Introduction: Multiple specialties managing the same disease offers the potential to stimulate interdisciplinary collaboration and increase diversity of thought. But there is a risk of specialty segregation, through reading and citing different publications or using a different vocabulary, which could result in separate silos of thought that act as barriers to knowledge dissemination and learning. A better understanding of how knowledge is shared between specialties on shared topics is essential. The effect of the internet on breaking down silos was studied.
Methods: Neurosurgery (NS) and Otolaryngology (ENT) are two medical specialties that share overlap on numerous clinical disorders. A large volume of scientific literature exists for a shared area of expertise, vestibular schwannoma (VS). Article information for all English-language research articles published through 2016 based on search “(vestibular schwannoma) OR (acoustic neuroma)” was downloaded from Web of Science. The publishing journal’s specialty and author’s specialty (based on department from corresponding address) was determined for 4,439 articles. All 114,647 of these article’s references were categorized by specialty.
Results: The references of neurosurgeon authors were 44.0% NS and 23.4% ENT, while ENT author’s references were 11.6% NS and 56.5% ENT publications. Also, article topics differed by specialty. Both journal specialty and author specialty influenced reference proportions, though the author’s specialty had a larger impact. Articles from opposing author specialties in the same journal type had an average of 22.3-percentage points difference in both NS and ENT references. While authors of the same specialty in opposing journal categories had a reference difference of 13.7-percentage points. Since 1997 (PubMed became publically available), there has been no change in the proportions of reference for either specialty.
Conclusions: On a shared topic and independent of the article’s journal placement, specialty authors are more likely to reference their own specialty’s publications. This difference does not appear to be affected by the internet, as there has been no change in distribution of references since the advent of online medical databases. Silos remain.
Patient Care: By understanding that the neurosurgical literature itself is inadequate to provide broad learning on the topic of vestibular schwannoma, and how this relates to learning in general.
Learning Objectives: Participants should be able to discuss the importance of medical publication on how neurosurgeons learn.