A Protocol for a Bibliometric Analysis of Traditional, Complementary, and Integrative Medicine Research Preprints

Article information

Perspect Integr Med. 2024;3(3):172-176

Publication date (electronic) : 2024 October 31

doi : https://doi.org/10.56986/pim.2024.10.007

Jeremy Y. Ng^1,2,3,, Brenda Lin^1,2, Sabrina Abdella^1,2, Magdalene Abebe^1,2, Isabella Tao^1,2, Holger Cramer^1,2

¹Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany

²Robert Bosch Center for Integrative Medicine and Health, Bosch Health Campus, Stuttgart, Germany

³Centre for Journalology, Ottawa Hospital Research Institute, Ottawa, Canada

^*Corresponding author: Jeremy Y. Ng, Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Osianderstr 5, Tübingen 72076, Germany, Email: ngjy2@mcmaster.ca, jeremy.ng@med.uni-tuebingen.de

Received 2024 August 24; Revised 2024 September 23; Accepted 2024 September 25.

Abstract

Introduction

Traditional, complementary, and integrative medicine (TCIM) encompasses a wide array of healthcare practices that fall outside conventional medicine. Traditional medicine is “the sum of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health and the prevention, diagnosis, improvement or treatment of physical and mental illness” [1]. Complementary medicine involves “the use of nonmainstream practices alongside conventional medical treatments,” while integrative medicine “brings conventional and complementary approaches together in a coordinated way” [2,3].

The US National Center for Complementary and Integrative Health has 3 main categories of complementary health approaches: nutrition, psychological, and physical. Nutritional therapies focus on dietary approaches to treatment such as the use of supplements and herbs. The psychological approach may include mindfulness and spiritual practices. The physical treatments encompass approaches such as massage therapy or spinal manipulation. Within these 3 categories of nutrition, psychological, and physical approaches, there are many treatments that intersect 2 or more of the categories such as meditation, which encompasses both a psychological and physical approach [2,4].

TCIM plays an important role in global healthcare, particularly in regions where traditional practices are deeply rooted in cultural heritage. A World Health Organization report published in 2019 shows that traditional medicine is widely used, and states that 88% of the global population has used some form of TCIM [5]. Patients use TCIM for numerous reasons such as enhancing quality of life, alleviating symptoms, as a supplement to conventional therapies, and gaining control over their healthcare [6–8]. This widespread use is paralleled by growing scientific interest and an increasing number of studies exploring the efficacy, safety, and mechanisms of TCIM therapies [9]. The integration of TCIM into modern healthcare systems aims to provide a more holistic approach to health and well-being which addresses the needs of individuals who seek a more personalized, and culturally resonant healthcare option [2,7].

TCIM is an important healthcare option and it is popular, however, TCIM research faces several significant challenges [10–12]. One of the primary barriers is access to funding [13,14]. TCIM research often struggles to secure financial support compared with conventional medicine research, and thus, limiting the scope and scale of the TCIM studies conducted [15,16]. High-quality research in TCIM is also hampered by methodological challenges including difficulties in standardizing treatments and monitoring outcomes, controlling for placebo effects, and ensuring rigorous study design that can withstand scientific scrutiny [17–19]. In addition, there are competency-related barriers such as insufficient training in research methods among TCIM practitioners and researchers, and inadequate research experience [13,16]. These issues may contribute to the perception that TCIM research is of relatively lower methodological quality compared with research in conventional medicine. Bias-related barriers further complicate TCIM research and lead to the belief that the evidence is anecdotal and TCIM practices and research may be discredited due to personal opinions within conventional medicine [20]. This skepticism can unnecessarily hinder the publication and dissemination of TCIM research [21].

Preprints are scholarly manuscripts posted on public servers often before formal peer review [22]. Preprints have been gaining traction since the COVID-19 pandemic as a means to rapidly disseminate research findings to the scientific community, and the public, providing immediate access to the latest research developments [23,24]. Preprints enhance the visibility and transparency of research by allowing scientists to read, comment on, and critique the work prior to formal journal publication [25,26]. This informal peer review process can lead to improvements in the study, and the manuscript, as authors can receive feedback and consider revisions outside of the peer review process which takes place within a peer-reviewed journal [26]. While some researchers have expressed hesitancy or lack experience in posting preprints, a recent survey has reported that many researchers are increasingly using the preprint process to disseminate their work more rapidly [27].

