Background/Purpose: Presentation order can influence the prominence of an academic article. Earlier-listed items or those at the top of tables of contents are more likely to be seen and read, and the serial ordering of articles within a journal issue can influence article citations over many years.  The aim of this study was to analyse what rheumatology journals prioritize through the presentation order of research articles within journal issues.

Methods: A content analysis of original articles published in general rheumatology journals from 2013-2018 was undertaken.  All included journals produced regular issues, reported original research, and had 2016 Thomas Reuters Impact Factor > 3.0.  The following data were extracted: gender of first and last author, country of origin, industry funding, and disease category.  Analysis of the overall distribution of article placement within issues was computed using cumulative density function plots and area under the curve (AUC) analysis. The odds ratio (OR) for articles published in one of the first three places of an issue compared with one of the last three places was also calculated. Downloads and altmetrics were analysed.

Results: A total of 6,787 articles were included.  There were no differences in presentation order based on gender, country of origin, or industry funding (Figure).  However, there were significant differences in presentation order based on disease category (Figure).  Articles about rheumatoid arthritis were more likely to be ordered towards the front of an issue (P < 0.001), and were more likely to be ordered in the first three places compared to the final three places (OR [95% CI] 5·77 [4·80, 6·92]). In contrast, articles about crystal arthritis, pain syndromes, pediatric rheumatic diseases, systemic lupus erythematosus, systemic sclerosis, and vasculitis were more likely to be ordered at the end of the issue (P for all < 0.001).  Journals presenting content grouped by disease category exhibited greater disease category prioritization compared to journals without disease category content groupings. Articles ordered in the first three places of an issue had higher download rate/article year (rate [95% CI] difference 441.9 [292.9, 591.0]) and mean altmetric scores (mean [95% CI] difference 4.88 [1.62, 8.15]), compared to articles in the last three places.

Conclusion: Contemporary rheumatology journals do not demonstrate presentation order bias for author gender, country of origin, or industry funding.  However, differences in the presentation order of disease categories are evident.  Editorial choices about the serial position of articles within journals can influence prioritization of certain rheumatic diseases.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/presentation-order-bias-in-rheumatology-journals-a-content-analysis/