In the current age of information overload, how does a physician determine the best source of information for his or her specialty? Given a finite amount of time but an increasing amount of information, what should be the selection criteria for educational input? With thousands of journals available, how is the value or importance of a scientific journal determined? All of these questions lie at the center of a centuries-old issue: Where does one obtain the most original, most significant, and most clinically relevant scientific results? In the mid-1930s, S. C. Bradford realized that the core literature for any given scientific discipline was composed of fewer than 1000 journals.1,2 Of these 1000 journals, only a few have a strong relevance to the given topic, while there are many with a weaker relevance to it. Those with a weak relevance to the given topic, however, usually have a strong relevance to another discipline. Thus, the core scientific literature forms itself around various topics, with individual journals becoming more or less relevant depending on the topic. Bradford found that a small core of essential journals forms the literature basis for all disciplines; furthermore, most of the important papers are published in relatively few journals. More to the point, recent citation analyses have shown that as few as 150 journals account for half of what is cited and one quarter of what is published. A core of 2000 journals now accounts for 85 percent of published articles and 95 percent of cited articles.1 The question remains: how does one determine the value or importance of a scientific journal? One of the primary means is the journal's "impact factor," which is determined by the Institute for Scientific Information. DEFINITIONS Institute for Scientific Information (ISI) A database publishing company that publishes Current Contents and Science Citation Index. The institute's database covers more than 16,000 international journals, books, and proceedings in the sciences, social sciences, and humanities. Its mission is to provide comprehensive coverage of the world's most influential and important research. Science Citation Index (SCI, also called "Journal Citation Report") One of the databases created by the Institute for Scientific Information that focuses exclusively on scientific publications. It provides current and retrospective bibliographic information, abstracts, and cited references from 3700 of the world's leading scholarly science and technical journals, covering more than 100 disciplines. It utilizes rigorous, ongoing selection criteria to maintain a dynamic listing of journals in its database, including editorial content, quality of peer review of journals, timeliness of publication, English language accessibility, international diversity, and sophisticated citation analysis. Impact Factor A measure of the frequency with which the "average article" in a journal has been cited in a particular year. This factor is a ratio between the citations and recent citable published articles, calculated by dividing the number of all current citations of articles published in a journal during the preceding 2 years by the total number of articles published in those 2 years. In short, it is a ratio of citations and recent citable articles published.3 The higher the number, the greater the impact factor; the greater the impact factor, the more "scientifically prestigious" a journal is; the more prestigious a journal, the greater the desire on the authors' part to submit papers to that journal for publication. PRACTICAL IMPLICATIONS OF THE SCIENCE CITATION INDEX As implied above, journals with a higher impact factor are considered to be more prestigious than those with lower impact factors. The average article in such journals is cited more frequently than those in "lesser" journals. Because researchers want their results disseminated as often and as broadly as possible, they will want to send their papers to those journals that have the higher impact factors. Publication in journals with higher impact factors is important not just for individual researchers. Tenure and promotion committees, research grant selection committees, committees that document intellectual property, and faculty committees that document academic productivity all take seriously the impact factor. Publishing articles in journals with high impact factors is a hallmark of academic achievement; it correlates highly with the opinion of peers as to a scientist's contribution to his or her field, and is used for promotional and grant reviews.4 Having articles cited completes the chain of publication, which itself underpins the evolution of scientific knowledge. In addition, a researcher can use the impact factor to help select what literature to search for any given subject. A high impact factor for a journal can serve as a selection criterion to help researchers weed out lower-quality journals.5 PLASTIC AND RECONSTRUCTIVE SURGERY'S IMPACT FACTOR The most recent Journal Citation Report was issued on June 22, 2005, and provided the Journal's impact factor for 2004 (the impact factor score always lags behind by 1 year). The 2004 impact factor for this Journal was 1.872, compared with 1.629 for 2003. In 2004, this Journal ranked thirty-third out of 139 surgical journals, compared with fortieth out of 141 surgical journals in 2003. Journal articles were cited 14,107 times in 2004, compared with 12,050 citations in 2003. For comparison, the top surgical journal in 2003 was the Annals of Surgery, with an impact factor of 5.937. Table 1 lists a selection of subspecialty specific journals especially pertinent to plastic and reconstructive surgery.Table 1: Journals Pertinent to Plastic and Reconstructive SurgeryAll of these journals, and others, form the core literature for plastic and reconstructive surgery. Some plastic surgery journals, which are good sources of plastic surgery information, unfortunately are not indexed by the Institute for Scientific Information. Thus, they do not qualify for an impact factor and are not listed in the Citation Index. LIMITATIONS ON THE VALUE OF THE IMPACT FACTOR SCORE Lumping the specialty-specific journals that pertain only to plastic and reconstructive surgery in with all surgical titles, and then assigning them a number (either an impact factor or a ranking within the overall surgical field), is somewhat misleading. Elite journals that cover a broad general field can be highly selective in the articles they publish, because they are not restricted to a specific area within medicine but cover the field as a whole. Hence, it is not surprising that they carry articles of generally high quality and citability.3 Specialty journals, on the other hand, deal with a specific field