The Internet & Healthcare Education: HELIX

With the advent of the World Wide Web (WWW), we are now on the cusp of a revolution in computer technology that will dramatically enhance medical education. An historical analogy might be Johann Gutenberg's invention of movable type in the 1400's-radically decreasing the cost, time, and expertise required to reproduce printed materials. Now, the WWW can decrease the cost of disseminating medical educational materials. When an educational module is authored for the Web, it can be placed on a computer "server" which in turn, distributes the program on the WWW to anyone with a computer and Internet access. Rapidly emerging standards are being developed to allow increasingly rich educational experiences on the Internet. With the introduction of HTML (hypertext markup language), a standardized method of placing text and graphics, as well as the connections between them, was created.

Predicting the DSM-V

Using regression estimates based upon data about past editions of the DSM, we predict various features of the DSM-V. Included in these predictions are the date of publication, number of pages, total number of categories, number of categories defined using diagnostic criteria, total number of diagnostic criteria, color of the manual, who will be in charge of the task force that creates the DSM-V, and revenues generated by the DSM-V. This article ends with comments on the changes in the editions of the DSMs and an analogy to the Sorcerer's Apprentice.

Economics of publishing

Images

Good manners win out

Disputes about priority have no place in the seemly publication of research data.

Funding in the emergency medicine literature: 1985 to 1992

STUDY OBJECTIVE

To examine the rate and source of funding of research articles published in the emergency medicine literature.

DESIGN

Review of all nonmilitary US research articles published in Annals of Emergency Medicine, American Journal of Emergency Medicine, and Journal of Emergency Medicine during the years 1985 and 1992.

METHODS

Data on research methodology, number of authors, number of institutions, and funding source were collected.

MEASUREMENTS AND MAIN RESULTS

One hundred sixty-nine articles met the entry criteria published in 1985, and 207 met the criteria in 1992. Retrospective studies, case series, clinical trials, and laboratory studies were the most common research methodologies in both years. The number of multicenter studies increased between the two years (P < .006). The rate of funding increased from 21.3% in 1985 to 29.0% in 1992. The funding sources, however, did not change significantly between the two years. Funded studies published in the emergency medicine literature are less likely to be federally funded and more likely to be funded by industrial sources than studies published in the literature of other specialties.

CONCLUSION

The majority of research articles published in the three journals during the two years did not list a source of funding. This is in contrast to other specialties, in which the majority of published research is funded. The emergency medicine literature relies more heavily on private industry funding than does the literature of other specialties.

[Evaluation of the results of the research funded by the Health Research Fund in 1988]

BACKGROUND

To analyse the scientific product of research projects funded by Fondo de Investigación Sanitaria in 1988 emphasizing its relation to money granted.

METHODS

270 out of 610 projects were evaluated in relation to the amount granted. The number of papers published to each project and the impact factor assigned to the journals where these papers were published; we also assessed the mean cost of papers and impact factor units. These projects were coded following UNESCO classifications, and papers as per ISI standards.

RESULTS

A total of 95 projects out of the 270 analysed produced no papers; the other 175 projects yielded 471 articles (2.7 per project); the mean cost of each article was 1.1 million pesetas, or 0.8 million if only the productive projects were considered. These papers reached a total of 818,709 impact factor units; the mean cost of the impact factor unit is 660,796 pesetas, or 459,626 pesetas if only productive projects are considered.

CONCLUSIONS

Non productive projects were those that received less funding. 33% of projects produced papers published in journals with an assigned impact factor equal or inferior to one. There are evident differences among areas of knowledge in terms of impact factor. This study must be completed with a statistical analysis of reported data.

Psychotherapy and addiction: a survey of journals

A content analysis was done on 1,239 articles published from 1984 to 1987 in seven leading alcohol and addiction journals to ascertain the frequency of articles on psychotherapeutic treatment published relative to other treatments for alcohol and drug dependence. Therapeutic intervention articles account for less than 10% and psychotherapy treatment articles for less than 3% of the articles analyzed. Postulations such as the effects of a prevailing acceptance of the disease model to level of practitioner sophistication are made about this relatively small number. Nontherapeutic treatment articles are classified according to research methodology. Suggestions for research are made.

