Clinical Orthopaedics and Related Research®

, Volume 470, Issue 8, pp 2313–2318

Representation of Developing Countries in Orthopaedic Journals: A Survey of Four Influential Orthopaedic Journals

  • Edward E. Aluede
  • Jonathan Phillips
  • Jamie Bleyer
  • Harry E. Jergesen
  • Richard Coughlin
Basic Research



The developing world contains more than ¾ of the world’s population, and has the largest burden of musculoskeletal disease. Published studies provide crucial information that can influence healthcare policies. Presumably much information regarding burden in the developing world would arise from authors from developing countries. However, the extent of participation of authors from the developing world in widely read orthopaedic journals is unclear.


We surveyed four influential English-language orthopaedic journals to document the contributions of authors from developing countries.


We surveyed Clinical Orthopaedics and Related Research, Journal of Orthopaedic Trauma, and the American and British volumes of The Journal of Bone and Joint Surgery, from May 2007 through May 2010. The country of origin of all authors was identified. We used the designations provided by the International Monetary Fund to define countries as either developed or developing.


Two hundred sixty-five of 3964 publications (7%) included authors from developing countries. Ninety percent of these had authors from developing countries with industrialized and emerging-market economies. Publications from Sub-Saharan Africa accounted for only 0.4% of the 3964 articles reviewed and 5.6% of the 265 articles with developing world authorship. Countries with the least robust economies were least represented. Less than 1/3 of articles with authors from the developing world had coauthors from developed or other developing countries.


Additional studies are needed to determine the reasons for the low representation noted and to establish strategies to increase the number of orthopaedic publications from parts of the world where the burden of musculoskeletal disease is the greatest.


