Content analysis
After collecting all of the citing sources, we conducted a relational
content
analysis15that explored the relationship between Portenoy and Foley’s 1986 article
and each of the citing works. While similar studies have focused on
whether citations were affirmative or
negative,16we expanded the scope of our study to construct a more detailed analysis
of the citation patterns in the scientific literature. We identified
five relevant outcomes: sign (affirmational, negational, or neutral
reference), accuracy of index study citation, attribution of the index
citation to driving the opioid crisis, agenda-setting, and article type
(Table 1).