Sunday 17 May 2020

Impact factor and other measures of science: a basic guide for every scientist

Source: https://medium.com/@stelios.serghiou/impact-factor-and-other-measures-of-science-a-basic-guide-for-every-scientist-935acee2bc36

Impact factor and other measures of science: a basic guide for every scientist

Jan 20 · 23 min read
“I have repeatedly stressed that the use of citation data in evaluating individual performance is valid only as a starting point in a qualitative appraisal.”
Eugene Garfield

TL;DR

• Many metrics attempt to measure what they call “influence” or “impact.”
• Most researchers and academic establishments use these metrics to make important and potentially life-changing decisions.
• However, most of these metrics were designed to help librarians choose subscriptions, not rank individuals.
• There is no single metric that can measure “quality” or “importance” of contribution to scientific knowledge.
• All measures should be used in conjunction and no important decisions should be made without a qualitative assessment.

Introduction

Measures of scientific output and impact hold a pre-eminent role within academia. Many researchers decide where to publish on the basis of journal impact factor, many prestigious universities condition hires and promotions on the h-index, many scientists use citation counts as a guide to new and important literature, and even the US considers citation counts in awarding certain visas.
These measures have gained so much popularity because of their perceived ability to measure scientific quality and impact with relative ease. The current literature is too vast for any single faculty, librarian or researcher to embark on an expedition to qualitatively assess scientific output. However, very few of those using these metrics actually understand what they represent, or their caveats. Indeed, even though these measures have a substantial impact on a scientist’s academic career, very few of us actually receive formal training in what they are.
As such, I compiled a quick pocket-guide to the top 10 such metrics (in chronological order of creation) as a reference and some recommendations on best practice. For a more detailed and comprehensive review, Agarwal et al. (2016) is a good read.

Metrics

Publication count

Description. This is the number of peer-reviewed publications for which an individual is a listed author. Many institutions may place further constraints on this, such as only counting first or last-author publications listed on PubMed. Many prestigious institutions will traditionally require more than a certain number (e.g. 25) of such publications to consider a hire or promotion.
Purpose. This is primarily regarded as a measure of an author’s productivity, rather than a measure of their impact.
Pros. (1) A quick and easy measure of productivity.
Cons. (1) It does not account for importance, impact, innovation or usefulness of publications. (2) It does not account for the amount of work that went into each paper; it may well be that a single paper by one researcher is equivalent to two or three papers by another researcher in terms of workload. (3) Citation frequency varies dramatically with field of study; for example, a medical researcher has on average far more citations than an econometrician; this varies with norms, research activity and researchers in a field of science. (4) It does not account for academically important but non-peer-reviewed work (e.g. books). (5) It does not differentiate between types of papers (e.g. an editorial vs a review vs original data). (6) It does not take into account rate; a researcher can achieve 5 publications in 5 years or in 30 years. (7) It does not translate well across disciplines (e.g. a count of 20 may be considered relatively low in medicine, but extremely high in mathematics). (8) Most publications of a researcher tend to arise from work in which they were not the main contributors. (9) It only increases, it never decreases, say with retractions. (10) It does not discriminate between first/last authorship and in between.

