Objective: Both the total number of publications and the number of publications in high-ranking journals determine a country's reputation in scientific research. A predominance of national authors in a country's international high-ranking journals has occasionally been presumed. We therefore analysed the publication output of various countries and the proportion of national authors in international high-ranking journals. Methods: The database EMBASE(R) (Excerpta Medical by means of the online service Dialog(R) was used to analyse the national publication output of various countries during the years 1986 to 1990 and 1991 to 1995 and the proportion of national authors in The Lancet and The New England journal of Medicine (NEJM.). Results: American and British publications played the leading roles in the total number of medical publications from 1986 to 1990 (35.6 % and 8.8 %, respectively) and also from 1991 to 1995 (34.3 % and 9.1 %, respectively). A more detailed analysis revealed an unexpectedly high national publication output (publications per million inhabitants) of smaller countries, which exceeded that of larger nations during both periods studied (national publication output 1986-90 vs. 1991-95: Israel: (3386 vs. 3447), Sweden: (3303 vs. 3620), Switzerland: (2930 vs. 3722), Denmark: (2884 vs. 3167), UK: (2186 vs. 2825), USA: (2042 vs. 2388)). Furthermore, the proportion of national authors during both periods (1986-90 vs. 1991-95) studied was 41.8% vs. 34.1 % in the case of The Lancet and 77.9 % vs. 69.5 % in the case of The New England journal of Medicine. Conclusions:The present study found an unexpectedly high national publication output of smaller countries as well as a clearly disproportionate number of published articles from national authors in The Lancet and the NEJM during the years 1986 to 1990 and 1991 to 1995.