and are committed to covering a wide range of topics within that particular field. In addition, they are committed to publishing articles of a confirmatory nature that back up original research. This sort of article does not result in press releases and is not featured in national news stories. (Interestingly, an article in the New England Journal of Medicine found that coverage of medical research in the popular media amplified the effects of that research on the scientific community. Articles in New England Journal of Medicine that were covered by The New York Times received a disproportionate number of scientific citations in each of the 10 years after the New England Journal of Medicine articles appeared.6) Another area of potential skewing of the impact factor comes into play with foreign language publications. Much high-quality scientific literature published in foreign languages is not included in the English-language databases. Studies conducted regarding articles published in French,7 Spanish,8 and German9 all found the impact factor to underestimate the value and importance of such foreign language research. For a number of reasons, articles in specialty journals can vary in quality and immediacy more than those in general journals. For this reason, it is inappropriate to compare such specialty journals with the general and review journals. The overall quality and strength of a scientific journal can, and should, be calculated based on a number of metrics, not just the journal's impact factor. Other objective metrics include the journal's circulation, both to relevant society members (if the journal is a society journal) and to nonsociety or nonspecialty members. The online presence and availability of a journal's content, especially on globally disseminated databases such as Ovid, serve as an important index of a journal's position in the literature. Advertisement sales are often an important measurement of a journal's importance and strength. The number of pages published in a year can serve as an indication of a journal's strength and importance in the field, as can the international diversity of the authors who submit and publish in a journal. All of these components, in addition to the impact factor, help form an overall picture of a publication's strength. Fortunately, in all of these categories, Plastic and Reconstructive Surgery remains the leader in the field of plastic and reconstructive surgery. THE PHILOSOPHICAL ISSUE AND PLASTIC AND RECONSTRUCTIVE SURGERY We return then to the real issue that underlies the impact factor: what are the best sources of clinically and scientifically important plastic and reconstructive surgical literature? The importance of reading journal articles for clinical care is evident. The increasing number of journals from which important and relevant articles are found, combined with the decreasing number of personal subscriptions, makes it more important than ever for physicians to choose carefully which journals to subscribe to and read.2 This decision should not be based on intuition alone. Plastic and Reconstructive Surgery is dedicated to being the best single source of relevant clinical and scientific information for plastic surgeons worldwide. We are committed to providing the plastic surgery community in particular and the broader medical community in general with better articles based on more stringent and demanding review criteria. Interestingly, since I became Editor-in-Chief and since the entire process of submitting and reviewing manuscripts for publication in the Journal went online via Enkwell, there has been a dramatic increase in manuscript submissions, upward of 50 percent more submissions than the previous year. We are not able to increase either the number of issues published or the number of pages published per year. On the contrary, we are committed to decreasing our number of issues from 14 per year in 2006 to 13 per year in 2007 and 12 per year in 2008. Because the number of issues and pages we publish per year will decrease, we naturally have to dramatically increase our rejection rate to accept only the best of the best articles. This is also what you, the reader, want from the Journal, as indicated in our reader surveys. Readers have indicated that they want more quality and less quantity, more articles with online videos, and evidence-based studies that scientifically document how the practice of plastic surgery can improve and not merely articles that express one expert's opinion. You have also indicated that you want more review articles on special topics related to your clinical practice, as well as basic research that would improve patient care and safety. The Journal will deliver these kinds of studies. We are increasing our article rejection rate and are accepting only the best, most significant and important articles that feature novel information. We are working on improving the timeliness of publication of articles we accept; we are going to dramatically reduce the time from acceptance of an article to the time of publication. This improvement will give Plastic and Reconstructive Surgery articles greater immediacy. Also, we will intensify our cooperative efforts with the American Society of Plastic Surgeons to have more lay-press exposure for articles published in the Journal. Along with this, we will continue our efforts to appeal to a broader subscriber and readership base in related specialties (such as dermatology, oculoplasty, and otolaryngology). Lastly, we are dedicated to make improvements to the delivery of articles via both the online and print modalities. Plastic and Reconstructive Surgery is committed to improving its impact factor score. We believe that the score will increase through our commitment to providing all manuscripts with rigorous, stringent peer review, meeting high standards of excellence, and shortening the time from acceptance to publication. We believe that Plastic and Reconstructive Surgery offers the best articles in the field, and we think that the best guarantee of quality of articles lies not in the Journal's impact factor score but rather in the peer review process we give to all manuscripts. That is why we salute our Editorial Board, Section Editors, and the more than 500 reviewers annually who continue to help make and keep Plastic and Reconstructive Surgery strong and the most consistent and optimal source of information for all of plastic surgery. For the benefit and improvement of plastic surgery worldwide, we continue to encourage authors to send their quality and potentially landmark papers to the Journal.
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Rohrich et al. (2006) studied this question.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: