Creative thought in neurosurgical research: the value of citation analysis

Creative research thought, embodying original ideas that are adaptable and lasting, changes the scholarship and course of neurosurgery, and will be recognized by high citation frequency. Thirty-nine of 50 of the first American neurosurgeons were the first authors of 411 research papers, which were studied by analysis of citations between 1965 and 1979. Of all papers written by these authors between 1896 and 1976, 11% concerned research; this category received 22% of the aggregate of citations. The five research areas that received the largest number of citations were brain tumors (745), central nervous system physiology (279), experimental hydrocephalus (232), increased intracranial pressure (222), and head injury (107). Solutions to these problems were resolved with varying degrees of success. Interest in brain tumor research was reflected by the use of special staining techniques in 30% of these papers. Seventy percent of neurosurgical research papers appeared in clinical journals. The Archives of Neurology and Psychiatry had the largest number of papers and of total citations for journals. The paper cited most often was Dandy's, "Internal Hydrocephalus: An Experimental, Clinical, and Pathological Study." Cushing and Penfield each wrote 3 of the 10 most cited research papers. The most productive research authors were also most often cited. They included Bailey (441), Cushing (431), Penfield (423), Dandy (246), and Davis (158). Among the 50 authors, the percentage of published research papers did not separate the neurosurgeon with laboratory experience from his clinically oriented counterpart with regard to productivity and creativity. The data suggest that neurosurgeons are generally not basic scientists but clinical investigators.