  1. 1.
    Beveridge M, Howard A. The burden of orthopaedic disease in developing countries. J Bone Joint Surg Am. 2004;86:1819–1822.PubMedGoogle Scholar
  2. 2.
    Brooks PM. The burden of musculoskeletal disease: a global perspective. Clin Rheumatol. 2006;25:778–781.PubMedCrossRefGoogle Scholar
  3. 3.
    Central Intelligence Agency. CIA World Factbook. Available at: Accessed December 22, 2011.
  4. 4.
    Dormans JP. Orthopaedic surgery in the developing world: can orthopaedic residents help? J Bone Joint Surg Am. 2002;84:1086–1094.PubMedGoogle Scholar
  5. 5.™. Ranking and mapping scientific knowledge. Available at: Accessed December 22, 2011.
  6. 6.
    Ezzati M, Hoorn SV, Rodgers A, Lopez AD, Mathers CD, Murray CJ; Comparative Risk Assessment Collaboration Group. Estimates of global and regional potential health gains from reducing multiple major risk factors. Lancet. 2003;362:271–280.PubMedCrossRefGoogle Scholar
  7. 7. What is the G-20? Available at: Accessed March 22, 2011.
  8. 8.
    Garcia PJ, Curioso WH. Strategies for aspiring biomedical researchers in resource-limited environments. PLoS Negl Trop Dis. 2008;2:e274.PubMedCrossRefGoogle Scholar
  9. 9.
    Global Forum for Health Research. 10/90 Gap Report. Available at: Accessed March 20, 2012.
  10. 10.
    Gonzalez Block MA, Mills A. Assessing capacity for health policy and systems research in low and middle income countries. Health Res Policy Syst. 2003;1:1–20.PubMedCrossRefGoogle Scholar
  11. 11.
    HINARI Access to Research in Health Programme. Available at: Accessed December 22, 2011.
  12. 12.
    International Monetary Fund. World economic and financial surveys: world economic outlook database. Available at: Accessed March 22, 2011.
  13. 13.
    Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health. 2000;90:523–526.PubMedCrossRefGoogle Scholar
  14. 14.
    Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL. Measuring the global burden of disease and risk factors, 1990–2001. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, eds. Global Burden of Disease and Risk Factors. Vol 1. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; and New York, NY: The World Bank and Oxford University Press; 2006:1–14.Google Scholar
  15. 15.
    Mahawar KK, Malviya A, Kumar G. Who publishes in leading general surgical journals? The divide between the developed and developing worlds. Asian J Surg. 2006;29:140–144.PubMedCrossRefGoogle Scholar
  16. 16.
    Man JP, Weinkauf JG, Tsang M, Sin DD. Why do some countries publish more than others? An international comparison of research funding, English proficiency and publication output in highly ranked general medical journals. Eur J Epidemiol. 2004;19:811–817.PubMedCrossRefGoogle Scholar
  17. 17.
    McMichael C, Waters E, Volmink J. Evidence-based public health: what does it offer developing countries? J Public Health (Oxf). 2005;27:215–221.CrossRefGoogle Scholar
  18. 18.
    Meltzer D. Economic approaches to valuing global health research. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P, eds. Disease Control Priorities in Developing Countries. 2nd ed. Washington, DC: The International Bank for Reconstruction and Development/The World Bank; and New York, NY: The World Bank and Oxford University Press; 2006:157–163.Google Scholar
  19. 19.
    Mock C, Cherian MN. The global burden of musculoskeletal injuries: challenges and solutions. Clin Orthop Relat Res. 2008;466:2306–2316.PubMedCrossRefGoogle Scholar
  20. 20.
    Nayyar D. China, India, Brazil and South Africa in the world economy: engines of growth? In: Santos-Paulino AU, Wan G, eds. Southern Engines of Global Growth. Vol 1. Oxford, UK: Oxford University Press; 2010:9–27.CrossRefGoogle Scholar
  21. 21.
    Neufeld V, MacLeod S, Tugwell P, Zakus D, Zarowsky C. The rich–poor gap in global health research: challenges for Canada. CMAJ. 2001;164:1158–1159.PubMedGoogle Scholar
  22. 22.
    Noordin S, Wright JG, Howard AW. Global access to literature on trauma. Clin Orthop Relat Res. 2008;466:2418–2421.PubMedCrossRefGoogle Scholar
  23. 23.
    Noordin S, Wright JG, Howard AW. Global relevance of literature on trauma. Clin Orthop Relat Res. 2008;466:2422–2427.PubMedCrossRefGoogle Scholar
  24. 24.
    Ozgediz D, Jamison D, Cherian M, McQueen K. The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ. 2008;86:646–647.PubMedCrossRefGoogle Scholar
  25. 25.
    Page J, Heller RF, Kinlay S, Lim LL, Qian W, Suping Z, Kongpatanakul S, Akhtar M, Khedr S, Macharia W. Attitudes of developing world physicians to where medical research is performed and reported. BMC Public Health. 2003;3:6.PubMedCrossRefGoogle Scholar
  26. 26.
    Parnes P, Cameron D, Christie N, Cockburn L, Hashemi G, Yoshida K. Disability in low-income countries: issues and implications. Disabil Rehabil. 2009;31:1170–1180.PubMedCrossRefGoogle Scholar
  27. 27.
    Patel V, Sumathipala A. International representation in psychiatric literature: survey of six leading journals. Br J Psychiatry. 2001;178:406–409.PubMedCrossRefGoogle Scholar
  28. 28.
    Peden M, McGee K, Sharma G. The Injury Chart Book: A Graphical Overview of the Global Burden of Injuries. Geneva, Switzerland: World Health Organization; 2002.Google Scholar
  29. 29.
    Phillips J, Jergesen HE, Caldwell A, Coughlin R. IGOT-The Institute for Global Orthopaedics and Traumatology: a model for collaboration and change. Techniques in Orthopaedics. 2009;24:308–311.CrossRefGoogle Scholar
  30. 30.
    Rizkallah J, Sin DD. Integrative approach to quality assessment of medical journals using impact factor, eigenfactor, and article influence scores. PLoS One. 2010;5:e10204.PubMedCrossRefGoogle Scholar
  31. 31.
    Taira BR, Kelly McQueen KA, Burkle FM Jr. Burden of surgical disease: does the literature reflect the scope of the international crisis? World J Surg. 2009;33:893–898.PubMedCrossRefGoogle Scholar
  32. 32.
    Thompson Reuters. Journal citation reports. Available at: Accessed December 22, 2011.
  33. 33.
    Tucker J, Gao X, Wang S, Chen Q, Yin Y, Chen X. Organising an English journal club in the developing world. Postgrad Med J. 2004;80:436–437.PubMedCrossRefGoogle Scholar
  34. 34.
    Vasconcelos SM, Sorenson MM, Leta J. Scientist-friendly policies for non-native English-speaking authors: timely and welcome. Braz J Med Biol Res. 2007;40:743–747.PubMedCrossRefGoogle Scholar
  35. 35.
    Wang J, Lu YQ. Reflection on internationalization of Chinese surgery journals. Chin J Traumatol. 2009;12:243–246.PubMedGoogle Scholar
  36. 36.
    World Health Organization. World Health Statistics 2010. Available at: Accessed December 22, 2011.

Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • Edward E. Aluede
    • 1
  • Jonathan Phillips
    • 1
  • Jamie Bleyer
    • 1
  • Harry E. Jergesen
    • 1
  • Richard Coughlin
    • 1
  1. 1.Department of Orthopaedic Surgery, Institute for Global Orthopaedics and TraumatologySan Francisco General HospitalSan FranciscoUSA

Personalised recommendations