The Contribution of Seminars in Thrombosis and Hemostasis beyond the Academic Community

In a recently published editorial, the Editor-in-Chief of this journal introduced readers to some of the journal's achievements during the past year, including its most recent (2018) impact factor and associated citations.[1] It is, however, important to emphasize that such traditional metrics are being increasingly substituted by other impact indicators. Many researchers now consider alternative metrics to assess journals following guidelines established seven years ago in the San Francisco Declaration on Research Assessment (known as DORA).[2] This manifesto suggests avoidance of the impact factor as it can be influenced and biased,[3] [4] [5] namely, importance should be drawn to the scientific content of the papers instead of journal metrics.

In 2010, Priem et al[6] proposed the use of alternative metrics (known as altmetrics) to assess the broader impact of the research being published, instead of the journals in which these studies are published, by making use of various social media platforms that offer real-time information on usage and audience. Currently, it is possible to trace interactions with social reference managers, social media platforms, mainstream media, and patent databases, among other sources. These interactions are the basis of altmetric indicators, which are generated by two commercial companies founded in 2011, Altmetric.com and Plum Analytics. While both forums provide similar indicators, there are slight differences in their end value as each company tracks and reports data differently.[7] Irrespective, these complement traditional bibliometrics by providing a more holistic view of societal impact.

There are additional reasons why altmetrics may be integrated into research evaluation. Instead of assessing citations against specific articles, which may take years, Altmetrics counts user numbers, for example, who bookmark or read an article in an online reference management tool (such as Mendeley). Thus, early impact can be assessed.[8] [9] [10] Nevertheless, caution is indicated as some readers may not belong to academia, and thus such holistic impact may not translate into citations. Another source tracked by Altmetric.com is Dimensions, a scholarly database that collects metric data that includes publications, books, datasets, and clinical trials.[11] In regard to data sources, Thelwall[12] established that 97% of all Scopus articles with DOIs published in 2012 and related to Food Science were found in Dimensions. Additionally, Orduña-Malea and Delgado-López-Cózar[13] showed that the citations received by 20 journals belonging to the Library and Information Science research area displayed slightly less citations in Dimensions as compared with Scopus. While such findings may be of specific interest to librarians, editorial managers, and academia, Altmetric may show societal benefits through the generation of public policies and patents. For example, a brief report[14] on the use of graduate compression stockings has since been twice used by the United Kingdom's National Institute of Health and Care Service as a reference in their official guidelines for reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. Likewise, many articles that have been published on thrombosis have been used to generate patents. As an example, one article[15] was cited only 12 times according to Web of Science, but has been used as a reference in 83 patents.

Thus, the main objective of this review of Altmetric data as related to the previous editorial was to establish how such articles have otherwise contributed to impact by outreaching a wider audience, beyond academia.

Information was retrieved using Altmetric Explorer (www.altmetric.com) as the search engine because it captures real-time mentions in public policy documents, mainstream media, online reference managers, peer-review platforms, and blogs.[16] Altmetric.com began collecting data in 2011. The query was made on March 17, 2020, for 1,119 documents that were published by Seminars in Thrombosis and Hemostasis (STH) between 2010 and 2019. The information was exported to Excel for data analysis.

The first assessment investigated the 36 top-cited papers that contributed the most to the journal's 2018 impactor factor.[1] Nearly half of these papers (16) also attracted online attention from different sources ([Table 1]). Most, however, were not mentioned in social media networks such as Twitter or Facebook despite all having a DOI (digital object identifier). The absence of mentions in news or policy documents may relate to a lack of standardization in bibliographic reference format, since to identify a specific paper, Altmetric.com collects data from its DOI. For instance, the article “Diagnosis and treatment of hyperfibrinolysis in trauma (a European perspective)” published in 2017 was noted in tweets within 4 weeks of publication by 45 individuals from the United Kingdom, Australia, United States, Canada, Spain, Netherlands, Saudi Arabia, Germany, and Chile; this reveals the speed at which interesting content can become globally widespread using social networks. Another indicator is Wikipedia mentions, which comprise papers cited in Wikipedia pages written in English, Finnish, or Swedish. In order for Altmetric.com to find a mention, the reference ought to include a DOI or PubMed ID. Here, two papers focused on fibrinogen disorders ([Table 1]) were used as references on five Wikipedia pages in English. Another indicator, which may be regarded as a proxy for future impact, is the count of Mendeley readers. Here, two papers registered more than 100 Mendeley readers since their publication, whereas the other 14 ranged from 8 to 71 Mendeley readers. Unlike citations that only capture readership from papers that have been published, Mendeley readership is collected and registered more rapidly. Thus, correlations between Mendeley readership and citations have been established by several studies.[17] [18] [19]

Table 1 Altmetric indicator of the top 2018 cited papers published in 2016/2017 as previously reported[a]

