Hepatitis B and C and liver and colorectal cancer are now the most cited publications in gastroenterology and hepatology, while topics like gastric ulcers and inflammatory bowel disease have slipped down the list.

A comprehensive analysis just published in BMJ Open identified the most cited articles that were published either in specialised gastroenterology and hepatology journals, or in the entire medical literature (see the list of the top 10 below).

“Top-cited articles from the 1950s to the late 1970s dealt primarily with animal models for the study of gastric ulcerations, cytoprotection of gastric mucosa by prostaglandins, animal

models for intestinal ischaemia, the development of a numerical scoring system for assessing histological activity in patients with chronic active hepatitis and the development of Crohn’s disease activity index,” the authors said.

During the 1980s to early 1990s the emphasis shifted to colitis, p-glycoprotein, the biology of bilirubin, non-A and non-B viral hepatitis, and colorectal cancer.

“From 1994 to 2005, top-cited articles focused on three hepatology topics – steatohepatitis and fatty liver, hepatocellular carcinoma and viral hepatitis C diagnosis and treatment – as

well as three gastroenterology topics – colorectal cancer, inflammatory bowel disease and colitis, and E. coli and diarrhoeal diseases,” they said.

“The studies after 2006 continued to explore new aspects related to hepatocellular cancer, hepatitis B and hepatitis C.”

Some historical papers continued to influence current researchers. A paper by Shay on an animal model of gastric ulcers was cited 58 times between 2013 and 2015.

The most influential papers in general journals appeared in the New England Journal of Medicine, Science and Nature.

Multicentre and multinational papers were more likely to attract citations, but having a larger numbers of authors didn’t have any impact. Women were under-represented among authors (45 vs 254).

“While the number of citations alone cannot reveal why a paper is considered important enough to attract citations by other researchers nor reflect fully the quality of a paper, the citations received by scientific publications have been used as a proxy measurement to assess the work of researchers and impact of research, and to rank researchers on the basis of differences in citation indices,” they said.

Top 10: Most-cited gastroenterology and hepatology articles, published in any journal

1. Hurwitz et al, 2004

Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer (New England Journal of Medicine)

2. Choo et al, 1989

Isolation of a cDNA clone derived from a blood-borne non-A, non-B viral hepatitis genome (Science)

3 Pugh et al, 1973

Transection of the oesophagus for bleeding oesophageal varices (British Journal of Surgery)

4 Manns et al, 2001

Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial (Lancet)

5 Fried et al, 2002

Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection (New England Journal of Medicine)

6 Llovet et al, 2008

Sorafenib in advanced hepatocellular carcinoma (New England Journal of Medicine)

7 Kinzler and Vogelstein, 1996

Lessons from hereditary colorectal cancer (Cell)

8 Perna et al, 2001

Genome sequence of enterohaemorrhagic Escherichia coli O157:H7 (Nature)

9 Hugot et al, 2001

Association of NOD2 leucine-rich repeat variants with susceptibility to Crohn’s disease (Nature)

10 Tomb et al, 1997

The complete genome sequence of the gastric pathogen Helicobacter pylori (Nature)