Future of CMAJ may depend on publishing research

Canadian Medical Association Journal 1996; 154: 755-764

[Letters]

I write this letter with good intentions, as a supporter of CMAJ. During this period of heavy financial cut-backs, I am concerned about the future of the journal. I am sure that many of your readers agree that our national medical journal should continue to provide political and social commentary on Canada's health care system as well as the personal reflections of the CMA's individual members.

However, I feel strongly that CMAJ fails to offer itself as a journal dedicated to the publication of high-quality research, from within and outside Canada. Few articles report randomized controlled trials, meta-analyses, quality-assurance projects or cases. There is also a paucity of review articles on general topics, like those published in national medical journals in Australia, Britain, Ireland and the United States. These types of articles should be the main focus of CMAJ. Instead, readers are inundated with many commentaries and articles by freelance writers.

The day may come when members of the CMA are asked to vote on the future status of CMAJ. If that happens, I hope that CMAJ will be there as both a reputable scientific forum and a medium for outstanding patient care, bringing Canadian medical researchers and clinicians together.

Joel Ray, MD
Senior resident
Department of Medicine
McMaster University
Hamilton, Ont.

[The associate editor-in-chief responds:]

Dr. Ray may not be aware of a few facts about CMAJ. According to the 1993 Institute for Scientific Information database that ranks journals by "impact factor," CMAJ is in the top 25% of the world's medical journals. Among general medical journals, it is 14th in the world. The impact factor of CMAJ has increased by 33% in the last 8 years. We believe this speaks to the quality of the research published in our journal.

CMAJ differs significantly from most Canadian journals in its editorial mandate and scope. In addition to scientific peer-reviewed material, it also publishes news and features relevant to physicians. We could not quite understand Ray's complaint about "many commentaries and articles by freelance writers." These are generally the news and features articles that "provide political and social commentary on Canada's health care system," which he extols at the beginning of his letter.

We usually publish only one scientific editorial per issue -- fewer than in similar journals. We have been a leader in publishing clinical practice guidelines and we specifically eschew "review articles on general topics" because these have been shown to lack comprehensiveness and tend to be biased. In addition, we have encouraged the publication of systematic reviews, which appear with increased frequency in the journal.

This is not to say that we could not do better. Like many Canadian enterprises, we are at a disadvantage because of the widespread belief that, to prove oneself professionally, one must seek recognition outside the country. This belief thrives only because it is accepted. We encourage Canadian researchers to reject this outdated notion and to have a little more national pride. Only by working together can we make CMAJ reach its potential and offer the best of Canadian medicine to its readers.

Patricia Huston, MD, MPH
Associate editor-in-chief

| CMAJ March 15, 1996 (vol 154, no 6) |