Title	Issue	Mendeley readers	Tweet mentions	Wikipedia mentions	Dimension citations
Platelet physiology	2016;42(3):191–204	152	0	0	62
Hydroxychloroquine to improve pregnancy outcome in women with antiphospholipid antibodies (HYPATIA) protocol: a multinational randomized controlled trial of hydroxychloroquine versus placebo in addition to standard treatment in pregnant women with antiphospholipid syndrome or antibodies	2017;43(6):562–571	46	2	0	29
Factor XII contact activation	2017;43(8):814–826	30	0	2	19
The role of platelets in venous thromboembolism	2016;42(3):242–251	29	3	0	22
What is the biological and clinical relevance of fibrin?	2016;42(4):333–343	71	0	0	42
Laboratory and genetic investigation of mutations accounting for congenital fibrinogen disorders	2016;42(4):356–365	8	0	5	34
Clinical features and management of congenital fibrinogen deficiencies	2016;42(4):366–374	38	0	5	33
Diagnosis and treatment of hyperfibrinolysis in trauma (a European perspective)	2017;43(2):224–234	44	45	0	29
Circulating extracellular DNA: cause or consequence of thrombosis?	2017;43(6):553–561	28	2	0	22
Pathophysiology of trauma-induced coagulopathy and management of critical bleeding requiring massive transfusion	2016;42(2):155–165	53	4	0	36
Von Willebrand disease and pregnancy: a review of evidence and expert opinion	2016;42(7):717–723	32	3	0	13
Fibrinolysis in trauma: “myth,” “reality,” or “something in between”	2017;43(2):200–212	47	1	0	18
Alterations in fibrin structure in patients with liver diseases	2016;42(4):389–396	21	1	0	23
Environmental and genetic risk factors associated with venous thromboembolism	2016;42(8):808–820	115	0	1	27
Monitoring therapy during treatment of von Willebrand disease	2017;43(3):338–354	23	1	0	16
Risk assessment scores for cancer-associated venous thromboembolic disease	2017;43(5):469–478	15	7	0	14

^a Data shown only for those publications with mentions in these forums.

A second objective was to identify which papers attracted online attention. The first indicator analyzed was News, which considers pieces of content that mention scholarly articles. Ten papers registered mentions, with “Moderate Red Wine Consumption and Cardiovascular Disease Risk: Beyond the French Paradox” collecting most mentions ([Table 2]). Although published in 2010, The Huffington Post (an American news and opinion Web site) posted in 2015 a news item that made reference to this study. A year later, the Microsoft Service Network (MSN) posted another note entitled “What the world's healthiest foods have in common.” Likewise, the American magazine “Outside Online” and the Argentinian digital newspaper “Infobae” both published news items that related to the same publication. Some of the other news outlets that mentioned other STH publications are Yale News, Technology.org, SciTech Daily, The Conversation, and BioScience Technology. Considering that portals such as SciTech Daily and The Conversation reported just for the month of December 2019 a total of 1.41 million and 11.8 million visitors, respectively, the potential impact of any publication referenced in one of these portals is likely to be high. However, the URL for any paper needs to be included as part of the news item; otherwise, the news mention is undetected.

Table 2 List of papers published between 2010 and 2019 with news mentions according to Altmetric.com

Title	Publication date	News mentions
Moderate red wine consumption and cardiovascular disease risk: beyond the French paradox	April 13, 2010	8
Underreporting of hemorrhagic and thrombotic complications of pharmaceuticals to the U.S. Food and Drug Administration: empirical findings for warfarin, clopidogrel, ticlopidine, and thalidomide from the Southern Network on Adverse Reactions (SONAR)	October 21, 2012	5
Pulmonary embolism and atrial fibrillation: two sides of the same coin? A systematic review	February 14, 2017	4
Pulmonary embolism as a consequence of ultrasonographic examination of extremities for suspected venous thrombosis: a systematic review	January 25, 2016	2
Relationship between ABO blood group and hemorrhage: a systematic literature review and meta-analysis	January 8, 2013	1
ABO blood group and vascular disease: an update	December 31, 2013	1
Non-O Blood type is the commonest genetic risk factor for VTE: results from a meta-analysis of the literature	June 27, 2012	1
Vascular disease and dementia: lipoprotein(a) as a neglected link	May 16, 2019	1
Hemostatic abnormalities in dementia: a systematic review and meta-analysis	May 16, 2019	1
Classic and global hemostasis testing in pregnancy and during pregnancy complications	September 21, 2016	1

The visibility of papers can also be assessed by use in generation of policy documents. As defined by Lui,[20] policy sources need to be aimed at changing or influencing guidelines, policies, or practices. Some of the tracked sources are government guidelines, international development organizations, research institutes, and advisory committees. Again, a unique identifier (e.g., DOI) is essential for tracking. As shown in [Table 3], seven papers have been cited on policy documents generated by organizations from Germany, the United Kingdom, and the United States, as well as the World Health Organizations of the United Nations. While this quantity may seem small, a recent study established that < 0.5% of papers, from different disciplines, indexed by Web of Science, were mentioned at least once in policy-related documents.[21]

