Article in the Spotlight

By Barnaby Nicolas, MSIS

In our monthly “Article Spotlight” series, we’re showcasing achievements of Mount Sinai faculty and researchers using Altmetrics. This month, we’re looking at an article co-written by Dr. Jonathan Halperin, MD, Professor, Medicine, Cardiology at Icahn School of Medicine at Mount Sinai. The article examines the use of digoxin to treat atrial fibrillation.

Citation: Washam JB, Stevens SR, Lokhnygina Y, Halperin JL, Breithardt G, Singer DE, et al. Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). The Lancet.385(9985):2363-70.

Halperin article

Article Summary: This study examines the use and outcomes of digoxin in patients. Digoxin treatment was associated with a significant increase in all-cause mortality, vascular death, and sudden death in patients with AF. This association was independent of other measured prognostic factors, and although residual confounding could account for these results, these data show the possibility of digoxin having these effects. The researchers find that a randomised trial of digoxin in treatment of AF patients with and without heart failure is needed.

BACKGROUND: Atrial fi brillation (AF) is the most common arrhythmia encountered in clinical practice, estimated to currently affect more than 30 million people worldwide. It is associated with increased risk of stroke, heart failure, cognitive impairment, and death, and complicates management of other disorders. Digoxin is a widely used drug for ventricular rate control in patients with atrial fi brillation (AF), despite a scarcity of randomised trial data. The researchers studied the use and outcomes of digoxin in patients in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism

Trial in Atrial Fibrillation (ROCKET AF). For this retrospective analysis, the authors included and classifi ed patients from ROCKET AF on the basis of digoxin use at baseline and during the study. Patients in ROCKET AF were recruited from 45 countries and had AF and risk factors putting them at moderate-to-high risk of stroke, with or without heart failure. The researchers used Cox proportional hazards regression models adjusted for baseline characteristics and drugs to investigate the association of digoxin with all-cause mortality, vascular death, and sudden death. ROCKET AF was registered with, number NCT00403767. In 14,171 randomly assigned patients, digoxin was used at baseline in 5239 (37%). Patients given digoxin were more likely to be female (42% vs 38%) and have a history of heart failure (73% vs 56%), diabetes (43% vs 38%), and persistent AF (88% vs 77%; p<0·0001 for each comparison). After adjustment, digoxin was associated with increased all-cause mortality, vascular death, and sudden death.

URL to this article on Plum X

Dr. Halperin’s profile

Levy Library now offers NEJM Resident 360

NEJM Resident 360 is here to make life easier for busy Icahn School of Medicine at Mount Sinai residents. This resource offers clinical content targeted specifically to residents’ needs, guidance in career decisions, and a way to connect with peers. Features such as Rotation Prep help residents solidify their foundational medical knowledge with materials that have been written and curated by a team of physician experts, fellows, and residents, and mapped to 14 common residency rotations in internal medicine.  Each rotation includes brief topic overviews, links to landmark clinical trials and review articles from NEJM and other highly-respected sources, and a selection of test questions from NEJM Knowledge+.


To access NEJM Resident360, visit our databases page. Icahn School of Medicine at Mount Sinai residents must create a personal account to NEJM Resident 360 while on campus. If you’re off campus, you can create an account through our NEJM eJournal subscription.

If you are an Icahn School of Medicine at Mount Sinai resident and you have created a Resident 360 account previously at another institution and want to maintain your current account, you can simply login to their personal 360 account while on campus networks at Mount Sinai Hospital Mount Sinai Beth Israel to get access to the institutional modules that are included in t subscription.

Contact with any questions.

The Complexity of Measuring the Impact of Books: Article in Publishing Research Quarterly · June 2016

By Gali Halevi, MLS, PhD, Barnaby Nicolas, MSIS, Judit Bar-Ilan, PhD


Libraries have been looking for ways to measure the value of their collections for decades. Discovering the amount of downloads, citations and views of journal articles are some of the major methods used by librarians to define how much their collection are used by patrons and whether or not they should keep them. Altmetrics, mainly the ability to track the social impact of scientific artefacts via networks, introduced a new dimension to these evaluations. Nowadays, scientific impact can be measured via traditional metrics such as citations but also via alternate metrics such as downloads, views, clicks and so forth.

That being said, studying the scientific and social impact of books still remains a challenge. The main reason is that books vary in format, content and genre. Books not only adhere to disciplinary or multidisciplinary foci, but also differ in categorical type and targeted audiences. Within the general classification of books into “Fiction” or Non-fiction” classes, books also display a complex categorical structure which includes genres (i.e. science, drama, history) and types (i.e. encyclopedia, dictionary, text book).

In addition, while many platforms can track the number of citations, downloads and views of single chapters of scientific and text books, hardly any can track altmetrics or offer a book-level aggregation of such impact.

Our study endeavored to discover whether there are scholarly evaluation metrics that can be applied to a wide range of books’ types and contents. We analyzed over 70,000 books and collected various metrics per each title including traditional and altmetrics measures. Our results show that books display different impact in each of the measurements and vary by types and content. There isn’t one measure that captures the impact of books across the board.

Therefore, we concluded that books should be evaluated by types and contents while using different measures per each.  We believe that in order to capture the scientific impact of books, it will be important to use a variety of measures. Furthermore, in light of our analysis, we recommend using both traditional metrics such as citations and reviews as well as altmetrics such as social media mentions, downloads, reads and views. Using platforms such as PLUMx can assist in capturing such metrics.

We also recommend creating topic – related books data sets as well as type-related ones. In this manner, the evaluator can track different metrics around topics and types and compare them better. For example, a library looking to evaluate its books collection should create data sets of text books around a specific discipline and benchmark them against.

Full article DOI: 10.1007/s12109-016-9464-5

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