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Concept: The New England Journal of Medicine


Objective To estimate financial payments from industry to US journal editors.Design Retrospective observational study.Setting 52 influential (high impact factor for their specialty) US medical journals from 26 specialties and US Open Payments database, 2014.Participants 713 editors at the associate level and above identified from each journal’s online masthead.Main outcome measures All general payments (eg, personal income) and research related payments from pharmaceutical and medical device manufacturers to eligible physicians in 2014. Percentages of editors receiving payments and the magnitude of such payments were compared across journals and by specialty. Journal websites were also reviewed to determine if conflict of interest policies for editors were readily accessible.Results Of 713 eligible editors, 361 (50.6%) received some (>$0) general payments in 2014, and 139 (19.5%) received research payments. The median general payment was $11 (£8; €9) (interquartile range $0-2923) and the median research payment was $0 ($0-0). The mean general payment was $28 136 (SD $415 045), and the mean research payment was $37 963 (SD $175 239). The highest median general payments were received by journal editors from endocrinology ($7207, $0-85 816), cardiology ($2664, $0-12 912), gastroenterology ($696, $0-20 002), rheumatology ($515, $0-14 280), and urology ($480, $90-669). For high impact general medicine journals, median payments were $0 ($0-14). A review of the 52 journal websites revealed that editor conflict of interest policies were readily accessible (ie, within five minutes) for 17/52 (32.7%) of journals.Conclusions Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research.

Concepts: Medicine, Specialty, The New England Journal of Medicine


The CONsolidated Standards Of Reporting Trials (CONSORT) Statement provides a minimum standard set of items to be reported in published clinical trials; it has received widespread recognition within the biomedical publishing community. This research aims to provide an update on the endorsement of CONSORT by high impact medical journals.

Concepts: Academic publishing, Impact factor, The Colbert Report, The New England Journal of Medicine


Impact Factor, the pre-eminent performance metric for medical journals, has been criticized for failing to capture the true impact of articles; for favoring methodology papers; for being unduly influenced by statistical outliers; and for examining a period of time too short to capture an article’s long-term importance. Also, in the era of search engines, where readers need not skim through journals to find information, Impact Factor’s emphasis on citation efficiency may be misplaced. A better metric would consider the total number of citations to all papers published by the journal (not just the recent ones), and would not be decremented by the total number of papers published. We propose a metric embodying these principles, “Content Factor”, and examine its performance among leading medical and orthopaedic surgery journals. To remedy Impact Factor’s emphasis on recent citations, Content Factor considers the total number of citations, regardless of the year in which the cited paper was published. To correct for Impact Factor’s emphasis on efficiency, no denominator is employed. Content Factor is thus the total number of citations in a given year to all of the papers previously published in the journal. We found that Content Factor and Impact Factor are poorly correlated. We further surveyed 75 experienced orthopaedic authors and measured their perceptions of the “importance” of various orthopaedic surgery journals. The correlation between the importance score and the Impact Factor was only 0.08; the correlation between the importance score and Content Factor was 0.56. Accordingly, Content Factor better reflects a journal’s “importance”. In sum, while Content Factor cannot be defended as the lone metric of merit, to the extent that performance data informs journal evaluations, Content Factor–an easily obtained and intuitively appealing metric of the journal’s knowledge contribution, not subject to gaming–can be a useful adjunct.

Concepts: The New England Journal of Medicine


The use of social media by health professionals and medical journals is increasing. The aim of this study was to compare online views of articles in press (AIPs) released by Annals of Emergency Medicine before and after a nine-person social media team started actively posting links to AIPs using their personal Twitter accounts.

Concepts: Medicine, Health, Web 2.0, Twitter, The New England Journal of Medicine


