School of Podiatric Medicine - Student Research

Document Type

Poster

Publication Date

2-24-2026

Abstract

Introduction: As the field of foot and ankle surgery advances, it is valuable to identify qualities of research publications that get more attention. Evaluating the factors that contribute to the traction would also help emerging authors identify areas of focus to improve visibility of their work in the profession. Our study aims to evaluate the relationship between the number of citations by articles published in the Journal of Foot and Ankle Surgery (JFAS) and the level of clinical evidence (LOE), article access level, the type of publication, the authors’ institution, and the country of submission.

Methods: We used Scopus to identify all publications in JFAS from 2020 to 2022. We extracted the date of publication, number of citations, LOE, type of publication, access level (open vs. subscription), institutions (academic vs. private vs. VA vs. military), and country (primary author’s country). We also assigned the LOE to 27 publications that did not already have the designation. We excluded publications that were editorials, letters to the editor, and corrections to prior articles. We also excluded publications that did not apply a clinical level of evidence or were not related to our field. “Country” was dichotomized into the top ten vs. the rest of the countries in terms of number of publications. For articles with unclear categorization, the research team met and assigned the category through consensus.

The outcome measure was “traction” (impact of an article), defined by citations per month. The number of citations was adjusted by time by the following formula: Citation per Month (CPM) = number of citations / months the article has been out since publication until September 2025. Using R (version 4.2.2), bivariate analyses were performed to identify factors associated with CPM using either Student’s t-test, ANOVA, or Pearson's correlation test. When the p-value was >0.2, the variable was included in the final linear multiple regression model to identify factors independently associated with a higher CPM. If the p-value was less than 0.05, it was considered statistically significant.

Results: We extracted 769 articles in JFAS between 2020 and 2022, and after exclusion criteria were applied, 708 were included in the analysis. The mean CPM of all the included articles during the time period was 0.11 (range 0.00-1.56). After bivariate analysis, we identified LOE, publication type, and institution to be included in the final model (all P < 0.001). CPM was not associated with access or country in the bivariate analysis. After adjusting for the significant covariates, a higher level of evidence (p = 0.001) and review article type (p = 0.001) remained significantly associated with a higher CPM.

Discussion: The traction, measured in CPM, was significantly associated with a higher LOE and the type of publication, specifically review articles. At the same time, there was no such association with the open access type or country of publication. This suggests that, for the growth of our profession and journal, articles with a higher LOE, i.e., randomized clinical trials, are needed. Simultaneously, we cannot ignore good-quality review articles.

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