altmetrics creates a new approach to evaluating the impact of publications by considering the number of downloads , shares , and discussions on social networks.1 this approach does not replace the traditional bibliometric indicators , such as impact factor and h - index , but rather focuses on new aspects of publication impact.2 although still in its infancy , altmetrics has the potential to become a valid assessment strategy for the evaluation of publication impact.3 altmetric tools capture information through the use of metrics from html views and downloads of articles , blog posts , tweets , bookmarks , etc .
all of these sources are alternative indicators of impact that go beyond traditional citation , focusing on the content and uses of the social web,4 with this information provided in real time .
altmetrics elucidate not only the impact of scientific research by researchers but also the impact of the research on the public through social media.2,5 in fact , through altmetrics , the impact of research can be measured at the individual - article level , using a combination of such data as the number of times that a particular paper has been downloaded , discussed , shared , and cited.6 this approach allows not only researchers but also institutions to analyze postpublication activity around a paper in near - real time using various online resources.5 to use this new tool , we focused on the italian researchers of the simpar group , which was founded in pavia in 2007 .
this group has rapidly become an eminent translational group in the pain field , with its annual meeting now considered a major international pain conference ( www.simpar.eu ) .
in addition to the authors of this study , the other nine members of the simpar group are drs marco baciarello , dario bugada , christian compagnone , andrea fanelli , stefano govoni , maurizio marchesini , cristina e minella , carolina muscoli , and william raffaeli .
simpar s multidisciplinary collaboration has included several professionals of different disciplines and has produced a number of publications on the personalization of pain therapy through a multidisciplinary approach , including traditional medical , genetic , epigenetic , and 
table s1 lists each of the 18 papers published by at least two simpar members in collaboration between 2010 and 2015 .
as described herein , we have been able to obtain statistically significant results regarding the force of the group as a whole in both the research and public communities .
for each of the 12 researchers of which our team is comprised , we created an orcid ( open researcher and contributor i d ) account ( www.orcid.org ) , in addition to an impact story ( https://impactstory.org ) account that imported our data and synchronized it with the unique orcid identifiers .
collected items were assigned to specific categories , such as  cited  ( or highly cited ) ,  saved  ( or highly saved ) , or  discussed  . in doing so
, our impact story provided us with data regarding the number of times an article was saved by scholars , cited by other researchers , publicly discussed ( facebook , etc ) , and cited by the general public ( blog posts , wikipedia ) .
these metrics were classified along two dimensions : audience ( scholars or the public ) and type of engagement with the online research products ( viewed , discussed , saved , cited).7 from impact story , we were able to retrieve all altmetrics data for the 12 researcher accounts ( paper citations , discussions , views by the research community or public ) . through the personal profiles of altmetrics , for each member of the simpar group
, we were able to count the number of citations , times a paper was saved , and discussions from the public community for each paper published .
then , we compared the simpar group percentages of articles cited ( or highly cited ) , saved ( or highly saved ) , or discussed relative to those published by single authors ( either written alone or in collaboration with coauthors who were not members of the simpar group ) by means of fisher s exact test .
quantitative variables are described as median and interquartile range ( iqr ) , ie , the 25th and 75th percentiles and compared to collective simpar data or individual publication articles by means of a nonparametric mann 
the association between citations from scopus and the altmetric score or its components ( eg , facebook posts , tweets , mendeley readers ) was expressed through a nonparametric spearman s -correlation coefficient .
all analyses were performed utilizing stata 14 ( statacorp lp , college station , tx , usa ) .
through the personal profiles of altmetrics , for each member of the simpar group , we were able to count the number of citations , times a paper was saved , and discussions from the public community for each paper published .
then , we compared the simpar group percentages of articles cited ( or highly cited ) , saved ( or highly saved ) , or discussed relative to those published by single authors ( either written alone or in collaboration with coauthors who were not members of the simpar group ) by means of fisher s exact test .
quantitative variables are described as median and interquartile range ( iqr ) , ie , the 25th and 75th percentiles and compared to collective simpar data or individual publication articles by means of a nonparametric mann 
the association between citations from scopus and the altmetric score or its components ( eg , facebook posts , tweets , mendeley readers ) was expressed through a nonparametric spearman s -correlation coefficient .
all analyses were performed utilizing stata 14 ( statacorp lp , college station , tx , usa ) .
the median number of articles by the authors was 17 ( iqr 1027 ) , and the median year of publication was 2013 ( iqr 20112014 ) .