In 2013, an independent group of researchers developed the CARE guidelines, a checklist to standardise reporting of case reports. This study assesses adherence to CARE guidelines among PubMed-indexed Indian medical journals in 2015 and the extent of endorsement of these guidelines by the journals. Case reports published in 2015 in journals indexed by PubMed, belonging to the medical stream, currently active, and that had an impact factor were included for analysis. Case series and journals that were published from India but for another country were excluded. Total adherence score and classification of adherence as “excellent”, “very good”, “good”, and “poor” as also adherence to individual components of the checklist were the outcome measures. A total of 162 journals were identified by the search strategy, of which 36 satisfied the selection criteria. In these 36 journals, 1178 case reports were published. We tested the association between the type of journal and impact factor with adherence by using the chi-squared test and generated crude odds ratios. All analyses were done at 5% significance. Based on the total percent score, no case report had excellent adherence, and 19% had good, 70.7% average, and 10% poor adherence, respectively. Among the sub-items, the best adherence was seen in the clinical findings [97.9%], followed by keywords [88.5%], and introduction [71.5%]. The items with extremely poor adherence were patient perspective [0%], informed consent [2.8%], and timeline [4.6%]. Journals with an impact factor of more than 1 had better adherence, relative to those with an impact factor lower than 1. Only one journal’s website mentioned the CARE guidelines. Greater awareness needs to be created among authors, peer reviewers, and editors about using these guidelines. As informed consent is a metric of autonomy, all stakeholders must ensure its reporting.

Concepts: Medical terms, Informed consent, Report, Academic publishing, Autonomy, Case series, Case report, The New England Journal of Medicine


The number of citations an article receives is an important indication of its impact and contribution to the clinical world. There is a paucity of literature concerning top article citations in cardiology. The main objective of this investigation was to bridge this gap and to provide readers a practical guide in evaluating the cardiovascular literature. Scopus Library database was searched to determine the citations of all published cardiovascular articles. One hundred two journals were included in our investigation under the Institute of Science Information Web of Science subject category “cardiology, cardiovascular, and heart.” We did not apply any time or study-type restriction in our search. The top 100 cited articles were selected and analyzed by 2 independent investigators. The journal with the highest number of top 100 cited articles was Circulation with 36, followed by 28 in the European Heart Journal. A statistically significant association was found between the journal impact factor and the number of top 100 cited articles (p <0.005). United States had the highest number of articles (49). Contrary to bibliometric analyses published in other medical fields, the largest subset of the cardiology articles (n = 42) was published in the 5-year period from 2006 to 2010. General medical journals such as The Lancet (n = 4) and The New England Journal of Medicine (n = 1) contributed only 5 articles to the list despite their extremely high impact factors. In conclusion, our analysis provides an insight on the citation frequency of top cited articles published in cardiovascular medicine to help recognize the quality of the works, discoveries, and the trends steering cardiology.

Concepts: Medicine, Academic publishing, Nature, Impact factor, The Lancet, Bibliometrics, The New England Journal of Medicine, Journal of the American Medical Association


In times of globalization there is an increasing use of English in the medical literature. The aim of this study was to analyze the influence of English-language articles in multi-language medical journals on their international recognition - as measured by a lower rate of self-citations and higher impact factor (IF).

Concepts: Bibliometrics, The New England Journal of Medicine


Background:Although randomized controlled trials (RCTs) are considered as the highest level of evidence, they are also subjected to bias due to a lack of adequately reported randomization and therefore the reporting should be as explicit as possible for readers to determine the significance of contents. Our aim is to evaluate the methodological quality of published RCTs in respiratory research from high ranking clinical journals in 2010.Methods:The methodological quality, including generation of the allocation sequence, allocation concealment, double-blinding, sample size calculation, intention-to-treat analysis, and flow diagram in RCTs published in twelve top ranking clinical respiratory journals and five top ranking general medical journals were assessed. The number of medical centers involved, sample size, disease areas, type of the funding source, type of the intervention, registration status, times cited count, journal impact factor, journal type, and CONSORT endorsed status of each trial were also retrieved.Results:176 trials were included in the final analysis, in which 93 (53%) reported adequate generation of the allocation sequence, 66 (38%) reported adequate allocation concealment, 79 (45%) were double-blind, 123 (70%) reported adequate sample size calculation, 88 (50%) reported intention-to-treat analysis, and 122 (69%) reported flow diagram. Multivariate logistic regression analysis revealed that impact factor≥5 was the important factor influencing the adequate allocation sequence generation. Registration and impact factor≥5 were the important factors influencing the adequate allocation concealment. Medical intervention, registration and journals endorsed CONSORT were the important factors influencing the adequate double-blinding. General medical journals publication was the important factor influencing the adequate sample size calculation.Conclusions:This study shows that the reported methodological quality of RCTs in respiratory research still needs improvement. Stricter adoption of the CONSORT statement might enhance the reporting quality of RCTs.

Concepts: Pharmacology, Experimental design, Epidemiology, Clinical trial, Randomized controlled trial, Pharmaceutical industry, Clinical research, The New England Journal of Medicine