The concept of citation network analysis is not new, but it is important. In this manuscript, Dr. Leng uses Web of Science to analyze a subfield of papers about radomized controlled trials (RCTs) of coronay heart disease between 1965-1984. While this topic seems limited in scope, Dr. Leng argues the opposite is true: this example provides insight into how scientists resolve conflict through manuscript publciation. He finds clear citation bias toward positive studies and reviews. In general, the scientific literature reports an overwhelming % of positive results, and it is unsurprising this study finds that reviews of the RCT literature was biased toward studies that presented positive data. Notably, "one finding of this paper is that reviews in this field were poor at considering all the available empirical evidence". This makes sense when one considers the limitations of review articles and the narrative-centric motivations of review authors. In sum, this paper aims to emphasize the limitations of citation metrics in evaluating the impact of individual manuscripts and the direction of research fields.