In the context of TCIM research, preprints facilitate quicker dissemination, allow a broader access to research findings, and may help overcome funding-related access issues for other researchers to access current TCIM research (e.g., exorbitant journal article processing fees) [28]. The open access nature of preprints allows for greater scrutiny and input from a diverse audience, potentially improving the methodological quality of TCIM research [26]. Additionally, the transparency of preprints can help counteract bias by making the entire research process visible, from initial findings to final publication [29]. This increased openness and the potential for early feedback make preprints a valuable tool for advancing the credibility and reliability of TCIM research.

As interest in preprinting practice increases, it is crucial to assess TCIM research that is being posted on preprint servers. A research method known as bibliometric analysis involves the statistical assessment of a subset of publications, within a given field, and can be used to facilitate an improved understanding of research characteristics and impact [30–32]. Although bibliometric analyses of peer-reviewed publications in the field of TCIM have been performed previously [33–35], and a scoping review of all TCIM-related bibliometric analyses is currently underway as described in a review protocol [36]. To date, to the best of our knowledge, no studies have comprehensively explored the characteristics of TCIM preprints. Thus, the objective of this protocol was to design a study to conduct a bibliometric analysis to identify the quantity and characteristics of preprints posted on TCIM research.

Materials and Methods

Discussion

The objective of this protocol for the study to conduct a bibliometric analysis was to identify the quantity and characteristics of preprints posted on the topic of TCIM research. To our knowledge, only a few bibliometric analyses have been performed on preprints in other specialties of medicine and health; 1 example is a bibliometric analysis of preprints on dentistry topics [39]. The paucity of bibliometric analyses of preprints may be attributed to the existence of numerous preprint servers making the process of collecting, combining, and cleaning relevant bibliometric data across these platforms both challenging and time-consuming. Furthermore, standard bibliometric software commonly used for data exported from bibliographic databases (e.g., Scopus, and Web of Science) are generally not compatible with preprint servers. In addition, a necessary consideration is that some authors will not preprint their work due to the policies of the journal to which they intend to submit their manuscript. Thus, even authors who have an interest and support preprinting may choose not to do so. Sherpa Romeo is an online resource that summarizes the preprinting policies of different peer-reviewed journals [40].

Analysis of the preprints will reveal which TCIM topics are more common, provide insights into what modalities have the highest research activity and interest. Preprints serve as a valuable resource for disseminating research findings quickly and openly, potentially addressing barriers such as limited access to funding for research and bias against TCIM practices. By providing a platform for rapid dissemination and feedback, preprints enhance transparency, collaboration, and innovation in TCIM research.

All articles will be included that meet the inclusion criteria for the study since each preprint server’s inception, therefore, the study will represent a comprehensive coverage of preprints. The analysis will also capture the characteristics of all preprints posted regardless of publication language, and this will further broaden the scope of TCIM research. However, the analysis will rely on preprints available on specific preprint servers that have TCIM subject area filters, which may not provide a comprehensive view of all posted TCIM preprints in existence. Despite this limitation, selecting only preprint servers that have TCIM subject area filters will ensure that all preprints included in this study are TCIM-related and will eliminate the need for arbitrary categorization of preprints as TCIM related. Another limitation is that potential bias in preprint server coverage may influence the representativeness of the sample. The types of preprints included in our study may be influenced by the fact that some journals have partnerships with specific preprint servers, resulting in the increased likelihood of manuscript submissions appearing on those servers.

In conclusion, this protocol outlines a comprehensive bibliometric analysis aimed at exploring the characteristics and impact of TCIM research preprints. By systematically analyzing preprints from select servers, with TCIM-related subject filters, the study seeks to illuminate trends in research activity, collaboration, and dissemination within the field. The findings may contribute valuable insights into the evolving landscape of TCIM research, highlighting areas of high interest and activity whilst also addressing potential barriers related to visibility and methodological rigor. Despite limitations regarding the representativeness of preprints from specific servers, the proposed study offers a cost-effective and inclusive approach to understanding the role of preprints in advancing TCIM research. Ultimately, this work aims to enhance the transparency, accessibility, and credibility of TCIM research, supporting its integration into broader scientific and healthcare conversations.

Data Availability

All relevant data are included in this manuscript.

Article information Continued