How to get through the mire of orthodontic publications?

Every month, there is a vast number of orthodontic publications. As a result,   It is easy to get overawed by the sheer volume of information that journals publish.  This brings me to question whether there are too many papers. If this is the case, how do I identify the important ones?  Read on for how I try to do this.

I came across this paper by an Ireland-based team, and this prompted me to think about the torrent of papers. The EJO published their paper.

I would like to declare a conflict. I know several members of this team well. Padhraig Fleming is also a co-writer of this blog with me.

What did they ask?

They wanted to

“Evaluate where orthodontic research papers are published and to explore potential relationships between the journal and the characteristic of the study and the authors”.

What did they do?

They did a bibliometric study of 29 databases to search for orthodontic publications published between 1 January 2022-31 December 2023. 

One researcher extracted the data from the journals.  Using this data they classified the journals as legitimate, uncertain and predatory. 

They also divided the journals into established and less established orthodontic journals. 

The team identified 38,648 articles. They then analysed these further and identified a final sample of 9020 articles. Next, they randomly selected 1500 articles. The final subset was 753 orthodontic articles. These were from 246 unique journals associated with 117 publishers. This illustrates an incredible number of publications from one dental speciality.

What did they find?

The authors provided a large amount of data and very detailed methods for classifying the journals and papers. I do not have space to go into these here, but I felt that these were the main findings.

• The established journals were AJO-DDO, Angle, EJO, Journal of Orthodontics, Orthodontics and Craniofacial Research and Progress in Orthodontics
• Surprisingly, only 37% of the articles were from journals with orthodontic titles.
• 21% were published in other dental journals.
• 48% of the papers in orthodontic journals were published in the more established journals.

• 78.8% of papers were published in legitimate journals, 8.8% in journals of uncertain legitimacy, and 12.4% in predatory journals.  Therefore, 1 in 5 papers were published in predatory or uncertain legitimacy journals.

• When they looked at the type of study. They found that 21% were cross-sectional, 11.9% in vitro, 10.9% were retrospective cohorts, 10.4% were case reports and 8.1% were validation studies.  Just under half of the cohort studies did not have controls.

• 67% of the studies were classified as low quality. Only 18% were high quality (RCTs, systematic reviews, non-randomised controlled clinical trials, and prospective cohorts).

• Established orthodontic journals had higher odds of publishing higher-quality studies.

Their overall conclusion was.

“Most orthodontic articles were published in non-orthodontic journals. 1 in 5 were in predatory or uncertain legitimacy publications”.

“Higher quality studies were published in the five “established” orthodontic journals.

What did I think?

This was an interesting paper relevant to all practitioners interested in clinical research. It raises some critical questions. The most important is that a large amount of research is published in non-orthodontic journals.  But should we be concerned about this?

In considering this topic, I have thought about my own experiences as a paper author. First and foremost, for those aiming for an academic career, publishing is crucial. There is a strong emphasis on producing as many papers as possible to enhance one’s curriculum vitae. This pressure can lead to a proliferation of papers in non-orthodontic and predatory journals.

When I began my career, I focused on improving the quality of my papers. However, I also aimed to publish as many as possible to impress promotion panels. As a result, some of my early papers may not have been of the highest quality. It was only in the last 20 years, once I was established, that I became very selective and focused on publishing only in the AJO. So there is no doubt that I fell into the “publish or perish” trap.

The current situation is becoming more complicated with the rise of predatory journals which offer fast reviews and publication for a fee. Unfortunately, the quality of the papers published in these journals is consistently low. For this reason, serious researchers should avoid publishing in these journals. Additionally, predatory publications may be linked to potential academic misconduct.

As a result of these factors, we may need to accept that the issues mentioned in this paper are here to stay. As clinician scientists, this necessitates careful consideration of our reading material. This brings me to a series of tips in reading the orthodontic research literature.  

Applying a filter?

 This is how I select papers to discuss in this blog. These are.

• Concentrate on the “established” journals.
• Scan the titles and abstracts to identify higher-level studies and read these critically.
• Primarily focus on studies concerning clinical research
• Pay some attention to any retrospective study. It may be interesting but it will have selection bias.  You need to bear this in mind when you read the conclusions.
• Do not read anything in a predatory journal. These papers are written by authors who are simply trying to get anything published.

I hope that by doing this, I find the most valuable papers. However, I miss some and tend to pick these up by joining social media groups and streams on orthodontic research.