REVIEWING THE REVIEWS:
THE CASE OF CHRONIC FATIGUE SYNDROME

Simon Wessely, John Joyce, and Sophia Rabe-Hesketh
King's College School of Medicine and the Institute of Psychiatry, King's College and Maudsley Hospitals, 103 Denmark Hill, London SE5 8AZ, UK

Objective: To test the hypothesis that the selection of literature in review articles is influenced by the authors' disciplines and nationalities.

Design: Both retrospective review of data and bibliometric analysis were performed. A search was made for all overviews (reviews) of chronic fatigue syndrome (CFS) between 1980 and March 1996 in English-language journals from 3 major databases. Record of data sources in each overview was noted as was the departmental specialty of the first author and his/her nationality. The references cited in each index paper were tabulated by assigning them to 6 specialty categories by article title and to 8 nationality categories by place of publication of journal. Associations were tested for using repeated measures MANOVA and subsequently displayed using biplots.

Results: Of 89 overviews, 3.4% reported on literature search and described the search method. There was a significant interaction between choice of specialty to cite and authors' discipline (P=.01, F12,185 = 2.84) and authors' nationality (P=.02, F4,69 = 3.25), with authors from laboratory based disciplines preferentially citing laboratory references and authors from psychiatry based disciplines doing the reverse. The interaction between nationality of reference and authors' nationality was also significant (P< 0.001, F1,72 = 145.3), with both US and UK authors preferentially citing their own nationality.

Conclusions: Most overviews fail to fulfill basic criteria for scientific acceptability. Citation of the literature is influenced by the author's discipline and nationality.

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