In 2009, two polls asked their respondents essentially the same question: Which are the medical journals most important to your life’s work?
The two groups separately reporting back were first, MDs with specific medical specialties or special responsibilities within medical administration. These doctors typically read a mix of journals consisting of few of the most important general medical journals and several others more narrowly focused on their particular specialty.
The second group polled were biomedical librarians. Spending several billions of dollars annually within the US alone, they subscribe both to many general medical titles as well as to many other journals across a wide variety of clinical specialties. Despite the magnitude of their collective expenditures, individual biomedical librarians generally have to live within fairly tight budgets for those libraries they administer on behalf of medical schools and of the teaching hospitals with which they have an affiliation, and of necessity, have become experts at buying the best journals first.
The New England Journal of Medicine’s “Essential Journals Study”
The firm polling the doctors was the Matalia Group, Inc., an independent research firm, hired by the Massachusetts Medical Society, publishers of the New England Journal of Medicine. They had successfully done this work before for the association. While its sponsorship was not known to the medical poll takers, the poll’s underlying purpose was to find out where the New England Journal of Medicine placed in the poll respondent’s opinions in several medical specialty areas. They asked questions seeking to determine whether it was among those journals read first, read the longest and most closely, and/or re-read most often, compared to its competition. The data was reported to the advertising sales group within the journal, and then to potential advertisers, in a publication entitled “2009 Essential Journals Study.”
The NEJM poll is available at http://nejmadsales.org/html/marketresearch.html
The SLA DBIO 100 Poll
The group which polled the biomedical librarians is the sponsor of this blog, the BioMedical and Life Sciences Division (DBIO) of the Special Libraries Association. The poll sought to identify the 100 most influential journals over the last 100 years in three broad areas of biology and medicine,.
They also determined which journals were voted in the top 10, which was the publisher of the Centennial, and which was the Journal of the Centennial.
Since the DBIO 100 poll sought to cover many areas of biology in addition to clinical sciences within its self-limited roster of 100 winners, by design, only 33 of the journal finalists in the poll could come from medicine.
Furthermore, only 3 could be selected from among those 33 for the top 10.
And of course, only one journal of any type of biology or medicine could be named the journal of the Centennial.
(In the interests of full disclosure, I conceived the poll, recruited the expert panels who drew it up, edited the final version, and was the reporter of the results.)
For an electronic listing of the DBIO 100 winners: click on http://units.sla.org/division/dbio/publications/resources/dbio100.html
For a more detailed analysis see: Tony Stankus & Sarah E. Spiegel. 2009. The SLA DBIO 100 Poll: 100 Journals voted by SLA’s BioMedical and Life Sciences Division as the most influential over the last 100 years. Serials Review 35 (4): 202-212.
Are the Polls Directly Comparable?
There are several areas in which the polls differ.
First the NEJM poll focused on fourteen different medical specialties or user groups, not all of which were covered within the DBIO 100 poll.
Most notably, the NEJM poll included the fields of Hospitalists (doctors employed full-time on the wards , taking over the care of patients from their personal physicians) and Formulary Committee members (doctors who decide which drugs are recommended and kept in stock for dispensing for patients while they are in the hospital). The latter two groups are particularly important to the NEJM’s advertising team, because the bulk of advertising in the NEJM (and in most other medical journals) is for drugs, including those that are regarded as best for use on patients within hospital settings.
The DBIO 100 poll allowed for 30 areas of clinical interest, including many not covered as separate entities in the NEJM poll. Examples included Dentistry, Dermatology, Emergency Medicine, General Surgery, Geriatrics, Intensive Care, Neuropsychology, Nursing, Nutrition, Obstetrics & Gynecology, Pathology, Pediatrics, Physical Therapy, Psychiatry, Public Health and Radiology.
In some areas, the DBIO 100 poll combined fields within a single voting category. Examples include Urology + Nephrology, and Bone & Joint Diseases (Orthopedics + Rheumatology), or in somewhat different groupings: the DBIO 100 used two sections consisting of Hematology & Leukemia and General Oncology while the NEJM featured three separate categories for Hematology, Hematology/Oncology & (General) Oncology. The NEJM subsumed Emergency Medicine within Pulmonology while the DBIO100 kept those two fields distinct.
