A limitation of indicators based on citation counts is that they do not apply to all types of KM outputs, only to published scientific literature, where influence in the scientific community is a goal and a sign of success. For many other KM outputs, such as a database or course curriculum, influence in the scientific community is not a primary goal. In some instances, KM practitioners and authors in low- and middle-income countries may find this indicator not useful for them. Even when influence in the scientific community is a goal, authors in developing countries often face biases and other limitations that make it difficult for them to make their work known to others in the scientific community. A related limitation is that many relevant journals published in developing countries are not included/indexed in some widely used databases such as MEDLINE. Internet search engines, such as Google Scholar, can only provide partial information on the number of times a publication is cited online. Citation reports are costly, but easy to obtain from specialized services.