The publication trend of neuropathic pain in the world and China: a 20–years bibliometric analysis

Neuropathic pain, a pain syndrome caused by a lesion or disease of the somatosensory system, is a major public health concern and becoming the global burden [1‐3]. Epidemiological research showed that the prevalence of neuropathic pain is likely to lie between 6.9% and 10% and cost increases year by year [4, 5]. According to site of major pathology, the classification of neuropathic pain also includes pathology, peripheral, spinal and brain [6]. Yet, few studies, until now, have uncovered the precise mechanism and a therapeutic approach. In the past two decades, innumerable research and money focused on this field to make clear the underling mechanism of neuropathic pain and therapeutic target. Meanwhile, many related research results were published in all kinds of journals in the form of articles [7‐9] . Along with the tremendous economic growth, China’ scientific strength grows rapidly and achieves great accomplishments in neuropathic pain field. However, current studies have not shown the global and China’s development trend regarding neuropathic pain yet.

Bibliometrics is concerned with the analysis of research based on citation counts and patterns. This method can be used to evaluate the influence of an individual research output, such as a journal article, or a collection of research outputs, such as all works by a particular author, research group or institution. Different fields, such as anesthesiology [10], respiratory medicine [11], urology [12], and cancer [13] have performed this method to measure and rank research output both within institutions and on a national or international level.

To evaluate the quantity and quality of global neuropathic pain research, we utilized the bibliometrics analysis to analyze the research progress and growing trend in this field during two decades 2008–2017. At the same time, we also compared the neuropathic pain publications records from Chinese institutions and other developed countries to make clear the China’s contribution to neuropathic pain research and a gap in the quality of publications between China and other developed countries.

In our studies, we completed a bibliometric study of the scientific publications in global neuropathic pain research and analyzed the China’s achievement and gap in neuropathic pain field in the last 2 decades, which helped us to comprehend the global scientific trend in neuropathic pain and the direction of the scientific and technological innovation in China. In the past 20 years, neuropathic pain research had made a continuous and rapid growth in number of papers at world level. Like its economic power, the USA held the first place in every category, with largest publications and citations and highest H-index. The scientific research and development are still unbalanced, and developed countries are leading the global neuropathic pain trend. China scored a tremendous achievement in neuropathic pain field. However, compared to articles published by other leading countries, the quality of China’s papers still needs to be improved. In terms of articles type, same as the world, Chinese researchers also focused more attention on basic research with more output. Accompanied by official attention and support, neuropathic pain related NSFC funding became more and more, which enhanced the development of China’ scientific research further.

Amazing achievement were acquired in global neuropathic pain research, with 320 papers in 1998 increasing to 2723 in 2017, which inspired those people suffered from pain with neuropathic characteristics. Based on these researches and outcomes, neuropathic pain was classified more and more accurate, and its several important contributory mechanisms included abnormal discharge in nociceptive nerves, peripheral and central sensitization, chronic and pathological activation of microglia, and impaired inhibitory modulation [6]. Current treatment still recommended antidepressants (tricyclic agents and serotonin-norepinephrine reuptake inhibitors) and anticonvulsants (gabapentin and pregabalin) as first-line treatments [4]. Individualized multidisciplinary patient care provided new direction for neuropathic pain, which may cause further advancements to neuropathic pain research in the future.

In the early decade, neuropathic pain research in China seemed to be faltering, but burst after 2010, reaching 223 articles in 2013, which ranked second in the world and was in accordance with NSFC funding assistance in 2010. The following reasons may explain this phenomenon: The scientific research power is based on economic strength. The world’s second largest economy boosted the neuropathic pain research in the past 20 years in China, which was also demonstrated by many bibliometric studies of other disciplines. The NSFC is a barometer of scientific research investments in China. Besides these funding of national level, most of the provinces would increase the supporting funding in neuropathic pain following national science and technology policy, such as provincial or municipal natural science fund key projects. It is because of these policy and funding that more and more talented person returned to China with advanced concept and techniques and promoted the international cooperation on neuropathic pain diagnosis and treatments. Additionally, the huge population base is a precious resource for clinical trial in neuropathic pain in China. That is why clinical trials and random controlled trials increased rapidly in the last ten years. However, completed clinical database and analysis system should be planned to unite and integrate these independent different hospital and massive amount of clinical resource.

Except for quantity increase, we should emphasize the quality of publications. For the citations frequency and h-index, there exists still a considerable gap between China and other developed countries. Compared to ourselves, our quality of neuropathic pain publications had improved. But it need more time to catch up other leading countries. At first, China should continue to introduce the top talents and leading professors to construct high quality neuropathic pain research platform and multi-center studies. In our bibliometric analysis, no Chinese institutions could rank into top20 contributing institutions. No experts, no institutions. Second, consideration that there is no top pain related journal from China, several international journals on neuropathic pain should be created in China so as to attract more submissions and spread academic perspective. Based on these situations, China still has great potential to grow in publications quality.

Obviously, there are some limitations in our analysis. Firstly, some research outcomes may involve in international collaboration with different countries. Our retrieved results of institutional affiliations could cause bias in the study. Second, on account of “neuropathic pain” as subject term, we may ignore some papers, such as those indexed with “chronic pain”. Third, some articles collection from WOS and PubMed database may be delayed so that citations and H-index exist flaw.

At world level, neuropathic pain research had made impressive growth in volume during the last 20 years. The USA is still the leader of neuropathic pain research both in quality and quantity. In the past two decades, China gradually became a critical force on neuropathic pain research. However, compared with the publications quantity growth, there is still a considerable gap in research quality between China and other leading countries. Therefore, there is still a long way to go, China need take measure to complete high-quality neuropathic pain studies.