Reprint requesters and providers in radiology

After the publication of any medical paper, its authors normally receive requests for reprints. An analysis was performed to determine the geographic origin of requests, the frequency of requests and the response rate for individual requesters, the additional work that these requests entail for major authors and some of the associated costs. A total of 209 consecutive reprint requests received over a 11-month period for radiologic articles written by one of the authors of this paper were reviewed. Overall, 45% of the requests originated in the United States, 22% in Western Europe (excluding Britain), 19% in Eastern Europe, 8% in Canada, 4% in Britain and 2% collectively in India, Cuba and Mexico. A questionnaire was sent to each requester; 122 (58%) replied. The respondents requested between 3 and 2000 reprints each year; respondents from the United States requested by far the most reprints. The respondents received reprints for between 25% and 100% (mean, 70%) of their requests. The requesters found the articles in the original journal in 41% of cases, in Current Contents (ISI Press, Philadelphia) in 34%, in both the journal and Current Contents in 23% and in other sources in 2%. Twenty-seven of 39 frequently published authors (69%) replied to a questionnaire about the requests they received; 19 reported receiving at least 100 requests and 4 at least 500 requests every year. Inquiries to 29 radiologic journals about the cost of reprints and the frequency of requests for additional copies yielded 18 replies. Twelve journals provided free reprints, and for the other 6 the average cost of 100 reprints was $90 (Can) when the reprints were ordered at the time of the original printing (as offprints).

Cigarette advertising policy and coverage of smoking and health in British women's magazines

A survey of cigarette advertising and coverage of health aspects of smoking in 86 British magazines with a large female readership was done in 1989. The findings were compared with the results of a 1985 survey which had led to the introduction of new voluntary restrictions in 1986 on cigarette advertising in magazines. Although there was a decrease in the proportion of magazines accepting cigarette advertising (64% to 42%), the new restrictions failed to cover the most popular magazines, so that an estimated collective readership of 7 million women aged 15-24 years were still exposed to cigarette advertising. Revenue from cigarette advertising by women's magazines increased by 10% in real terms between 1985 and 1988. There was a small decrease in the coverage given to health aspects of smoking; a third of magazines were willing to use pictures of people smoking in their editorial pages. The findings show that the voluntary restrictions introduced in the UK in 1986 have had a small effect on cigarette advertising and have failed to achieve their aim of protecting young women.

The electronic journal for dentistry

Electronic publishing is expanding very rapidly and will soon substitute in part for the traditional role of paper and printing in accessing information and in its library storage. This change is occurring now for medicine and engineering. For dentistry the compact disc (CD-ROM) would have advantages over tape or on-line computer systems; one or two discs a year could hold all current dental journal and textbook literature. The setting of standards is the key to the successful introduction of this technology through production and playback systems. Indexing, retrieval and hardware are considered as well as copyright problems. The profession has the chance to guide the introduction of this publishing system in preference to it being fragmented between multiple publishers and thereby becoming costly. A proposal is offered which includes the nexus of traditional printing with this new publishing form through a forum for considering standards and goals for agreement on principles.

Productivity of sustained research funded by the Medical Research Council of New Zealand during the period 1973-84

From 1973-81, Medical Research Council funding for sustained research rose from $1.6 to $4.4 million per year but, during 1982-84 fell to $3.8 million. Corrected for inflation, this funding was constant until 1982-84 when it fell by one-third. Publications increased from about 190 in 1974 to a peak of about 310 in 1980 but fell to 200 during 1982-4. Grantees who failed to publish took about 16% of sustained project grants and 10% of such funding. The average cost of an article rose from $5500 in 1973 to $20,000 in 1983/4 but, in real terms, the cost in 1984 was two-thirds of that in the mid-1970's. Cost of publications from Auckland increased steadily from 1973-84. Those for Dunedin remained constant from 1974-80, but increased to exceed $20,000 in 1982-84. From 1973-78, articles from Wellington cost $12,000 but this rose to $20,000 thereafter. Costs in Christchurch increased from $2500 in 1973 to $12,000 in 1984. Inflation-corrected costs per publication from Auckland, Wellington and Dunedin have shown a downward trend while those from Christchurch showed a slight increase.

The literature of American internal medicine: a historical view

The literature of medicine is shaped by social and intellectual forces as well as by scientific discoveries. In America, the literature of internal medicine evolved gradually in response to changes in the structure and philosophy of medical education and the growing emphasis on research during the past century. When careers in medical education and research became possible through philanthropic and government support, Americans became more productive in research. As academic advancement came to depend primarily on publication, the literature of American internal medicine expanded dramatically. The current scope and character of the medical literature also reflect the persistent trend toward specialization and subspecialization that began more than a century ago. Although medical journals have been the most important medium for the publication of new medical knowledge for nearly 200 years, recent dramatic advances in the technology of information storage and transfer promise to undermine their primacy.