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Mapping patient safety: a large-scale literature review using bibliometric visualisation techniques

S P Rodrigues, N J van Eck, L Waltman, F W Jansen

Author Affiliations
Department of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
Centre for Science and Technology Studies, Leiden University, Leiden, The Netherlands
Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands

Abstract
Background The amount of scientific literature available is often overwhelming, making it difficult for researchers to have a good overview of the literature and to see relations between different developments. Visualisation techniques based on bibliometric data are helpful in obtaining an overview of the literature on complex research topics, and have been applied here to the topic of patient safety (PS).

Methods
On the basis of title words and citation relations, publications in the period 2000-2010 related to PS were identified in the Scopus bibliographic database. A visualisation of the most frequently cited PS publications was produced based on direct and indirect citation relations between publications. Terms were extracted from titles and abstracts of the publications, and a visualisation of the most important terms was created. The main PS-related topics studied in the literature were identified using a technique for clustering publications and terms.

Results
A total of 8480 publications were identified, of which the 1462 most frequently cited ones were included in the visualisation. The publications were clustered into 19 clusters, which were grouped into three categories: (1) magnitude of PS problems (42% of all included publications); (2) PS risk factors (31%) and (3) implementation of solutions (19%). In the visualisation of PS-related terms, five clusters were identified: (1) medication; (2) measuring harm; (3) PS culture; (4) physician; (5) training, education and communication. Both analysis at publication and term level indicate an increasing focus on risk factors.

Conclusions
A bibliometric visualisation approach makes it possible to analyse large amounts of literature. This approach is very useful for improving one's understanding of a complex research topic such as PS and for suggesting new research directions or alternative research priorities. For PS research, the approach suggests that more research on implementing PS improvement initiatives might be needed.

Citation
BMJ Open 2014;4:e004468 doi:10.1136/bmjopen-2013-004468

Conclusions
Our findings suggest that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. In light of the growing emphasis placed on cancer survivorship, we consider that further research within this area is warranted to ensure that psychological distress in patients with prostate cancer is not underdiagnosed and undertreated.

Correspondence to
S P Rodrigues; s.p.rodrigues@lumc.nl

Correspondence to
Professor George Lewith; glewith@scmrt.org.uk

Received 12 November 2013; Revised 4 February 2014; Accepted 17 February 2014; Published 13 March 2014