CardioExchange Archive

One of my cardiology colleagues seemed hard at work at his computer recently. “Working on that paper for the New England Journal of Medicine?” I joked. “No,” he replied, “I’m writing a review for the Journal of Atrial Fibrillation.”

I had never heard of this journal and, in an attempt to feign familiarity, nodded knowingly.

Getting back to my desk, I Googled the journal and was transported to a fairly busy website with articles by experts, news about atrial fibrillation, and numerous links for article submission. There was even an adjoining afib blog and patient page. The only thing missing was a section on subscriptions, generally the lifeblood of a publication. This, I found soon enough, was because it is an open-access, online-only journal.

The exercise made me curious about how many cardiology journals existed.

I searched the internet for published subspecialty cardiology journals, and lost count at about 150. Considering that a significant percentage of cardiology-related research is published in general medicine journals, it struck me as a fairly high number.

Surely, even 150 journals should be more than enough to house the research endeavors of cardiologists worldwide worth publishing.

Apparently not.

Instead of decreasing or staying constant, the number of journals has exploded over the last decade, with new publications at all ends of the quality spectrum. The leading cardiovascular journals — Circulation, JACC, and the European Heart Journal — have spawned a family of subspecialty journals, growing from 3 to 20. Numerous other journals, many of them open-access/online-only, have emerged.

While high-quality publications like the New York Times and Newsweek are on the road to bankruptcy, even middle-tier journals can stay viable while charging exorbitant amounts for subscriptions. Annual subscriptions can range from $170-$400 for 12 issues (by comparison, a subscription to the Economist costs $160 for 51 issues).

Several questions come to mind:

What has caused this upsurge in number of journals?

Are many of these studies helping advance the field or just overwhelming us with data?

Should there be any barriers to the creation of online open-access journals?

Does creating more subspecialty journals contribute to the creation of too much information, about small aspects of the field, such that specialists move closer to “knowing everything about nothing”?

In this state of information overload, how should cardiologists keep up with new findings?

The point can be made that more data improve clinical decision-making, and therefore, patient care. However, this may not necessarily be the case, as columnist David Brooks pointed out in a recent New York Times op-ed:

As we acquire more data, we have the ability to find many, many more statistically significant correlations. Most of these correlations are spurious and deceive us when we’re trying to understand a situation. Falsity grows exponentially the more data we collect. The haystack gets bigger, but the needle we are looking for is still buried deep inside.

That said, perhaps the driving force for more journals can be best described by some sage advice my mentor gave me recently: “A publication is a publication.”