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      Orthopaedic research in low-income countries: A bibliometric analysis of the current literature


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          Background: To perform a bibliometric analysis and quantify the amount of orthopaedic and trauma literature published from low-income countries (LICs).

          Methods and methods: The Web of Science database was utilised to identify all indexed orthopaedic journals. All articles published in the 76 orthopaedics journals over the last 10 years were reviewed, to determine their geographic origin.

          Results: A total of 131 454 articles were published across 76 orthopaedic journals over the last 10 years. Of these, 132 (0.1%) were published from LICs and 3515 (2.7%) were published from lower middle-income countries (LMICs); 85.7% ( n = 112 716) of published orthopaedic research was undertaken in a high-income setting. The majority of the studies ( n = 90, 74.4%) presented level IV evidence. Only 7.4% ( n = 9) were high-quality evidence (level I or II). Additionally, the majority of research (74 articles, 56%) was published in partnership with high-income countries (HICs).

          Conclusions: There is a stark mismatch between the publication of scientific reports on orthopaedic research and the geographical areas of greatest clinical need. We believe there is an urgent need for orthopaedic research to be carried out in low-income settings to guide treatment and improve outcomes, rather than assuming that evidence from high-income settings will translate into this environment .

          Level of evidence: IV

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          Most cited references20

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          Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development.

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            Mapping of available health research and development data: what's there, what's missing, and what role is there for a global observatory?

            The need to align investments in health research and development (R&D) with public health demands is one of the most pressing global public health challenges. We aim to provide a comprehensive description of available data sources, propose a set of indicators for monitoring the global landscape of health R&D, and present a sample of country indicators on research inputs (investments), processes (clinical trials), and outputs (publications), based on data from international databases. Total global investments in health R&D (both public and private sector) in 2009 reached US$240 billion. Of the US$214 billion invested in high-income countries, 60% of health R&D investments came from the business sector, 30% from the public sector, and about 10% from other sources (including private non-profit organisations). Only about 1% of all health R&D investments were allocated to neglected diseases in 2010. Diseases of relevance to high-income countries were investigated in clinical trials seven-to-eight-times more often than were diseases whose burden lies mainly in low-income and middle-income countries. This report confirms that substantial gaps in the global landscape of health R&D remain, especially for and in low-income and middle-income countries. Too few investments are targeted towards the health needs of these countries. Better data are needed to improve priority setting and coordination for health R&D, ultimately to ensure that resources are allocated to diseases and regions where they are needed the most. The establishment of a global observatory on health R&D, which is being discussed at WHO, could address the absence of a comprehensive and sustainable mechanism for regular global monitoring of health R&D. Copyright © 2013 Elsevier Ltd. All rights reserved.
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              Injuries: the neglected burden in developing countries.


                Author and article information

                SICOT J
                SICOT J
                EDP Sciences
                26 November 2019
                : 5
                : ( publisher-idID: sicotj/2019/01 )
                : 41
                [1 ] Liverpool School of Tropical Medicine Liverpool L3 5QA UK
                [2 ] Orthopaedic Research Unit, Department of Orthopaedic Surgery, Groote Schuur Hospital, University of Cape Town Cape Town 7700 South Africa
                [3 ] Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town Cape Town 7700 South Africa
                [4 ] Director, Liverpool School of Tropical Medicine Liverpool L3 5QA UK
                [5 ] Alder Hey Hospital Liverpool L12 2AP UK
                [6 ] Oxford Trauma, NDORMS, University of Oxford OX3 9DU UK
                [7 ] University of Malawi College of Medicine Private Bag 360 Chichiri, Blantyre 3 Malawi
                [8 ] Countess of Chester Hospital Chester CH2 1UL UK
                [9 ] AO Alliance Foundation, Africa Regional Director Davos Switzerland
                Author notes
                Author information
                sicotj190049 10.1051/sicotj/2019038
                © The Authors, published by EDP Sciences, 2019

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 13 May 2019
                : 11 October 2019
                Page count
                Figures: 3, Tables: 4, Equations: 0, References: 23, Pages: 6
                Lower Limb
                Review Article

                bibliometric analysis,low-income countries,orthopaedic,research


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