Top cited articles in concussion: A bibliometric analysis of the state of the science

Objective Citation analyses identify the most-cited publications in a given field, which aids in understanding areas of the literature that are well-developed and those where additional research is required. Our objective was to perform a citation analysis in concussion to understand the state of the science from a bibliometric perspective. Design We performed a keyword search for articles related to concussion in Harzing's Publish or Perish, which scrapes Google Scholar for citation metrics. This approach was used to identify the 50 articles with the most lifetime citations as well as the 50 articles with the highest citation rate. Main outcome measures Citations and citation rates. Results Per our citation analysis, we found that concussion guidelines are among the most cited publications (comprising ≥20% of each citation cohort), yet there is a dearth of widely cited clinical trials to inform them; only one randomized trial (studying the effects of rest following concussion) was included in our citation analysis. The majority of study designs (≥40% of each citation cohort) were cross-sectional. Concussion recovery and secondary complications of concussion were common study topics, with ≥20% of publications in each citation cohort focused on these issues. The publications included in our analysis were authored by 596 authors from only 12 countries, suggesting a lack of global representation in concussion research. Conclusions Existing reviews and consensus statements have called for additional, high-quality research in concussion; our citation analysis quantifies this need. Further, although concussion is a global problem with its incidence and burden increasing in the developing world, our citation analysis demonstrates that the most-cited and discussed articles in concussion are published by authors from only 12 countries. Going forward, to address the global problem that is concussion, a more global research perspective is called for.