitate comparisons between surgeons with different career lengths. Departmental ranks were determined using the cumulative sum of faculty time-corrected indices. Two-sided tests examined gender differences in bibliometrics. Kruskal-Wallis tests assessed for bibliometric differences between academic roles (i.e., chair, professor, associate, and assistant professors). Kendall tau correlation coefficients (τ) assessed for congruency between calculated research rankings and Doximity rankings. P-values ≤0.05 were deemed significant.
RESULTS: Eight-hundred and fifty academic plastic surgeons across 81 programs were identified. Men had statistically greater h-indices than women (median 13.0 [IQR: 7.0-21.0] vs. 6.0 [3.0-13.0]; p<0.001); a similar pattern was observed for e- and g-indices. Professors had the highest median h- (21.0 [14.0-31.0]), e- (28.65 [18.37-41.49]), and g-indices (38.0 [24.0-54.5]) across all academic roles. When correcting for time, there were no significant differences in m-quotient and ec-index between genders. Department/division chairs had significantly higher indices than all other roles after correcting for time; this difference was less pronounced compared to uncorrected indices. Compared to Doximity rankings, the calculated research ranks were low-to-moderately correlated (τ = 0.495 [95% CI: 0.345-0.646; p<0.001]).
CONCLUSION: This study represents the largest publication analysis of academic plastic surgeons and their programs. The use of time-corrected indices indicates that there are no differences in publication quality between men and women. Furthermore, the absolute differences in citation impact between academic roles is less pronounced when correcting for time. The h-index is a valid metric but should be complemented by additional metrics that better encompass an authorís impact.


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