By contrast with the NEJM poll, in the DBIO 100 poll, journals of general clinical investigation, constituting the most crowded field of the entire poll in terms of the number of entries nominated by the expert panel that designed the ballot, were allowed four winners, not just one.
Finally, while the NEJM poll fixed the fields of medical practice that would be surveyed, it did not rely on having respondents choose from a list of nominated titles. It asked the voters to think on their own of the titles that came to mind fist or most often, and then rate them in certain ways. It is a remarkable tribute to the NEJM that it was constantly on the mind of so many practitioners in so many fields.
Despite these differences, there is enough overlap to test whether or not, doctors and the medical librarians who serve them in teaching and research, are on the same page in terms of journals they regard as essential and influential.
General Internal Medicine & Clinical Investigation
While the vote in this category was close in the DBIO 100 poll, The New England Journal of Medicine ranked first in this category, just as it did in its own poll.
Not only did the NEJM make the overall top 10 in the DBIO 100 poll, it ranked number two in the overall Journal of the Centennial race among all journals of biology and medicine, losing only to the journal, Nature.
Other journals that placed well in the NEJM poll in this category included JAMA: the Journal of the American Medical Association (which almost tied with the NEJM in the DBIO 100 poll), the Annals of Internal Medicine, American Family Physician, the American Journal of Medicine, the Archives of Internal Medicine and four others. Not too surprisingly, the expert panel that composed this category for the DBIO 100 poll included all of these titles on the ballot.
The DBIO 100 poll also voted in as winners two other journals not even mentioned in the NEJM top 10 in this General Internal Medicine and Clinical Investigation category: The BMJ: British Medical Journal and The Lancet.
In the DBIO 100 poll the BMJ joined with the NEJM and JAMA in filling in the three slots of the clinical sciences contribution to the overall top 10.
It should be noted that in addition to its strong showin in the DBIO 100, The Lancet made numerous appearances throughout the NEJM poll, placing well in among members of Formulary committees, as well as among gastroenterologists, hematologists, neurologists, and oncologists.
The NEJM’s poll respondents voted the Journal of the American College of Cardiology their first choice as an essential journal. (Not surprisingly, they voted the NEJM their second place choice, even though it is not primarily a journal of cardiology.) Remaining journals more specifically focused on cardiology followed in this order: Circulation and the American Journal of Cardiology.
The DBIO 100 results flipped the top of the sequence somewhat: In this exclusively cardiovascular section, Circulation was first, followed by the Journal of the American College of Cardiology, followed by the American Journal of Cardiology. Experts constructing the DBIO 100 poll also included titles not mentioned in the NEJM poll: Circulation Research, the European Heart Journal and Cardiovascular Research which finished in that sequence.
While in the NEJM poll, the NEJM itself was voted as the most essential title by endocrinologists, the title specifically devoted to Endocrinology that they ranked as most essential was the Journal of Clinical Endocrinology & Metabolism. This was followed by other endocrinology titles in this descending order: Diabetes Care, Endocrine Practice, Diabetes, Thyroid, Endocrinology, and Endocrine Review.
In the DBIO 100 poll, in this section which limited itself strictly to Endocrinology, the Journal of Clinical Endocrinology & Metabolism easily finished first. Following this were Diabetes Care, Diabetes, Endocrinology and Cell Metabolism, this last not a title mentioned in the NEJM poll.
The journal Gastroenterology won big in both the NEJM and DBIO 100 polls. The American Journal of Gastroenterology followed suit in second. The most notable difference between the two polls was the third place finish of Gut, the British leader, in the DBIO 100.
Hematology, Hematology/Oncology, and General Oncology
The NEJM poll featured separate categories for Hematology, Hematology/Oncology, and General Oncology, but there was a great deal of overlap in responses. The Journal of Clinical Oncology topped all three groups and the journal Blood followed as the next specialty journal. These were trailed by Oncology, Cancer or Clinical Cancer Research in slightly different orders depending on which NEJM poll group was being checked.