altmetrics demonstrated that simpar group publications were more likely to be saved ( 78% vs 53% , p=0.05 ) and publicly discussed ( 61% vs 4% , p<0.0001 ) than individual publications .
however , no significant difference emerged between the simpar group publications and individual publications in terms of being cited ( cited 44% vs 36% , highly cited 22 vs 11% ; p=0.20 ) and publicly viewed ( 11% vs 3% , p=0.25 ) .
notably , eleven of 18 articles published collectively by the simpar group received a tweet ( median 1 , iqr 13 ) , while only 36 of 151 individual publications received a tweet .
moreover , 15 articles from the simpar group collectively were accessed through mendeley readers ( median times accessed 4 , iqr 111 ) versus 85 of the individual publications ( median times accessed 2 , iqr 08 ; p=0.01 ) .
we describe the correlation between scopus citations and the single components of the analyzed alternative metrics in table 1 .
we found that the alternative metrics were generally low , with the exception of those for mendeley readers ( =0.47 , p<0.0001 ) ( figure 1 ) .
we found significant correlations between the simpar group collective publications and their impact on the indicator linked to research activity ( mendeley readers ) , although not to public discussion ( such as facebook and tweets ) .
however , the impact of collective simpar group articles was high also on general public items , even though it did not reach statistical significance .
this is meaningful , as funders , universities , and publishers increasingly demand indicators of the impact of science on society.8 moreover , we are confident that the new metrics of medical groups could have an impact on the pain - patient community as well . through online platforms , such as twitter and facebook , like - minded people can form their own communities to discuss their shared experiences , problems , and more . our results also illustrate how collaborative multidisciplinary teams and their projects improve the overall impact of researchers work on the researchers themselves . if collaborative efforts are more widely disseminated than individual publications , as our study suggests , such efforts can potentially provide additional exposure to group members , which may result in greater career enhancement than individual publications . through these avenues
, researchers can leverage social media opportunities to their own professional and academic advantage.9 enhanced exposure allows for the sharing of ideas and research among respective networks , spotlighting pain studies both nationally and internationally . finally , as the simpar group take research ethics seriously , we opine that our collaborative approach is an ethical one as well as an effective one .
ways to increase the  yield  from biomedical research have been identified as an imperative.10 as our collaborative efforts have been demonstrated to enhance access to meaningful , clinically relevant research results , our approach results in more 
bang for the buck  by more readily disseminating useful information to practicing clinicians , as well as to other researchers interested in building upon the fund of data obtained through our investigations .
the 18 papers published from italian simpar group ( from at least two members ) analyzed in the paper are as follows : 
 perotti l , cusato m , ingelmo p , et al . a comparison of differences between the systemic pharmacokinetics of levobupivacaine and ropivacaine during continuous epidural infusion : a prospective , randomized , multicenter , double - blind controlled trial .
postoperative analgesia after laparoscopic ovarian cyst resection : double - blind multicenter randomized control trial comparing intraperitoneal nebulization and peritoneal instillation of ropivacaine .
2015;22(5):759766.casale r , di matteo m , minella ce , fanelli g , allegri m. reduction of painful area as new possible therapeutic target in post - herpetic neuropathic pain treated with 5% lidocaine medicated plaster : a case series .
2014;7:353357.bugada d , allegri m , lavandhomme p , de kock m , fanelli g. inflammation - based scores : a new method for patient - targeted strategies and improved perioperative outcome in cancer patients . biomed res int .
2014;2014:142425.gigliuto c , de gregori m , malafoglia v , et al . pain assessment in animal models : do we need further studies ?
clinical pharmacokinetics of morphine and its metabolites during morphine dose titration for chronic cancer pain .
2014;36(3):335344.compagnone c , tagliaferri f , allegri m , fanelli g. ethical issues in pain and omics research . some points to start the debate .
croat med j. 2014;55(1):12.bugada d , guardia nicola f , carboni v , allegri m. transversus abdominis plane catheter infusions after major abdominal surgery in morbidly obese patients : reply to comments .
2014;80(6):747.fanelli a , ghisi d , allegri m. is spinal anaesthesia a suitable technique for ultra - short outpatient procedures ?
2013;84(1):7680.bugada d , guardia nicola f , carboni v , allegri m. tap block for opioid - free postoperative analgesia in obese surgery .
genetic variability at comt but not at oprm1 and ugt2b7 loci modulates morphine analgesic response in acute postoperative pain .
consequences of the 118a > g polymorphism in the oprm1 gene : translation from bench to bedside ?
