Readers’ editor: Influence beyond the impact factor

David PayneThe BMJ’s impact and influence should be measured by more than just established metrics such as impact factor.

But the new figures, released two weeks ago, are very welcome. The journal’s impact factor rose more than 20% to 17.215. My first thought on discovering this was that a strategic aim to increase the impact of the BMJ’s scholarly content is starting to pay off.

The new figure makes the BMJ the most highly cited open access general medical journal in the world, now higher than PLoS Medicine and puts it in the top four general medical journals, above the Annals of Internal Medicine. This is due in part to a conscious drive to publish research that will be highly cited as well as widely read by clinicians around the world.

But authors also value media coverage alongside measures such as impact factor, and articles in the BMJ get namechecked regularly in UK and international newspapers, magazines, blogs, and broadcast channels. This blog aims to illustrate the ripple effect caused by media coverage and the debate it can engender, both in the BMJ and beyond.

Mostly these are triggered by an article being referenced in a press release, but not always. Each week the BMJ press team sends an update of the most recent media mentions.

Let’s start with nickel allergy. Last week’s included a BBC Health Check online feature about nickel allergy and new coins which cites a letter published in the BMJ.

The letter, published in April 2012, was about the UK Treasury’s plans to introduce Royal Mint nickel-plated coins. The authors, from St John’s Institute of Dermatology and the Royal Hallamshire Hospital in Sheffield, said there has been no assessment of the new coinage which is being brought in to save costs. Letters aren’t routinely press released by the BMJ press team, but this one was.

Secondly, neither Treasury officials nor the Royal Mint had considered the potential costs to health in terms of skin disease, financial implications to the NHS, or other costs to the taxpayer. Sweden, in contrast, had concluded that nickel-plated coins pose unacceptable risks to health. It will stop producing any nickel-containing coins from 2015.

The BBC story was pegged to a new study published in the Wiley journal Contact Dermatitis. The study compares the performance and allergy risk of the new nickel-plated coins (five and ten pence) with those of the cupro-nickel coins being replaced. The study was also covered in the Dail Mail and by WebMD on the Boots website.

A Royal Mint spokeswoman told the BBC it was satisfied that there was no increased risk of people developing nickel allergy by handling the coins. Not so, say the authors of the Wiley study.

A second story published in the mainstream press last week was a call to ban junk food and fizzy drinks in hospitals. The topic was debated at the British Medical Association’s annual representive meeting in Edinburgh, covered in the BMJ, and national news outlets including the Daily Mail and Mirror.  The story was also covered on Sky News, BBC News online and in The Guardian, Huffington Post, The Scotsman, Medical News Today, Top News USA and Health Service Journal.

The calls were led by Aseem Malhotra, interventional cardiology specialist registrar, Royal Free Hospital, London, who had written a BMJ Observations column to support his argument.

Retired GP Francois Fouin described the high rate of obese NHS staff as a “national disgrace” in his online response to Dr Malhotra’s column. Those of us who are old enough will remember our years in hospital enthralled by the nursing profession when prestigious hospitals only recruited the smartest in mind and body.” he added.

In a separate response, psychiatry core trainee Thomas Burden said: “There is evidence that dietary interventions and a healthy diet may help to treat or prevent antipsychotic-induced weight gain. Despite this, most psychiatric hospitals continue to serve patients calorifically-dense meals of poor nutritional value. I believe that this needs to addressed urgently.”

Thirdly, a BMJ research paper published last week investigated the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer.

The accompanying press release, “Fatty acids found in fish linked to lower risk of breast cancer,” helped to ensure the story got widespread coverage across the globe (Daily Telegraph, The Mirror, Hong Kong Standard, The New Age, iAfrica, Business Standard, Daily Mail, and Bangkok Post).

Finally, Glasgow GP Margaret McCartney’s argued in a recent Medicine and the Media that the NHS and some UK royal colleges profit by selling commercial advertisers access to pregnant women through promotions such as Bounty bags.

The article sparked a lively debate on the BMJ website but also led to a blog from Finnish Medical Journal medical editor in chief Päivi Hietanen and news editor Jaana Ahlblad about the cardboard baby boxes distributed there.

The box doubles as a cot and was commended in a BBC News Magazine article. An image of the box and its contents was also chosen as our print picture of the week last week. Margaret’s column was picked up by “househusband” blogger Daniel Owen as well as dozens of national news  media titles , culminating in a letter from health minister Dan Poulter to NHS chief executives in England urging them to review their systems for allowing sales people to have access to new mothers.

David Payne is readers’ editor and editor of