Citation count

Description. Tracking citations was an idea first introduced by a couple of chemists at Pomona College (Gross and Gross, 1927; Bergstrom, 2007). Citation count can refer to the number of citations of a peer-reviewed publication, or the total number of citations across an author’s body of work. As for publication count, citation count and its derivatives have been widely used to assess publications, their authors and their institutions.
Purpose. This is primarily regarded as a marker of a publication’s or of an author’s impact or influence, rather than their productivity (Agarwal et al., 2016; Yang and Meho, 2006). However, as per Eugene Garfield, one of the founders of Scientometrics, “Citation frequency is a measure of research activity, or of communication about research activity. The measure is a sociometric device. In itself, the number of citations of a man’s work is no measure of significance. Like one scale on a nomogram, it must be used along with other scales to obtain anything useful or meaningful, particularly if the object of the evaluation is in any way qualitative” (Garfield, 1973; an excellent read).
“The measure is a sociometric device. In itself, the number of citations of a man’s work is no measure of significance.”
Eugene Garfield
Pros. (1) A quick and easy estimate of an individual’s research activity.
Cons. (1) Citation frequency varies dramatically with field of study; for example, a medical researcher has on average far more citations than an econometrician; this varies with norms, research activity and researchers in a field of science. (2) Certain types of articles, such as reviews and methods, tend to accumulate on average many more citations than research articles. (3) Certain types of articles, such as perspectives and editorials, tend to be very widely read, but rarely cited. (4) Certain types of work, such as software development, tend to be very widely used, but rarely cited (e.g. PubMed is very frequently used in producing biomedical research, but rarely cited). (5) The distribution of citation frequency tends to be very right skewed; in fact, total author citation count tends to be dominated by a few very highly cited publications. (6) Authors can game the system by unnecessary self-citation (i.e. citing themselves). (7) It does not take into account many activities of scientific value and impact, such as teaching and leadership. (8) Most publications of a researcher tend to arise from work in which they were not the main contributors. (9) It only increases, it never decreases, say with a retraction. (10) The older you are, the more publications you have and the more citations you have. (11) Number of citations differs between providers (e.g. WOS, Google Scholar, etc.) depending on the number and type of resources they track. (12) An article is not necessarily cited strictly because of its content — it could well be cited because of journal prestige, author prestige, marketing. (13) It does not discriminate between first/last authorship and in between. (14) Not all citations are favorable — for example, the now retracted Wakefield et al. (1998) article reporting on the association of the MMR vaccine with autism has been cited more than 3000 times according to Google Scholar.

Journal Impact Factor (JIF)

Description. Eugene Garfield, a professor at University of Pennsylvania and one of the founders of Scientometrics, first proposed the use of the “impact factor” in 1955 (Garfield, 1955) and eventually published the Science Citation Index (SCI), an index mapping citations between journals, in 1961 with Irving H. Sher (Garfield, 2006). SCI belongs to the Institute for Scientific Information (ISI) founded by Garfield in 1960, acquired in 1992 by Thomson Reuters and eventually spun off as Clarivate Analytics in 2016 (Clarivate Analytics also owns Web of Science, EndNote and Publons). The Journal Impact Factor (JIF) is calculated by dividing the number of citations to work published in the two preceding years, by the number of citable publications in that journal within those two years. For example, the 2018 JIF for a journal is the total number of citations of its publications from 2016 and 2017, divided by the total number of publications in 2016 and 2017. Having said that PhD Comics begs to disagree:
Purpose. Garfield himself indicated that “Irving H. Sher and I created the journal impact factor to help select additional source journals […] to be covered in the new Science Citation Index (SCI)” (Garfield, 2006). He went on to caution that the “use of journal impacts in evaluating individuals has its inherent dangers. In an ideal world, evaluators would read each article and make personal judgments. […] Most individuals do not have the time to read all the relevant articles. Even if they do, their judgment surely would be tempered by observing the comments of those who have cited the work.” Unfortunately, JIF is grossly misused in making hiring and promotion decisions in academia and beyond by counting number of publications of faculty in journals with high JIF (Bergstrom et al., 2008; Repanovici et al., 2016).
Website. Journal Impact Factors are officially calculated by Clarivate Analytics and published yearly at InCites Journal Citation Reports (paywalled). However, the 2019 list of JIFs may be accessed for free here.
Pros. (1) A quick and simple measure to help librarians decide to which journals their library should subscribe. (2) A quick and easy measure to help researchers identify venues with a potentially larger audience for their work.
Cons (1) JIF varies dramatically with field of study — fields such as medicine possess journals with very high JIF, whereas fields such as physics possess journals with very small JIF. (2) Journals that tend to publish many review articles or guidelines, increase their JIF because they tend to receive more citations; in fact, the journal with the highest JIF, CA — A Cancer Journal for Clinicians, only publishes such articles. (3) The amount of citations contributed by each article within a journal varies dramatically and much of the JIF may in fact come from very few super-cited articles (dramatic right skew). (4) Disciplines vary in how quickly they produce new research — the faster they produce research, the higher the JIF. (5) Journals can and do game the JIF by making authors cite articles from their journal, soliciting reviews and prioritizing articles on the basis of likely potential attention rather than quality. (6) When used to evaluate individuals, it does not differentiate between order of authors. (7) JIF is self-perpetuating — journals with a high JIF tend to roughly maintain or increase their JIF because they are preferred by authors and readers (Ioannidis, 2018).
Notes. (1) Eugene Garfield provided his own review of the history and meaning of the Journal Impact Factor in 2006 in JAMA here (paywalled). (2) JIF calculations do not include correspondence, letters, commentaries, perspectives, news stories, obituaries editorials, interviews or tributes. (3) JIF can also be used to evaluate authors. (4) There are many variants of JIF trying to address several of its shortcomings, such as the 5-year impact factor or the source-normalized impact per paper (Crotty, 2017b).

