Journal of Orthopaedic Business

Citations are Only Weakly to Moderately Correlated with Social Media and Online Attention in Hip and Knee Arthroplasty Database Publications

Nadim Barakat — 2024-10-01

Objectives: Citations remain an important way to measure the impact of published research. However, social media provides the opportunity to assess an article’s engagement more rapidly. It is unclear if these metrics are redundant or serve complementary roles in assessing an article’s impact. This study sought to identify the correlation between a study’s citations and both its Altmetric Attention Score (AAS) and number of X posts.

Design: Retrospective study.

Setting: Articles published in the orthopedic literature.

Article Selection: A total of 116 hip and knee arthroplasty articles utilizing administrative databases or clinical registries published in 2020 in four orthopaedic journals with social media accounts were studied.

Intervention: None.

Main Outcome Measurements: AAS, X posts, and citations for each article were extracted. Correlations between citations with both AAS and X posts were determined using Pearson’s correlation coefficient (r) for the entire sample and each individual journal.

Results: For the entire sample, there were statistically significant (p < 0.001) weakly to moderately positive correlations (r = 0.363, r = 0.410) between citations to X posts and AAS, respectively. Only articles published in Clinical Orthopaedics and Related Research (n = 16) demonstrated a statistically significant (p < 0.001) strongly positive correlation (r = 0.872, r = 0.878) between citations and AAS and X posts, respectively.

Conclusions: Citations are weakly to moderately correlated with X posts and AAS, with correlation strengths varying across journals. These metrics appear to serve complementary roles in measuring an article’s impact; authors and journals should consider both to assess the overall interest in a study.

Level of Evidence: Level V.

Research Study Characteristics Associated with Media Engagement in Hip and Knee Arthroplasty Database Studies

Nadim Barakat — 2024-10-01

Objectives: This study identified associations between a study’s Altmetric Attention Score (AAS) and the number of times it was posted on X (formerly Twitter) with article characteristics such as the topic or publishing journal.

Design: Retrospective study.

Setting: Articles published in the orthopedic literature.

Article Selection: A total of 116 eligible articles using administrative databases or clinical registries published in 2020 in four orthopaedic journals were studied.

Intervention: None.

Main Outcome Measurements: Each of the 116 selected articles was assigned one of the following topics: complications and outcomes, technology, medications and/or anesthesia, logistics, and surgical techniques. AAS and X posts for each article were retrieved. Kruskal-Wallis tests were used to identify differences in the AAS and X posts across journals and topics.

Results: Kruskal-Wallis tests revealed a difference between an article’s publishing journal and its AAS (p = 0.034) and number of X posts (p = 0.032), with articles published in the Bone & Joint Journal (BJJ) having the greatest mean AAS (16.27) and X posts (25.73). Kruskal-Wallis tests showed a difference between an article’s topic and its AAS (p = 0.001) and number of X posts (p= 0.027), with articles focused on surgical techniques having the greatest mean AAS (26.50) and X posts (37.00).

Conclusions: There is significant variation in the degree of media engagement for hip and knee arthroplasty database studies. The topic of the article (surgical techniques) and journal of publication (BJJ) were associated with a greater level of engagement.

Level of Evidence: Level V.

Hand and Upper Extremity Procedures Are Significantly More Cost Effective When Performed in Ambulatory Surgery Centers Versus Hospital Outpatient Departments

Vincent P. Federico — 2024-07-01

Objective

Orthopaedic surgery has high rate of utilization of the outpatient settings including ambulatory surgery centers (ASC) and hospital outpatient departments (HOPD). We seek to compare costs at these outpatient facilities, ASC versus HOPD, for hand and upper extremity procedures.

Design/Setting:

Database review was performed with publicly available data from Center for Medicare and Medicaid Services (CMS) via the Medicare Procedure Price Lookup Tool and Current Procedural Terminology (CPT) codes for hand and upper extremity procedures. Total costs, facility fees, Medicare payments, and patient payments were obtained for each procedure code. Descriptive statistics were used to calculate means and standard deviations. Differences were analyzed using Mann Whitney U test.

Results:

Thirty-seven CPT codes were divided into arthroscopy, fracture, arthroplasty/arthrodesis, and other. Arthroscopy demonstrated cost savings in total cost of procedure (1,886.00±58.72 vs 3,418.00±58.78; p=0.009), facility fees (1,360.00±0 vs 2,892.00±0; p=0.021), Medicare payments (1,509.00±47.27 vs 2,734.00±47.27 p=0.021), and patient payments (376.75±11.87 vs 682.75±11.87; p=0.021) in ASCs compared to HOPD. Fracture procedures had lower total costs (3,886.58±1,527.61 vs 5,975.92±1,890.96; p=0.021), Medicare payments (3,109.17±1,221.21 vs 4,780.75±1,511.90; p=0.021), facility fees (3,055.17±1,503.23 vs 5,228.67±1,725.74; p=0.018), and patient payments (776.92±305.46 vs 1,194.75±377.97; p=0.021) in ASCs. When CPT codes were grouped all together, there was 35% savings in total cost, 41% savings for facility fees, and 36% savings in Medicare payments, and 28% in patient payments for procedures performed at ASCs.

Conclusion:

ASCs demonstrate cost-savings across multiple procedures for the hand and upper extremity in a variety of areas including total costs, facility fees, Medicare payments, and patient payments when compared to HOPDs.