2013;6:331353.allegri m , clark mr , de andrs j , fanelli g. pain treatment : a new approach to link bench to bedside 
gregori s , de gregori m , ranzani gn , allegri m , minella c , regazzi m. morphine metabolism , transport and brain disposition .
2010;11(3):276282.allegri m , de gregori m , niebel t , et al . pharmacogenetics and postoperative pain : a new approach to improve acute pain management .
spontaneous cervical ( c1-c2 ) cerebrospinal fluid leakage repaired with computed tomography - guided cervical epidural blood patch .
perotti l , cusato m , ingelmo p , et al . a comparison of differences between the systemic pharmacokinetics of levobupivacaine and ropivacaine during continuous epidural infusion : a prospective , randomized , multicenter , double - blind controlled trial .
postoperative analgesia after laparoscopic ovarian cyst resection : double - blind multicenter randomized control trial comparing intraperitoneal nebulization and peritoneal instillation of ropivacaine .
casale r , di matteo m , minella ce , fanelli g , allegri m. reduction of painful area as new possible therapeutic target in post - herpetic neuropathic pain treated with 5% lidocaine medicated plaster : a case series . j pain res . 2014;7:353357 .
bugada d , allegri m , lavandhomme p , de kock m , fanelli g. inflammation - based scores : a new method for patient - targeted strategies and improved perioperative outcome in cancer patients .
gigliuto c , de gregori m , malafoglia v , et al . pain assessment in animal models : do we need further studies ?
2014;10(5):673684 . de gregori s , minella ce , de gregori m , et al .
clinical pharmacokinetics of morphine and its metabolites during morphine dose titration for chronic cancer pain .
compagnone c , tagliaferri f , allegri m , fanelli g. ethical issues in pain and omics research .
bugada d , guardia nicola f , carboni v , allegri m. transversus abdominis plane catheter infusions after major abdominal surgery in morbidly obese patients : reply to comments .
fanelli a , ghisi d , allegri m. is spinal anaesthesia a suitable technique for ultra - short outpatient procedures ?
bugada d , guardia nicola f , carboni v , allegri m. tap block for opioid - free postoperative analgesia in obese surgery .
genetic variability at comt but not at oprm1 and ugt2b7 loci modulates morphine analgesic response in acute postoperative pain .
consequences of the 118a > g polymorphism in the oprm1 gene : translation from bench to bedside ?
allegri m , clark mr , de andrs j , fanelli g. pain treatment : a new approach to link bench to bedside  the simpar meeting 2011 .
. de gregori s , de gregori m , ranzani gn , allegri m , minella c , regazzi m. morphine metabolism , transport and brain disposition .
spontaneous cervical ( c1-c2 ) cerebrospinal fluid leakage repaired with computed tomography - guided cervical epidural blood patch .
 in this study , we investigated the impact of scientific publications of the italian simpar ( study in multidisciplinary pain research ) group by using altmetrics , defined as nontraditional metrics constituting an alternative to more traditional citation - impact metrics , such as impact factor and h - index . by correlating traditional and alternative metrics , we attempted to verify whether publications by the simpar group collectively had more impact than those performed by its individual members , either in solo publications or in publications coauthored by non - simpar group investigators ( which for the purpose of this study we will refer to as  individual publications  ) . 
 for all the 12 members of the group analyzed ( pain therapists , biologists , and pharmacologists ) , we created open researcher and contributor i d and impact story accounts , and synchronized these data . 
 manually , we calculated the level metrics for each article by dividing the data obtained from the research community by those obtained from the public community . 
 we analyzed 759 articles , 18 of which were published by the simpar group . 
 altmetrics demonstrated that simpar group publications were more likely to be saved ( 77.8% vs 45.9% ) , discussed ( 61.1% vs 1.1% , p<0.0001 ) , and publicly viewed ( 11.1% vs 1.3% , p=0.05 ) than individual publications . 
 these results support the importance of multidisciplinary research groups in the impact of scientific literature ; the interaction and synergy among the research participants allowed the obtainment of high impact - literature in the field of personalized pain medicine . 
 finally , our findings demonstrate the potential of altmetrics in estimating the value of the research products of a group . 
Introduction
Materials and methods
Statistical analysis
Results
Discussion and conclusion
Supplementary material