h-index

Description. This was devised by UCSD physicist Jorge E. Hirsh (Hirsch, 2005). The h-index attempts to combine citation frequency with publication frequency; it is defined as the largest number h for which at least h articles of an author have been cited at least h times. For example, an author with an h-index 5 has at least 5 publications that have been cited at least 5 times and 5 is the largest such number for this author. This metric is gaining substantial popularity, especially in the context of faculty promotion decisions.
Purpose. This metric is treated by many as a combined marker of “productivity and broad impact.” Hirsch devised this metric to “quantify the cumulative impact and relevance of an individual’s scientific research output.” However, he cautions that “a single number can never give more than a rough approximation to an individual’s multifaceted profile, and many other factors should be considered in combination in evaluating an individual. […] Although I argue that a high h is a reliable indicator of high accomplishment, the converse is not necessarily always true.”
Website. Here is a sorted list of all 2610 authors with an h-index > 100 — Sigmund Freud leads the list with an h-index of 280.
Pros. (1) A simple and quick combination of a researcher’s number of peer-reviewed publications with their respective citation count. (2) h-index plateaus with a decrease in publication rate, unlike other measures, which can keep increasing. (3) Although self-citations still matter, their effect is smaller than in citation counts; for example, self-citations in an article with citations far exceeding h-index will not contribute to its h-index. (4) A variable m discussed in the original publication by Hirsch can be used to standardize h-index by years of publication activity — as such, it can be possible to compare scientists of similar publication age within the same field. (5) It tends to be the metric that varies least between different databases (Agarwal et al., 2016).
Cons. (1) A poor cross-disciplinary measure because citation and publication practices vary dramatically between fields; for example, medical researchers would have, on average, a much higher h-index than econometricians. (2) It favors older scientists because the longer a scientist has been publishing, the more articles they have and the more time they have had to accumulate citations. (3) A researcher with 5 publications each of 1000 citations will have an h-index of 5 and a researcher with 20 publications each of 20 citations will have an h-index of 20. (4) It only increases, it never decreases. (5) It does not take into account many activities of scientific value and impact, such as teaching and leadership. (6) Most publications of a researcher tend to arise from work in which they were not the main contributors. (7) It does not discriminate between first/last authorship and in between.
Notes. There are now many variants of the h-index, such as the Bh-index, which attempts to adjust for few, but significant, publications (Bharathi, 2013).

h5-index

Description. This is an adaptation of the h-index to journals. It is defined as the largest number h such that at least h articles in that journal were cited at least h times each over the last 5 years. The most well-known provider of h5-index is Google Scholar
Purpose. As above, but applied to journals.
Website. Here is a link of the top 100 publications in terms of h5-index by Google Scholar.
Pros. (1) Less susceptible to the impact of predominant publication of guidelines or reviews. (2) Less susceptible to a few super-cited articles.
Cons. (1) A poor cross-disciplinary measure because citation and publication practices vary dramatically between fields; for example, medical journals would have on average a much higher h-index than econometric journals. (2) It favors journals with bigger citable content; for example, PLoS One has a higher h5-index than Nature Neuroscience, even though its JIF is much lower. (3) A journal with 5 articles of 1000 citations each will have an h5-index of 5 and a journal with 20 articles each of 20 citations will have an h5-index of 20. (4) It only increases, it never decreases. (5) Many journals try to game the h5-index using practices such as requesting that authors cite their journal. (6) It can differ between databases, depending on what each database tends to count as a citation or a publication.

