“…To put these citation frequencies in quantitative perspective, and as emphasized by McAlister and colleagues, it is important to realize that from 1900 to 2005, only 0.5% of the Ϸ38 million published papers were cited more than 200 times, and half were never cited at all. 4,6 It would be interesting to ascertain the distribution of the very highly cited papers among the categories of original research articles, large clinical trials, methods papers, and reviews to gauge the extent to which the conflation of these distinctions confounds the assumption of scientific quality implicit in the citation frequency.…”