title: Declining critical care research publications by authors from U.S. Institutions, 1990-1999.
abstract: OBJECTIVE
  To determine whether the proportion of authors from U.S. institutions to those from non-U.S. institutions has changed for published critical care research in three critical care journals over the past ten years.
  
  
  METHODS
  The authors of designated critical care clinical or laboratory investigations published from 1990 to 1999 in the three leading U.S. critical care journals, American Journal of Respiratory and Critical Medicine, Chest, and Critical Care Medicine, were evaluated according to the locations of their institutions (U.S. versus non-U.S.) through a review of these publications.
  
  
  RESULTS
  The proportion of authorship by investigators from U.S. institutions has declined for critical care research publications from 61% of all authors in 1990 to 41% in 1999 (p < .00001). Statistically significant declines in the proportions of authors from U.S. institutions to those from non-U.S. institutions occurred in the American Journal of Respiratory and Critical Care Medicine (p < .05) and Critical Care Medicine (p < .00001), but not in Chest (p = .69).
  
  
  CONCLUSIONS
  The reasons for the decline in authorship by investigators from U.S. institutions are speculative and likely multifactorial. They are, however, consistent with other published data showing limited non-clinical time allocated for education activities for critical care faculty. Anecdotal concerns expressed by many faculty that rising clinical commitments necessitated by current health care and reimbursement pressures preclude research and educational academic activities are supported by these data.
authors.affiliation: Critical Care Medicine, Rutland Regional Medical Center, Rutland, Vermont 05701, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Powner
authors.forename: J A
authors.initials: JA
authors.lastname: Kellum
mesh_terms: D000047:Academies and Institutes / Q000706:statistics & numerical data*; D001319:Authorship; D003422:Critical Care / Q000706:statistics & numerical data*; D018166:Health Care Reform / Q000706:statistics & numerical data; D006801:Humans; D016017:Odds Ratio; D011642:Publications / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012051:Reimbursement Mechanisms / Q000706:statistics & numerical data; D012106:Research / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States; D016526:Workload / Q000706:statistics & numerical data