Eigenfactor Score

Description. The Eigenfactor project was launched in January 2007 by Carl Bergstrom (Department of Biology) and Jevin West (Information School) at the University of Washington. Eigenfactor Score (a score for journals) and the Article Influence Score (below; a score for articles) are collectively known as the Eigenfactor Metrics. Eigenfactor Score is based on “eigenvector centrality measures” and works in a similar fashion to Google’s PageRank algorithm (itself inspired by Garfield’s work on citations; Bergstrom, 2007), on the basis of which Google initially ranked search results. Briefly, it first considers the network of citations between journals and calculates the frequency with which an imaginary researcher would find themselves at an article within a specific journal by following chains of citation (Agarwal et al., 2016) — the more frequently they find themselves at a specific journal, the more influential that journal. Then, they divide a journal’s “influence” by the number of citations from that journal’s articles to calculate the journal’s weight; for example, an influential journal with many review articles and thus many citations to other journals does not have as high a weight as an influential journal with very few reviews and thus not as many citations to other journals. Weight can be thought of as the time spent at a journal: the more routes to that journal and the less routes from that journal, the more time spent at the journal. It finally considers the ratio of number of citations to the number of articles published by a specific journal (in a similar fashion to JIF), where each citation is weighted by the weight of the journal it came from. Unlike JIF, which considers citations within the past 2 years, Eigenfactor Score considers citations within the past 5 years.
“We can view the Eigenfactor score of a journal as a rough estimate of how often a journal will be used by scholars. The Eigenfactor algorithm corresponds to a simple model of research in which readers follow citations as they move from journal to journal. The algorithm effectively calculates the trajectory of a hypothetical “random researcher” who behaves as follows. Our random researcher begins by going to the library and selecting a journal article at random. After reading the article, she selects at random one of the citations from the article. She then proceeds to the cited work and reads a random article there. She selects a new citation from this article, and follows that citation to her next journal volume. The researcher does this ad infinitum. Since we lack the time to carry out this experiment in practice, Eigenfactor uses mathematics to simulate this process. Because our random researcher moves among journals according the citation network that connects them, the frequency with which she visits each journal gives us a measure of that journal’s importance within network of academic citations. Moreover, if real researchers find a sizable fraction of the articles that they read by following citation chains, the amount of time that our random researcher spends with each journal may give us a reasonable estimate of the amount of time that real researchers spend with each journal.” From Eigenfactor’s website here.
Purpose. According to the Eigenfactor website, they “launched the Eigenfactor project in January 2007 in order to provide the scientific community with what we believe to be a better method of evaluating the influence of scholarly journals.” They also note that as “librarians work to meet increasing subscription prices with increasingly constrained subscription budgets, powerful measures of journal influence and journal value may use fully supplement expert opinion and other sources of information in making difficult decisions about journal holdings. Our aim with the Eigenfactor project is to provide such a resource to the library community.”
Website. Journal ranking by Eigenfactor here.
Pros. (1) It accounts for where citations come from and weighs citations from more influential journals more highly than those from less influential journals. (2) It accounts for source of citation and weighs citations from articles with few citations more highly than those from articles with many citations. (3) It attempts to adjust for “citation culture” between journals and across fields by placing less weight to citations from articles with many citations. (4) Larger journals have larger Eigenfactor scores as it considers the total value of all articles published in a year by that journal. (5) Apparently it eliminates the impact of self-citations.
Cons. (1) Researchers often cite more established researchers and better-regarded journals because of who they are (i.e. their status or brand), not because they truly believe that their paper is more influential. (2) It lines very well with raw citation counts, which is a much simpler measure (Crotty, 2017b). (3) Even though it attempts to minimize the drawbacks of citation counts, it still relies heavily on them and thus largely suffers from similar drawbacks (Crotty, 2017b).

Article Influence Score

Description. This is part of the Eigenfactor Metrics. It is the Eigenfactor Score divided by the number of articles published in that journal and then normalized so that the average article has an Article Influence Score of 1.
Purpose. As per Eigenfactor Score, but adjusted for the number of articles published by each journal.
Website. Journal ranking by Article Influence here.
Pros. (1) Normalization makes articles of different journals immediately comparable. (2) Roughly analogous to the 5-year JIF as it is a ratio of a journal’s citation count to the number of articles it publishes.
Cons. (1) Very few articles in each journal carry most citations, thus giving two articles within the same journal an equal Article Influence Score makes little sense. (2) Similar drawbacks to Eigenfactor Score.

