Survey of h-index for neurosurgeons in Saudi Arabia

Discussion

Modern neurosurgery has been practiced in KSA for more than 30 years, mainly in tertiary care hospitals. The KSA neurosurgeons are relatively small in numbers, and they have contributed to the local and international literature. Hence, KSA neurosurgeons are a suitable group for a first attempt at calculating the h-index for practitioners in a medical specialty in KSA. The h-index is a robust statistic, but it has certain inadequacies. It cannot be used to compare scientists belonging to different fields, even closely related specialties.3 Its use in contrasting departments academic output may be considered unreliable.4,6 It undervalues the importance of high scientific impact work, which has citation numbers well above h.5,6 The h-index discriminates against those who work alone or in a small team, and underestimates the contribution of women who had a marital change in surname.5 In addition, the accuracy of its measurement is dependent on the reliability of the available databases, which are known to be influenced by authors name repetition and articles publication date.5,6 In an effort to compensate for these deficiencies many variants of the h-index were introduced,2,5,6 and some of them, such as the m-quotient5 and the g-index3 correlate well with the h-index. Nevertheless, at present, the h-index is a widely accepted measure that is useful in evaluating the academic performance of a researcher objectively.1-6

In this study, the median h-index for the KSA neurosurgeons was 2.5, and the mean h-index was 5.04. Khan et al4 reported an h-index median of 16, and a mean of 19.7 for 188 neurosurgeons working in 10 highly ranked USA institutions. Spearman et al1 calculated a median h-index of 9 for 1120 academic neurosurgeons working at all USA Electronic Residency Application Service-listed neurosurgery training programs. Wilkes et al5 stated a median h-index of 6 for 315 neurosurgeons in GB and Ireland. We observed a significant correlation between the h-index for KSA neurosurgeons and the duration after their neurosurgical certification (before or on, and after 2001), which is in agreement with other reports.3,4 We also noted that h-index for Saudi neurosurgeons and for those holding Saudi neurosurgical certification was lower than others but without significance. This is probably linked to the fact that the Saudi group compared to the non-Saudis, included a larger proportion of neurosurgeons who were newly qualified and holding a Saudi neurosurgical certification. It is agreed that the h-index is influenced significantly not only by the duration of the academic career, and but also by the academic rank,1-5 and by the holding of an additional high research degree, such as MD or PhD.5 The mean h-index for the 12 KSA neurosurgeons that reached the level of professor in our universities was 11.2, which is probably reasonable when compared to a mean h-index range of 10.1-28.1 for professors in major academic institutes in USA and GB and Ireland.3-5 It is also recognized that the h-index may be affected by the neurosurgical subspecialty with vascular neurosurgery4 and functional/epilepsy5 surgery being highest, while general neurosurgery being lowest.4 The h-index however, is not affected by the researchers’gender4 or their position in the articles’authorship.3

We observed some correlation between the h-index for KSA neurosurgeons and their neurosurgical center. The h-index for neurosurgeons working in KSA central region compared with other regions was higher but without significance. This is related to the presence of most of the well-established neurosurgical centers in Riyadh. The h-index was significantly higher for neurosurgeons working at KFSHRC, and it was significantly lower for those working at MOH hospitals. In addition, the h-index was higher but without significance for neurosurgeons working at the university hospitals. Reasons for the disparity in the h-index between neurosurgeons in various KSA neurosurgical centers are multifactorial. They include staff selection policy with regard to qualification, training, and academic background. In addition, the academic productivity is influenced by workload, experience, and logistic support, the level of which vary between different KSA hospitals. The MOH hospitals compared with others had the largest number of neurosurgeons in this study (31%), and their neurosurgical centers were probably more heterogeneous with regard to staff qualification, seniority, and facilities. This is likely to change in the future with the establishment in 2011 of the Saudi National Neuroscience Institute at the MOH King Fahad Medical City, Riyadh, KSA.

This study is an evaluation the h-index for 84 neurosurgeons that worked in KSA over a 24 year period. There may be limitations to the research. The study group is relatively small, and limits the generalizability of the findings. It is possible that a few neurosurgeons from the smaller hospitals in KSA may have been overlooked, but this is unlikely to influence the study results. Google Scholar was used because it is free and easy to use, and it correlates well with other subscription databases search engines; such as Scopus.3 There may have been errors, and omissions in the calculating the h-index due to name duplication and missed publications. Furthermore, the h-index was calculated manually rather than automated. This is known to influence the findings, particularly for the more senior neurosurgeons.4 Nevertheless, it is felt that the inaccuracies were minimized by the countercheck with a PubMed search, when there was doubt. In addition, using the mean h-index to compare groups of neurosurgeons implies that slight imprecisions in the individual h-index are unlikely to influence the conclusions.

In conclusion, the h-index is a useful measure that reflects the cumulative impact and relevance of an individual’s academic productivity. Its application to KSA neurosurgeons revealed a significant correlation with the duration after neurosurgical certification and with certain neurosurgical centers. Evaluation of the h-index should be included during the application process for academic positions in KSA. Saudi neurosurgeons should be encouraged not only to continue publishing papers, but to publish papers that will have an impact on the field reflected by a high citation count. However, there is a need for standardizing the current method of calculating the h-index.