Article- and Journal-Level Associations Between Altmetric Attention Scores and Citations in High-Attention Ophthalmology Publications

Importance Altmetric Attention Scores (AAS) measure attention to scholarly articles through social media, news coverage, or policy citations. How AAS aligns with impact factors for ophthalmic peer-reviewed medical literature remains unclear. Objective To assess correlations between AAS and citation metrics at the article and journal levels. Design, Setting, and Participants This cross-sectional study included all citable items published between 2022 and 2023 in a subset of ophthalmology journals indexed in the 2024 Journal Citation Reports. The top 500 articles ranked by AAS were selected as a high-attention publication subset for detailed analysis. Main Outcomes and Measures The primary outcome was Spearman rank correlations between AAS rankings and normalized citation rankings (calculated as total citations divided by months elapsed since publication) at the individual article level and between an entire journal’s AAS rankings and Journal Impact Factor (JIF) rankings. Results This study included 24 059 citable items in 99 journals. Among the top 500 high-attention articles, correlation between individual article–level AAS rankings and citation rankings was 0.08 (95% CI, −0.01 to 0.16; P = .08). At the journal level, correlation was 0.57 (95% CI, 0.41-0.69; P < .001). Correlations for predominantly clinical research–oriented journals compared with predominantly nonclinically or mixed research–oriented journals were 0.64 (95% CI, 0.46-0.79) vs 0.43 (95% CI, 0.09-0.69) (difference = 0.21; 95% CI, −0.09 to 0.60; P = .24). Multivariable analysis showed that AAS rankings were independent of document type (review vs original article: β = −10.6; 95% CI, −47.8 to 26.6; P = .58) or publication date (per month elapsed: β = 0.7; 95% CI, −1.1 to 2.5; P = .45). Conclusions and Relevance In this cross-sectional study of high-attention ophthalmology publications, individual article–level AAS rank was not associated with citation rank, whereas journal-level Altmetric rank was moderately associated with JIF rank and greater for clinical research–oriented journals. These findings suggest that online attention and impact factor reflect partially overlapping but distinct dimensions of research dissemination and that both metrics are independent, important variables that may contribute to judging the value of peer-reviewed medical journals.