SCImago Journal Rank (SJR)

Description. SCImago is “a research group from the Consejo Superior de Investigaciones Científicas (CSIC), University of Granada, Extremadura, Carlos III (Madrid) and Alcalá de Henares, dedicated to information analysis, representation and retrieval by means of visualization techniques.” SJR was made available online in 2008 (Butler, 2008) and it works in a very similar fashion to Eigenfactor Score, with a few differences: (1) it uses a 3-year window (unlike the 5-year window), (2) it is based on the Scopus database (Eigenfactor Metrics depend on WOS), (3) it is journal size-independent (Eigenfactor Metrics are size-dependent), (4) it depends more on journal influence and less on citation counts and (5) the value of a citation also depends on subject field (González‑Pereira et al., 2010; Agarwal et al., 2016).
Purpose. As per the authors, this is “a size-independent indicator of journals’ scientific prestige” (González-Pereira et al., 2010).
Website. Access all journal and country SJR information here.
Pros. (1) As per Eigenfactor. (2) It uses more journals than the Eigenfactor.
Cons. (1) As per Eigenfactor. (2) As anything based on citation, it is impossible to know whether a study was cited for its scientific merit, to be criticized or an entirely different reason. (3) Most, if not all, of the additional journals on Scopus are of limited scientific value.
Notes. SCImago partners with Elsevier, as of 2010.

CiteScore

Description. This is an alternative to JIF (of Clarivate Analytics) issued by Elsevier’s Scopus in 2016 as part of a family of CiteScore metrics. It works exactly like JIF, but instead: (1) it considers citations of papers over 3 years rather than over 2 years, (2) pulls data from many more journals than JIF and (3) counts citations to all articles published in a journal (rather than only research articles). For more differences visit Elsevier’s post here.
Purpose. Elsevier indicates that CiteScore metrics introduce “a new standard that gives a more comprehensive, transparent and current view of a journal’s impact that will help you guide your journal more effectively in the future.”
Website. CiteScore is freely available (unlike JIF) and can be found here.
Pros. (1) It alleviates bias introduced by having to decide whether a publication should be counted as a research article or not.
Cons. (1) As per JIF. (2) Elsevier has been accused of being impartial in creating CiteScore — by accounting for all published material, journals of the Nature Publishing Group take a hit in comparison to their JIF, whereas Elsevier journals benefit. Read this article on eigenfactor.org for further details.

Immediacy index

Description. The immediacy index is published by Clarivate Analytics, which notes here that it is “the average number of times an article is cited in the year it is published. It is calculated by dividing the number of citations to articles [of a journal] published in a given year by the number of articles published in that year.”
Purpose. From the same website: “For a researcher, publishing in a journal with a high Immediacy Index may increase the chances that his or her paper will get noticed within a year of publication. For a publisher, the Immediacy Index is an indicator that can be used to evaluate journals in the immediate term. Immediacy Index can answer questions about the speed of new content citation. Publishers can also compare Immediacy Index to competing journals — is their material cited faster?”
Website. Immediacy index is officially calculated by Clarivate Analytics and published yearly at InCites Journal Citation Reports (paywalled).
Pros. (1) A useful metric in identifying journals in fields with fast-paced research. (2) It adjusts for journal size because it is a per-article average.
Cons (1) As per JIF. (2) “Frequently issued journals may have an advantage because an article published early in the year has a better chance of being cited than one published later in the year.” (3) The usefulness of the immediacy index varies from field to field; for example, it may be more relevant in medicine than in mathematics. Similarly, in fields like biology, an article may have been read, but it may take more than a year of it to be incorporated in new published work.

Altmetrics

Altmetrics were initially introduced in 2010 by the publication of the altmetrics manifesto. Unlike more traditional measures of article influence or impact, which are primarily based on citation activity, these primarily measure article-specific web-based activity. For more information on altmetrics and a quick video go here. For scholarly articles on altmetrics, PLoS maintains a collection of articles here. I hereby discuss the two most frequently encountered altmetrics, the Altmetric Attention Score and PlumX.

