Meta-research in biomedical science is crucial for ensuring rigour, relevance, and transparency in an era marked by the exponential growth of scientific publications. This study examines global and historical trends in meta-research activities within biomedicine and investigates their relationship with health, science, and human development indicators. A systematic analysis of 9633 publications from Scopus, Web of Science, and PubMed was conducted, focusing on publication volume, citation impact, and geographic distribution. Regression analyses reveal a significant positive association between meta-research activity and the Human Development Index (HDI), suggesting that meta-research contributes to societal advancement by enhancing evidence-based decision-making in health. However, no association was found between meta-research output and research and development (R&D) expenditure, reflecting the minimal resource requirements of secondary data-driven studies compared to primary or experimental research. Meta-research activity correlates positively with clinical trial completion, indicating its role in refining study designs and addressing evidence gaps. These findings highlight the importance of expanding meta-research in underrepresented regions to promote equity in scientific advancement and improve the reliability of biomedical knowledge. This result underscores the need for targeted support for meta-research, particularly in low- and middle-income countries with limited scientific infrastructure and resources for new knowledge generation.

The post-pandemic era caused by coronavirus disease-2019 (COVID-19) has made a previously reported trend more visible over the last two decades: the "avalanche" of biomedical publications. One of the greatest paradoxes in contemporary science is the increasing availability of scientific evidence, coupled with a decrease in its quality. This has been a topic of broad international discussion, involving ethical, methodological, social, economic, and political arguments. In recent years, there has been a significant increase in paid journals, which has raised concerns about the quality of research being published, particularly in the context of government-funded projects. These journals often prioritize revenue generation over scientific rigor, creating a platform for studies with questionable methodologies to gain visibility. The pressure on researchers to publish frequently, driven by academic and institutional evaluation systems, has further exacerbated this issue. Also, the rise of predatory journals represents a critical challenge in maintaining the integrity of biomedical literature. These journals operate outside conventional editorial frameworks, often bypassing the peer-review process, which is a cornerstone of scientific credibility. This phenomenon has been fueled by the proliferation of open-access publishing models, which, while democratizing access to scientific findings, have also created opportunities for exploitative practices.

The world is facing a significant demographic transition, with a substantial increase in the proportion of older persons, as well as long-lived persons (especially nonagenarians and centenarians). One of the popular beliefs is that old age is synonymous with disease and disability. However, the successful aging hypothesis suggests that those older persons with advanced chronological age who maintain their functional capacity derive from it a delay in biological aging, enhancing the quality of organic aging and regulation. Therefore, regardless of chronological age, even in cases of extreme longevity, those older adults with a successful aging phenotype and favorable functional capacity would be expected to have satisfactory post-surgical recovery with a low risk of morbidity and mortality. Currently, there is a significant gap between the availability of high-certainty surgical evidence that allows for evidence-based interventions applicable to the long-lived population—taking into account the actual conditioning factors of the health phenotype in older persons—and, above all, predictors of satisfactory post-surgical evolution. The application of meta-research to geriatric surgery emerges as a fundamental tool to address this knowledge gap and reveals opportunities and limitations that need to be resolved in the near future to establish evidence-based surgical care for older persons. The aim of this manuscript was to present a real and globally relevant scenario related to surgical care, addressing the longevity, the availability, and the quality of surgical evidence applicable to this population, and also to present variables to consider in analysis and future perspectives in research and meta-research in geriatric surgery.

Background: Medical errors are a major public health concern, contributing to increased morbidity, mortality, and healthcare costs worldwide. Understanding the global research landscape on medical errors and its association with key health and development indicators can provide insights into gaps and opportunities for improving patient safety. Methods: A scientometrics analysis was conducted using data from Scopus, PubMed, and other bibliographic databases. A mixed-methods approach was employed, integrating bibliometric indicators with global health and research metrics. Regression models and meta-analyses were applied to evaluate associations between research productivity and health indicators across 6 World Health Organization regions. Results: A total of 2639 articles on medical errors were analyzed. The Americas produced the highest volume of research (48.01% of publications) with the highest citation impact (mean 46.5 citations per article). In contrast, Africa had the lowest research output (0.87%). Significant associations were observed between medical error research productivity and health indicators, including reductions in adolescent mortality (Coef. = ‐3676.56, P < .001) in the Western Pacific and under-5 mortality (Coef. = ‐0.18, P < .001) in the Americas. Each region showed a distinct pattern of associations with the global indicators. Research funding and health expenditure were positively associated with publication output and citation impact. Conclusion: Medical error research exhibits regional disparities and significant associations with global health indicators. Investment in medical errors research is associated with improved health outcomes in some regions, underscoring the need for equitable resource allocation and enhanced international collaboration to address gaps in patient safety research.

Background: Medical errors represent a critical challenge to global healthcare systems, ranking among the leading causes of preventable morbidity and mortality. The aim of this study was to explore the evolution, characteristics, and correlation of research on medical errors and global health and research indicators. Methods: A mixed-methods scientometrics study was conducted to analyse publications from 1865 to 2024 on medical errors from five databases. Correlational analyses were performed, focusing on publication trends, geographic and economic disparities, journal metrics, and thematic evolution. Multiple regression assessed relationships between bibliometric metrics and global indicators. Results: Five thousand seven hundred thirty-two publications related to medical errors were analysed. An annual growth rate of 1.49% was documented, with high-income countries contributing 83.32% of publications. The Americas accounted for the highest regional output, while Africa and Southeast Asia showed marginal contributions. Most studies were published in high-impact journals (46% in Q1), but only 22.98% were open access. Thematic analysis revealed a transition from error reporting to mitigation strategies. Correlations showed strong associations between intellectual property fees and publication volume (r²=0.75; p< 0.001), while official development assistance negatively correlated with publication output (r²=− 0.33; p< 0.01). Disability-adjusted life years showed weak correlations with publication volume (r²=0.32; p< 0.01) and journal impact (r²=0.14; p< 0.001). Conclusion: This study highlights significant inequities in global research on medical errors, with high-income countries dominating production. While thematic shifts suggest advancements in the field, the lack of representation from low- and middle-income countries and limited access to open-access publications pose barriers to global applicability.

Background. Six Sigma is widely implemented in healthcare to enhance efficiency, minimize medical errors, and improve patient safety. However, the global distribution and impact of Six Sigma research in healthcare remain underexplored. This study conducts a scientometrics analysis of Six Sigma research in healthcare, examining its association with global health, research, and development indicators across income groups. Methodology. A mixed-methods scientometrics study was employed, utilizing data from Scopus, PubMed, and other databases. Regression models and meta-analyses were applied to evaluate associations between Six Sigma research productivity and global health, research and development indicators. Publications were categorized by World Bank income groups, and bibliometric parameters such as impact were analysed. Results. A total of 804 Six Sigma-related publications in healthcare were identified, with high-income countries contributing 70.8% of the total output. The number of publications was significantly associated with adult mortality reduction in high- and upper-middle income countries (p <0.01). Research and development expenditure showed a strong positive correlation with Six Sigma research output across all income groups. However, low-income countries exhibited minimal research activity, with no significant associations detected. Conclusions. Six Sigma research in healthcare is predominantly concentrated in high-income countries, with increasing but uneven growth in upper-middle and low-middle income countries. The limited engagement of low-income countries underscores a critical research gap.