Research Article: Appreciation of literature by the anaesthetist: A comparison of citations, downloads and Altmetric Attention Score

Date Published: March 16, 2020

Publisher: John Wiley and Sons Inc.

Author(s): Jasper M. Kampman, Jeroen Hermanides, Pascal R. Q. Boere, Markus W. Hollmann.


Different metrics exist to evaluate the impact of a paper. Traditionally, scientific citations are leading, but nowadays new, internet‐based, metrics like downloads or Altmetric Attention Score receive increasing attention. We hypothesised a gap between these metrics, reflected by a divergence between scientific and clinical appreciation of anaesthesia literature.

We collected the top 100 most cited and the top 100 most downloaded articles in Acta Anaesthesiologica Scandinavica (AAS) and Anesthesia & Analgesia (A&A) published between 2014 and 2018. We analysed the relationship between the average number of citations per year, downloads per year and Altmetric Attention Score.

For both AAS and A&A, a significant correlation between the 100 most cited articles and their downloads (r = .573 and .603, respectively, P < .001) was found. However, only a poor correlation with Altmetric Attention Score was determined. For the 100 most downloaded articles, download frequency did not correlate with their number of citations (r = .035 and .139 respectively), but did correlate significantly with the Altmetric Attention Score (r = .458 and .354, P < .001). Highly cited articles are downloaded more frequently. The most downloaded articles, however, did not receive more citations. In contrast to the most cited articles, more frequently downloaded papers had a higher Altmetric Attention Score. Thus, a ‘trending’ anaesthesia paper is not a prerequisite for scientific appreciation, reflecting a gap between clinical and scientific appreciation of literature.

Partial Text

The traditional way of ranking individual scientists is, among others, based on the number of citations their papers receive and the impact factor (IF) of the journals their articles are published in. In the internet era, new metrics to measure the impact of a paper, such as the number of downloads or Altmetric Attention Score, are available. Those can be used to measure the impact of publications on both the clinical and non‐clinical community. It quantifies the influence and attention an article receives by looking at social media, Wikipedia citations, reference managers, blogs, media coverage and public policy documents.1 In recent years, many journals have reduced or abandoned their printed issues. As a result, researchers and other interested readers have to download an article before being able to read, or cite, it. This makes the number of downloads an increasingly accurate metric for the interest an article arouses with its readership.

This is the first study comparing between citations, downloads and Altmetric Attention Score within the field of anaesthesia. A large number of best performing papers published between 2014 and 2018 in Acta Anaesthesiologica Scandinavica and Anesthesia & Analgesia was analysed.

The authors certify that there is no conflict of interest with any financial organisation regarding the material discussed in the article.




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