Military Medicine Publications: What has Happened in the Past Two Decades?

BACKGROUND Military medical personnel, like all other physician specialists, face the challenge of keeping updated with developments in their field of expertise, in view of the great amount of new medical information published in the literature. The availability of the Internet has triggered tremendous changes in publication characteristics, and in some fields, the number of publications has increased substantially. The emergence of electronic open access journals and the improvement in Web search engines has triggered a significant change in the publication processes and in accessibility of information. OBJECTIVE The objective of this study was to characterize the temporal trends in the number and types of publications in military medicine in the medical literature. METHODS We searched all PubMed-registered publications from January 1, 1990 to December 31, 2010 using the keywords "military" or "army". We used the publication tag in PubMed to identify and examine major publication types. The trends were tested using the Mann-Kendall test for trend. RESULTS Our search yielded 44,443 publications in military medicine during the evaluation period. Overall, the number of publications showed two distinct phases over time: (1) a moderate increase from 1990 to 2001 with a mean annual increase of 2.78% (r(2)=.79, P<.002), and (2) a steeper mean annual increase of 11.20% (r(2)=.96, P<.002) from 2002 to 2010. Most of the examined publication types showed a similar pattern. The proportion of high-quality-of-evidence publication types (randomized controlled trials, systematic reviews, and meta-analyses) increased from 2.91% to 8.43% of the overall military medicine publications with a mean annual incremental increase of 14.20%. These publication types demonstrated a similar dual phase pattern of increase (10.01%, r(2)=.80, P<.002 for 1990-2001 and 20.66%, r(2)=.88, P<.002 for 2002-2010). CONCLUSIONS We conclude that over the past twenty years, scholarly work in the field of military medicine has shown a significant increase in volume, particularly among high quality publication types. However, practice guidelines remain rare, and meta-analyses are still limited in number.