Citation history of Bland and Altman (1986)

Our Lancet paper on agreement between two methods of clinical measurment (Bland and Altman, 1986) has now been cited more than 10,000 times (10,012 citations on the ISI Web of Science, 8 July 2005).

In 2003 it was reported to be the sixth most highly cited statistical paper ever (Ryan and Woodall 2005). To celebrate this and provide a bit of background for Tom Ryan, I compiled a history of citations of this paper.

Between 1986 and 2002 there were 7,684 citations of this paper recorded in the Web of Science, 651 mentions of "Bland" and "Altman" in abstracts or keywords, and 14 mentions of "Bland" and "Altman" in the title of papers.

The number of citations of this paper have increased fairly smoothly over time:

Graph of citations against year. Three series: citations for the 1986 paper rise to 900, citations for the 1983 paper level off at 80 in 1993, mentions in abstracts rise to 150. D

There is no obvious reason for the slight irregularity between 1998 and 1999, but this shows the year of addition to the Science Citation Index rather than the year of actual publication, so there might be some administrative reason for it. The paper was made available on the World Wide Web in 2000, and there is no obvious effect on citations. The figure also shows citations of our original 1983 paper in The Statistician (Altman and Bland 1983), in which we presented our ideas for the first time. The 1986 Lancet article was really only an attempt to publicise these to a medical audience.

Incidentally, we chose the authorship of the first paper on alphabetical grounds, and then swapped for the second one. Bland got lucky, as the first author of the big hit, but in fact these papers are very much our joint work and neither of us takes precedence.

The success of the 1986 paper led to continual enquiries from researchers about situations where the simple method did not apply. In response, we developed a series of more advanced approaches, which we described in Bland and Altman (1999). We both continue to get regular queries by email, about one per month to Doug and two to myself. I have included a number of replies to these questions on my website in an FAQ list.

Since I wrote the above, David Sharp, who was the Lancet editor originally responsible for the acceptance of the paper and for shortening and thereby improving it considerably, wrote little piece about citations (Sharp 2004). This contained the following advice for those seeking to be cited: "Stick to review articles or methods in the hope of striking occasional gold; the most cited Lancet paper (hereby acquiring yet another hit) is a method, 1 and second and third prizes go to publications of this sort too." Reference 1 was, of course, Bland and Altman (1986).

Martin Bland
31 August 2004


The data were as follows:

year cites86  abstr  title  cite83
1983    0        0     0      0
1984    0        0     0      2
1985    0        0     0     12
1986    9        0     0     23
1987   41        0     0     23
1988   80        0     0     13
1989  123        0     0     20
1990  160        0     0     22
1991  216        3     0     41
1992  276        4     1     43
1993  334        3     0     33
1994  415       13     0     61
1995  493       27     1     61
1996  628       44     3     72
1997  728       55     2     72
1998  817       64     0     60
1999  771       74     2     57
2000  839       95     3     47
2001  869      126     1     46
2002  885      143     1     60


I am very grateful to Norma Williams, Web of Science Support Officer, MIMAS Manchester Computing, Manchester University, for her help with the search, which exceeded the capacity of the Web of Science in the version to which I had access.


Altman DG, Bland JM. (1983) Measurement in medicine: the analysis of method comparison studies. The Statistician 32, 307-317.
PDF file by kind permission of the Royal Statstical Society.

Bland JM, Altman DG. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet i, 307-310.

Bland JM, Altman DG. (1999) Measuring agreement in method comparison studies. Statistical Methods in Medical Research 8, 135-160.

Ryan TP and Woodall WH (2005) The most-cited statistical papers. Journal of Applied Statistics 32, 461-474.

Sharp D. (2004) As we said... Lancet 364 744.

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