Altmetrics as Indicators of Research Dissemination and Impact in Thoracic Surgery

Background Citation analysis remains the traditional standard for assessing scientific impact, but it reflects influence only after years of academic uptake. Alternative metrics (altmetrics) capture early dissemination through online media, policy documents, and public engagement, offering a complementary perspective on research visibility. No previous study has systematically examined the relationship between bibliometric and altmetric indicators in thoracic surgery. Methods The Web of Science database was searched from January 1900 to December 2024 using the terms “thoracic” AND “surg” to identify the 100 most-cited English-language thoracic surgery articles. For each article, citation count, five-year journal impact factor, and Altmetric Attention Score (AAS) were recorded. Correlations between citation count and AAS were assessed using Spearman’s rho. Multivariable modelling included ordinary least squares regression of log-transformed citation counts, Poisson and negative binomial generalized linear models, and a reverse model with AAS as the dependent variable. Forecasting of 10-year trends in citations and AAS was performed using log-linear time–trend models with out-of-sample prediction accuracy assessed by mean absolute error. Results Among 179,930 eligible publications, the top 100 cited articles (citations range 345–2645; median 528, interquartile range [IQR] 303) spanned 1972–2019. Median AAS was 7 (IQR 17). Altmetric score showed a positive independent association with citation count across all regression models. In the negative binomial model, each doubling of AAS predicted a 5–6% increase in expected citations (coefficient 0.062, 95% CI 0.047–0.077, p<0.0001). Journal impact factor correlated with citation count (p=0.019) but not with AAS (p=0.246). Forecasting predicted continued exponential growth in both citations (≈9.2% annual increase) and AAS (≈5.6% annual increase) over the next decade, with no statistically significant difference in growth rates. Conclusions Altmetric indicators independently predict citation performance and capture early dimensions of research dissemination in thoracic surgery. While traditional citation counts remain the cornerstone of academic appraisal, integrating altmetric data provides a valuable, complementary measure of evolving influence and can guide researchers, institutions, and journals in optimizing the reach and real-world impact of thoracic surgical research.