The DBIO 100 poll also chose as a leader Blood (in its own Hematology & Leukemia category) but then flipped, choosing Cancer over the Journal of Clinical Oncology in deciding its first and second place winners. DBIO 100 voters also cast ballots for more research-oriented titles not mentioned in the NEJM poll, such as Cancer Cell, the Journal of the National Cancer Institute, Cancer Research, and British-based Lancet Oncology.
The NEJM and DBIO 100 polls mirrored each other in their top three finishers among journals devoted specifically to Infectious Diseases. Clinical Infectious Diseases, the Journal of Infectious Diseases, and AIDS were one, two and three in the hierarchy.
Both polls also showed votes for Antimicrobial Agents & Chemotherapy, although not in fourth place.
NEJM respondents showed a stronger “local responsibility” flavor in including more practical titles like Infection Control & Hospital Epidemiology. DBIO 100 voters were more research-oriented and cosmopolitan, favoring Emerging Infectious Diseases and British-based Lancet Infectious Diseases.
Because the DBIO 100 poll put Nephrology in with Urology, the best comparison to be made with the NEJM poll, is based on the answer to the following question: Which of the fewer Nephrology journals in the DBIO 100 poll also appeared in the NEJM poll, and in what order? Three journals were in both polls, albeit with the top two positions reversed. The DBIO 100 ranking put Kidney International ahead of the Journal of the American Society of Nephrology, with the American Journal of Kidney Disease coming in third in both polls.
Respondents in the NEJM poll favored Neurology, the Archives of Neurology, Muscle & Nerve, the Annals of Neurology, and Headache as their top five specialty neurology titles.
DBIO100 voters were partially in agreement with some changes in sequencing. Neurology was indeed number one, but the Annals of Neurology moved up into second place and then the British leader, Brain. The Journal of Neuropathology & Experimental Neurology, and British-based Lancet Neurology filled out the remainder.
Despite the somewhat separate ways in which the NEJM poll handled Critical Care as a subset of Pulmonology, a reasonable comparison with the DBIO 100 discloses the same top four in essentially the same rank order: Chest, American Journal of Respiratory & Critical Care Medicine, Critical Care Medicine, and Critical Care.
The NEJM poll put Arthritis & Rheumatism and the Journal of Rheumatology in first and second place, and when the journals of orthopedic surgery were factored out, so did the DBIO 100 voters.
· There is every reason to believe both polls when they suggest that that the NEJM is in fact, the most influential, most frequently consulted, and memorable, single medical journal in the US (and likely in the world), and that the attention garnered by its singular content exceeds or is on a par within many medical specialties with many of the more narrowly focused journals dedicated to those specialties. While this conclusion was not explicitly stated in the DBIO 100 poll, because the question was not posed directly that way, the NEJM’s placement by the DBIO 100’s voters as the second most influential journal in all Biology & Medicine over the last 100 years, implicitly gives great credence to this notion.)
· DBIO 100 voters agreed with NEJM poll respondents in placing JAMA in second place, but were more cosmopolitan in their third and fourth choices. The BMJ made its presence singularly felt in the DBIO 100 poll but did not appear at all in the NEJM poll. The Lancet did quite well in both polls, even though it led in no category.
· The DBIO 100 poll tends to confirm the NEJM poll to a remarkable degree in ranking the more specialized journals in virtually all shared specialties, with the occasional exception of some one-(or-rare) two place reversals . The same is true of the NEJM largely confirming the DBIO 100 poll.
· The principal difference between the polls tends to be one of the day-to-day awareness of journals of the two groups doing the voting. In the NEJM poll, physicians more quickly recalled and tended to vote more strongly for the journals to which they are most likely personally to subscribe, giving some preference to US based, practice-oriented titles. In the DBIO 100 poll, the biomedical librarian voters went with journals which were frequently requested or cited by those physicians who themselves published frequently, with a higher percentage of these being research journals of international high standing that are not likely to be among the personal subscriptions of the doctors.
· These are two groups of well informed professionals who are in strong general consensus agreement on the medical journals that really count.
Tony Stankus, FSLA firstname.lastname@example.org Life Sciences Librarian, Professor & Science Coordinator
University of Arkansas Libraries MULN 233 East
365 North McIlroy Avenue
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