Authors: Kimberly Anne Major; Oliver Mrowczynski, MD; Elias Rizk, MD; Alice Cai, BS (Annville, PA)


Citation analysis can be a useful tool in determining which articles have been most impactful in different specialties. This article identifies and compares the top 100 publications overall and top 50 articles from 2012- 2018 in pediatric neurosurgery, general pediatrics and pediatric surgery literature.


Four pediatric neurosurgery journals, 21 general pediatric journals, and four pediatric surgery journals were included in a Web of Science search to identify the top 100 most-cited articles in the overall literature and the top 50 most-cited articles from 2012-2018 in each specialty. These articles were analyzed for the number of authors, year of publication, citation count, adjusted citation count, and the 2011 Oxford Centre for EBM level of evidence.


In an analysis of the 100 most-cited articles in literature, 12.5% of pediatric neurosurgery articles were level 3 evidence or better, compared to 44% of general pediatric articles and 10% of pediatric surgery articles. A one-way ANOVA showed the difference between the citations per year and average adjusted citation count were significant between specialties (F(2,301)=257.821, p=5.80×10-66; F(2,301)=156.037, p=3.19×10-47). Analysis of the 50 most-cited articles from 2012 to 2018 found 22% of the pediatric neurosurgery articles were level 3 evidence or better,  compared to 36% of  pediatric surgery articles and 52% of general pediatric articles. A one-way ANOVA showed significance between specialties for both total citation count, F(2,147)=100.981, p=2.53×10-28, and adjusted citation count, F(2,147)=123.756, p=3.07×10-32.


The literature in general pediatrics outweighs that of pediatric neurosurgery and pediatric surgery in regards to the level of evidence, with general pediatrics having more level 3 evidence or better. Pragmatic registry-based observational studies and well-designed pragmatic randomized control trials should be considered in the pediatric neurosurgical and surgical fields to provide higher-level evidence to assist in practice.