Table 3 List of papers published between 2010 and 2019 with policy mentions according to Altmetric.com

Title	publication date	Policy mentions	Policy document	Publisher
Non-O blood type is the commonest genetic risk factor for VTE: Results from a meta-analysis of the literature	June 27, 2012	1	The Economics of Genomic Medicine: Workshop Summary	National Academy of Sciences
Management of complications related to central venous catheters in cancer patients: an update	March 4, 2014	1	UK SMI B 20: investigation of intravascular cannulae and associated specimens Closed Consultation Draft	UK Government
Alcohol dosing and the heart: updating clinical evidence	December 23, 2011	1	Hausärztliche Risikoberatung zur kardiovaskulären Prävention: Langfassung der Leitlinie	The Association of the Scientific Medical Societies in Germany
Prevention of venous thromboembolism: focus on mechanical prophylaxis	March 31, 2011	1	Venous thromboembolism: reducing the risk for patients in hospital: Addendum June 2015	National Institute for Health and Care Excellence
Parahemophilia: new insights into factor V deficiency	July 26, 2013	1	Hausärztliche Risikoberatung zur kardiovaskulären Prävention: Langfassung der Leitlinie	The Association of the Scientific Medical Societies in Germany
Thromboprophylaxis with low-molecular-weight heparins: an assessment of the methodological quality of studies	February 17, 2015	1	The selection and use of essential medicines. Twentieth report of the WHO Expert Committee 2015	World Health Organization
A review of safety, efficacy, and utilization of erythropoietin, darbepoetin, and peginesatide for patients with cancer or chronic kidney disease: a report from the Southern Network on Adverse Reactions (SONAR)	October 30, 2012	1	The selection and use of essential medicines: report of the WHO Expert Committee, 2017	World Health Organization

Lastly, there were substantial patent mentions associated with 22 articles published by STH ([Table 4]). “Therapeutic Complement Inhibition: New Developments” was used by six patents issued by the European Patent Office as well as the United States Patent and Trademark Office. This indicator represents the relationship between science and technology as citations from patents provide empirical evidence about the commercial impact of published research.[22]

Table 4 List of papers published between 2010 and 2019 with patent mentions according to Altmetric.com

Title	Publication date	Patent mentions
Therapeutic complement inhibition: new developments	September 23, 2010	6
Description of an in vitro platelet function analyzer-PFA-100	May 9, 2012	5
The multifactorial etiology of inhibitor development in hemophilia: genetics and environment	February 18, 2010	4
Therapy for thrombotic thrombocytopenia purpura: past, present, and future	December 31, 2013	3
Structure and function of a recombinant von Willebrand factor drug candidate	July 15, 2010	3
New insights into von Willebrand disease and platelet function	February 7, 2012	3
C1-inhibitor: more than a serine protease inhibitor	July 30, 2011	2
Interaction of platelets and inflammatory endothelium in the development and progression of coronary artery disease	April 22, 2010	2
Improvements in factor VIII inhibitor detection: from Bethesda to Nijmegen	February 18, 2010	2
Placental vasculature in health and disease	May 20, 2010	2
Sepsis and thrombosis	April 27, 2013	1
NETosis: a new factor in tumor progression and cancer-associated thrombosis	March 3, 2014	1
Development of the endothelium: an emphasis on heterogeneity	May 20, 2010	1
Vitronectin in vascular context: facets of a multitalented matricellular protein	July 30, 2011	1
Newer hemostatic agents	April 20, 2015	1
Critical factors contributing to the thromboelastography trace	October 26, 2010	1
Tissue factor, lipid rafts, and microparticles	November 3, 2010	1
Microparticles in cancer	November 3, 2010	1
Platelet aggregates-induced human CD34 + progenitor cell proliferation and differentiation to macrophages and foam cells is mediated by stromal cell derived factor 1 in vitro	April 22, 2010	1
Preliminary data from a field trial of the PFA-100 system	May 9, 2012	1
Variables influencing the Thrombostat 4000: recommended standardization	May 9, 2012	1
Thrombolytic therapy for acute pulmonary embolism	March 28, 2013	1

In conclusion, the massification of the internet has undoubtedly increased the interaction between journals and readers, allowing readers to search for papers of their interest through the use of freely available databases such as Google Scholar or Dimensions. Institutional repositories are facilitating this interaction by making available papers that are normally stored behind a paywall. Inadvertently, readers can now assess the perceived quality of a paper without considering citation number or the journal's impact factor. As this correspondence reflects, there are many ways of measuring the impact and visibility of articles. Traditional bibliometrics and altmetrics should be used complementarily to provide a more complete view of any research impact for any particular paper or journal. The content of a paper may inspire future studies to be translated into policy documents or to be used as a foundation for a patent.

Publication History

Article published online:
01 February 2021

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