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To the Editor, We previously performed an analysis of the academic output of anesthesiology departments across Canada from 2000-2004. Despite a steady increase in the total number of publications over this period, we identified a potentially concerning decrease in the number of randomized controlled trials (RCTs). Herein, we describe a follow-up analysis of publications by Canadian anesthesiology departments from 2005-2013 to evaluate whether the identified decrease in RCTs was a continuing trend. The search criteria were the same as those described for our previous analysis and included all publications (i.e., all publications with a digital object identifier from January 1, 2000 to December 31, 2013). All articles with a printed publication date were included in our analysis. The Pearson correlation coefficient (r value) was used to analyze overall publication trends among Canadian university anesthesiology departments. Average annual percent change and annual percent change (APC) were calculated using the Joinpoint Regression Program 4.0.4 (Statistical Research and Applications Branch, National Cancer Institute, USA). Our search identified 3,084 eligible articles, and we included 2,947 of these for analysis. We found a steady increase in both the total number of articles published from 2005-2013 (r = 0.86; 95% confidence interval [CI], 0.85 to 0.87) and the total number of publications from 2000-2013 (r = 0.91; 95% CI, 0.90 to 0.92) (Figure A). Using Joinpoint, APC analysis showed an average annual increase of 5.2% (95% CI, 3.8 to 6.5) for all publications from 2000-2013. A small but significant increase in total RCT publications occurred from 2005-2013 (r = 0.17; 95% CI, 0.06 to 0.28), contrasting with the decrease that was observed from 2000-2004 (r = -0.91). Our results show a slight overall increase in RCT publications throughout the entire period 2000-2013 (r = 0.26; 95% CI, 0.17 to 0.35) (Figure B). Analysis of APC with Joinpoint over this period showed an annual increase of 1.0% (95% CI, -1.7 to 3.9) for RCTs. Following the analysis of publications from 2005-2013, it was reassuring to see that the apparent declining trend in RCT publications did not continue beyond 2004. In fact, publication of RCTs showed a slight overall increase since 2000. This result is comparable with the findings of Pagel and Hudetz who studied the publication output of American anesthesiology departments. As shown in the Figure, the total number of publications and RCTs fluctuates from year to year, suggesting that the time frame covered in our original analysis may have been too small to provide an accurate depiction of publication trends. It is also reassuring that total publication activity increased in our latest period of analysis. A recent report by the Canadian Association of University Teachers reveals that the budget for the Canadian Institutes of Health Research, from which many medical researchers obtain their funds, fell 7.5% from 2007-2013. Although this finding is not indicative of budgetary decreases for other granting agencies, it does reflect the economic climate with regard to research funding in Canada over the last decade. Our findings suggest that lack of funding was not a major impediment to performing anesthesiology-related research during this period. As with the previous analysis, this study suffers from the possibility that institutions involved in multicentre or multidepartmental studies may be underrepresented since only the corresponding author’s institution was used in the search. The use of PubMed to perform our search likely D. K. M. Lam, BSc B. C. H. Tsui, MD (&) Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, AB, Canada e-mail: btsui@ualberta.ca

Analysis of the number of publications by Canadian anesthesiology departments from 2000-2013