Altmetric Attention Score

Description. This is a weighted count of all online activity in relation to a specific publication captured by Altmetric (note that Altmetric is a company producing altmetrics). These include mentions on social networks, news articles, Wikipedia, policy documents, etc. (a comprehensive list of sources here). In addition to the overall number, Altmetric indicates the exact records that have contributed to that count. The Altmetric Attention Score is denoted as in the picture above, where each color other than sky-blue refers to a source of mentions.
Purpose. Altmetrics considers that AAS indicates “the volume and likely reach of research’s attention, not quality or impact, at a glance.”
Website. All data held by Altmetric can be accessed for free using their API here. You can search for articles using their Altmetric Attention Score using the Dimensions database for free here.
Pros. (1) It simplifies the total social attention of a research output into a single value. (2) A useful map of all web-based social attention directed to an article.
Cons. (1) It is tempting to use this number out of context and without an appreciation of what feeds into it. (2) The formula used to calculate the score is not publicly available. (3) As far as I know, no academic committee at the moment uses this score to make decisions about faculty promotion. (4) Headline-grabbing articles can have a very high Altmetric Attention Score, even though they may be of doubtful scientific quality — for example, the now retracted Wakefield et al. (1998) article reporting on the association of the MMR vaccine with autism has an Altmetric Attention Score of 3626, which is one of the highest ever recorded (99th percentile).
Notes. More pros and cons at Altmetric’s website here.

PlumX Metrics

Description. Plum Analytics was founded in 2012. They track mentions of articles in social media, such as Twitter and news outlets, much like Altmetric. In addition to scores by Altmetric, it quantifies usage statistics (e.g. number of views) and captures (i.e. whether someone indicated that they want to return to a paper). In difference to Altmetric, it does not provide an overall score. Plum Analytics has now been acquired by Elsevier.
Stated purpose. As per Plum Analytics here, “PlumX Metrics provide insights into the ways people interact with individual pieces of research output (articles, conference proceedings, book chapters, and many more) in the online environment.”
Website. The PlumX Dashboard can be accessed here (paywalled).
Pros. (1) A useful map of all web-based social attention directed to an article.
Cons. (1) No overall weighted score provided to roughly compare between articles. (2) As far as I know, no academic committee at the moment uses this score to make decisions about faculty promotion. (3) Headline-grabbing articles can score very highly across a number of altmetrics, even though they may be of doubtful scientific quality.

Other metrics

There are many more other metrics. A few fun ones include the Erdos number, the Erdos-Bacon number and the Erdos-Bacon-Sabbath number (Stephen Hawking tops the list!), which calculate your degree of separation from the respective figures. arXiv Sanity Preserver features “top hype”, which collects all preprints on arXiv mentioned on Twitter over the last day.

Recommendations

All aforementioned metrics measure some form of attention; “influence” and “impact” are very ambiguous words. However, there is no metric that directly assesses the likelihood of a scientific finding being true, the likelihood of a specific scientist publishing a true finding or, generally, which contribution to our scientific knowledge, let alone overall prosperity, is likely most important. For example, even though Sigmund Freud has the highest h-index of all time at 280, much of his research has been discredited. Conversely, even though Einstein has contributed fundamental true insights, he barely makes the cut for individuals with an h-index above 100 at 106. Having said that, highly-cited scientists have indicated that their most cited work tends to align with what they think is their most important work (Ioannidis et al., 2014).
Nevertheless, these measures should always be used in conjunction, if at all, to quantify attention received and qualitatively appreciate what this attention may mean. Academic decisions, such as hiring or promoting faculty, should primarily depend on a qualitative assessment of name and journal-blinded selections of a researcher’s work and should consider all venues of possible scientific impact, not merely the peer-reviewed literature. It is unfortunate that the current system has led many scientists to primarily work just to increase that number. Scientometricians have put together the Leiden Manifesto, which was announced in Nature in 2015 and which lists 10 principles in evaluating science using any kind of metric — here is a must-watch 4.5 minute video overview on it.

Acknowledgements

This article was written after attending a journal club on scientometrics (the study of measuring science) by Mark Musen at Stanford University.

Disclaimer

This article may keep changing as I learn more about scientometrics. I apologize for not mentioning metrics that you may think were important — I only mentioned the ones I and, I think, most other people encounter most frequently and for which I believe we as scientists should all have a rudimentary knowledge and opinion. All reported h-index values were taken from webometrics — all values based on citation and publication counts vary with database (i.e. Scopus vs WOS vs Google Scholar).

Additional resources

Wikipedia offers an overview of journal ranking methods here. Eugene Garfield’s website offers an enormous wealth of information on scientometrics. The Encyclopedia of Library and Information Science offers more details about the initial development of citation counts here.

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Stelios Serghiou
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MD | PhD (Epidemiology)-MS (Statistics) student | Stanford University | Meta-research, evidence-based medicine and health informatics using machine learning

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