KEY POINTS• We recommend optimization of nonopioid pharmacotherapy and nonpharmacologic therapy, rather than a trial of opioids, for patients with chronic noncancer pain.

ITATION COUNTS ARE USED TO measure the impact of articles, journals, and researchers and are frequently incorporated in decisions of academic advancement. However, the validity and methods behind the procurement of citation counts have received limited attention. Until relatively recently, Web of Science was the only practical way to obtain citation counts. 1 In the general medical literature, virtually all previous citation analysis studies have used this database exclusively 2-6 and checking the accuracy or validity of these citation counts against another measure was not feasible. Now, however, several other citation databases have become available, including Scopus 7 and Google Scholar, 8 both introduced in 2004. Scopus, like Web of Science, requires a paid subscription, while Google Scholar is free. Each of these databases uses unique methods to record and count citations. The scope of these databases also differ 9-12 in that Web of Science and Scopus claim strong coverage of selected peer-reviewed journals, while Google Scholar might be better able to record citations from books and nontraditional sources, such as Web sites, dissertations, and open-access online journals. Previous studies in some scientific fields, such as computing, biology, physics, and oncology, have shown differences in citation counts among these databases. 9,13,14 To our knowledge, this See also p 1107.

Significant weight loss was observed with any low-carbohydrate or low-fat diet. Weight loss differences between individual named diets were small. This supports the practice of recommending any diet that a patient will adhere to in order to lose weight.

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In this sample of trials based on RCT protocols from 6 research ethics committees, discontinuation was common, with poor recruitment being the most frequently reported reason. Greater efforts are needed to ensure the reporting of trial discontinuation to research ethics committees and the publication of results of discontinued trials.