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  1. Hinds, Pamela S. PhD, RN, FAAN
  2. Keller, Susan MLS

Article Content

In cancer care and in almost all nursing specialties, we have adopted quality indicators of our direct care. The measures of these indicators are purposefully linked to credible sources that provide a benchmark against which each reporting nursing care setting and the units within each setting can be compared with each other across defined periods of time. We argue about the validity of what is chosen as an indicator, what the definition of the indicator includes, and how it is measured. Despite the unsettled aspects that are the basis of these arguments, we do have consensus about the merits of having a comparison metric that allows us to learn more about our own care.


In peer-reviewed publications, the journal impact factor is used as a quality indicator. The formula that underlies this impact metric is based on a calculation involving the average number of citations for that journal during the measurement period in relationship to the total number of papers published during that very same measurement period (for journals indexed by Thomson-Reuters). Arguments about the validity of this approach most certainly exist. A current conversation in different forms of media is a continuation of arguments against the journal impact factor and advocating for more of a focus on the impact of a single author or of a single article. This conversation includes the word altmetrics,1,2 which reflects the impact of the article and not the journal3 and serves as a real-time feedback indicator that can quickly alert a potential reader to the status of a published article being a "must read" or a "no need to read." With the volume of published studies steadily increasing, having a filter that could help to guide our decisions regarding our available time to absorb new content would have its place. Comparing our impressions of the must-reads as it applies to our individual research programs and comparing those impressions with the more traditional steps to identify relevant literature could indeed be a form of measurement. But like our current measures, this too would be informative but insufficient.


Trends at the individual author level are important and most certainly are used as indicators of quality when individuals are being considered for promotions or as an investigator for a submitted grant. Trends at the individual author level are also measureable within available literature for similar purposes, but a different kind of trend might be a more informative indicator of what readers of science are seeking. With that in mind, we have begun monitoring the number of citations per published paper in Cancer Nursing. We share these with you here as a way of honoring the authors involved and also as an indicator of what reviewers and readers seem to be favoring.


We have chosen the publication year of 2011 for our initial examination of impact in terms of most frequently cited studies published in Cancer Nursing. Of the 8 most frequently cited studies, 6 were related to developing and testing interventions to diminish negative experiences for individuals (adults or children) receiving cancer treatment or to increasing positive experiences of being a cancer patient. Three of the studies included a focus on fatigue and 2 of these included a focus on physical activity and fatigue. One of the studies focused on the experiences of oncology nurses. There is quite definitely a breadth of interest represented in the most frequently cited papers, and there are emerging themes such as the interest in interventions and symptoms. We are also monitoring where these published studies are being cited; most of studies were cited in cancer specialty journals, including the medical oncology journal, with the highest journal impact factor as calculated by the Thomson- Reuters formula, in interdisciplinary, nursing, and review journals. We take note that in general, the trend is of an increasing number of citations over the 3-year span (2011-2013) of our examined citations, indicating that a look at citations must be longitudinal.


We shall continue to examine trends in citations to see if the outcomes might contribute some degree of added guidance to our current review processes. Our interest remains in ensuring all readers of a high-quality review process such that the highest quality studies are moved forward into publication in Cancer Nursing. We have profound interest in learning the direct benefit of our published studies in patient care, but this interest exceeds the metrics now available to us. We look forward to the time when this metric is in our hands.


Our very best to you,


-Pamela S. Hinds, PhD, RN, FAAN




-Susan Keller, MLS


Department of Nursing Research and Quality Outcomes


Children's National Medical Center


Washington, DC




1. Priem J, Taraborelli D, Groth P, Neylon C. Altmetrics: a manifesto. http://altmetrics.org/manifesto/. Accessed January 24, 2014. [Context Link]


2. Carpenter TA. Stick to your ribs: altmetrics-replacing the impact factor is not the only point. http://scholarlykitchen.sspnet.org/2014/01/23/stick-to-your-ribs-altmetrics-repl. Accessed February 5, 2014. [Context Link]


3. Taylor M. Exploring the boundaries: how altmetrics can expand our vision of scholarly communication and social impact. Information Standards Quarterly, Summer. 2013; 25 (2): 27-32. http://www.niso.org/publications/isq/2013/v25no2/taylor/. Accessed February 5, 2014. [Context Link]