Are we making an impact?
Authors: L. Leibovici
Journal: Clinical Microbiology and Infection (2017)

We (authors, peer-reviewers, editors and publishers) are in the business of medical publishing because we hope to make an impact. Of course authors and editors are hoping for honours and promotion: and publishers are not averse to money. But, bottom-line, the best balm to the ego is making a difference. There are really two different questions about making a difference: whether the articles we publish are good enough to have an impact; and whether the editorial process (choosing the articles, peer-review, editorial work) improves them [[1]Smith R. The trouble with medical journals.J R Soc Med. 2006; 99: 115-119Crossref PubMed Scopus (90) Google Scholar]. Does CMI make a difference? There are a few indirect indicators that we can examine. The CMI 2016 impact factor (the number of citations in 2016 of articles published in 2014 and 2015 divided by the number of source articles published in 2014 and 2015) is 5.292 (2016 Journal Citation Reports, Clarivate Analytics 2017), a rise from the 2015 impact factor of 4.575. In 2016, CMI articles were downloaded 1 883 285 times by readers, compared with 1 240 252 times in 2015. To better drill down into the data we have looked at the 177 articles published in CMI in the second half of 2016 and examined the number of times they were cited, the number of times they were downloaded and their altmetric score (the altmetric is a weighted score summing the citation of the article in social media: Twitter, media coverage, Mendeley, etc.) till June 2017. Overall the articles were cited 306 times; downloaded 66 800 times and the altmetric sum was 564. Review articles are cited and downloaded the most. Editorials and Commentaries are downloaded and have a higher mean altmetric score than original articles, but are cited less (Table 1). It was interesting to observe that the number of citations correlates with the number of downloads (r 0.4, p 0.02); but neither of these correlates to any degree with the altmetric score. People probably tweet and draw attention to piquant items; not necessarily the articles they want to read or quote.Table 1Mean citations, downloads and altmetric score, up to June 2017; for articles published in CMI during the second half of 2016ItemCitationsDownloadsAltmetricsReview3.26365.0Original article1.93242.9Research notes1.21771.1Commentary/editorial0.65393.1Correspondence0.81444.4 Open table in a new tab The most popular publications in the second half of 2016 are shown in Table 2. Again, it is interesting to note the difference between what people read (downloaded probably means at least an intention to read at leisure); what they find useful to cite; and what they draw attention to (altmetric scores).Table 2The five articles (published in the second half of 2016) with top citations, downloads and altmetrics (up to June 2017)ArticleTypeCitedDownaDownloads.AltbAltmetric score.Most cited: Parasitic helminth infections and the control of human allergic and autoimmune disorders [2]Maizels R.M. Parasitic helminth infections and the control of human allergic and autoimmune disorders.Clin Microbiol Infect. 2016; 22: 481-486Abstract Full Text Full Text PDF PubMed Scopus (96) Google ScholarReview1231203 Spectrum of excess mortality due to carbapenem-resistant Klebsiella pneumoniae infections [3]Hauck C. Cober E. Richter S.S. Perez F. Salata R.A. Kalayjian R.C. et al.Spectrum of excess mortality due to carbapenem-resistant Klebsiella pneumoniae infections.Clin Microbiol Infect. 2016; 22: 513-519Abstract Full Text Full Text PDF PubMed Scopus (77) Google ScholarOriginal article1139219 Hepatitis C: global epidemiology and strategies for control [4]Lanini S. Easterbrook P.J. Zumla A. Ippolito G. Hepatitis C. Global epidemiology and strategies for control.Clin Microbiol Infect. 2016; 22: 833-838Abstract Full Text Full Text PDF PubMed Scopus (111) Google ScholarReview114743 Human cryptosporidiosis in Europe [5]Cacciò S.M. Chalmers R.M. Human cryptosporidiosis in Europe.Clin Microbiol Infect. 2016; 22: 471-480Abstract Full Text Full Text PDF PubMed Scopus (138) Google ScholarReview94391 Emerging infections caused by non-Aspergillus filamentous fungi [6]Douglas A.P. Chen S.C. Slavin M.A. Emerging infections caused by non-Aspergillus filamentous fungi.Clin Microbiol Infect. 2016; 22: 670-680Abstract Full Text Full Text PDF PubMed Scopus (63) Google ScholarReview84831Most downloaded: Parasitic helminth infections and the control of human allergic and autoimmune disorders [2]Maizels R.M. Parasitic helminth infections and the control of human allergic and autoimmune disorders.Clin Microbiol Infect. 2016; 22: 481-486Abstract Full Text Full Text PDF PubMed Scopus (96) Google ScholarReview1231203 Using whole genome sequencing to identify resistance determinants and predict antimicrobial resistance phenotypes for year 2015 invasive pneumococcal disease isolates recovered in the United States [7]Metcalf B.J. Chochua S. Gertz Jr., R.E. Li Z. Walker H. Tran T. et al.Using whole genome sequencing to identify resistance determinants and predict antimicrobial resistance phenotypes for year 2015 invasive pneumococcal disease isolates recovered in the United States.Clin Microbiol Infect. 2016; 22: 1002.e1-1002.e8Abstract Full Text Full Text PDF PubMed Scopus (73) Google ScholarOriginal article127159 Molecular mechanisms of hepatitis C virus-induced hepatocellular carcinoma [8]Vescovo T. Refolo G. Vitagliano G. Fimia G.M. Piacentini M. Molecular mechanisms of hepatitis C virus-induced hepatocellular carcinoma.Clin Microbiol Infect. 2016; 22: 853-861Abstract Full Text Full Text PDF PubMed Scopus (97) Google ScholarReview324771 Suddenly everyone is a microbiota specialist [9]Boers S.A. Jansen R. Hays J.P. Suddenly everyone is a microbiota specialist.Clin Microbiol Infect. 2016; 22: 581-582Abstract Full Text Full Text PDF PubMed Scopus (17) Google ScholarCommentary3241541 Use of systems biology to decipher host–pathogen interaction networks and predict biomarkers [10]Dix A. Vlaic S. Guthke R. Linde J. Use of systems biology to decipher host-pathogen interaction networks and predict biomarkers.Clin Microbiol Infect. 2016; 22: 600-606Abstract Full Text Full Text PDF PubMed Scopus (29) Google ScholarReview523860High altmetric score: Airport door handles and the global spread of antimicrobial-resistant bacteria: a cross-sectional study [11]Schaumburg F. Köck R. Leendertz F.H. Becker K. Airport door handles and the global spread of antimicrobial-resistant bacteria: a cross sectional study.Clin Microbiol Infect. 2016; 22: 1010-1011Abstract Full Text Full Text PDF PubMed Scopus (12) Google ScholarCorrespondence029854 Antibiotic de-escalation for bloodstream infections and pneumonia: systematic review and meta-analysis [12]Paul M. Dickstein Y. Raz-Pasteur A. Antibiotic de-escalation for bloodstream infections and pneumonia: systematic review and meta-analysis.Clin Microbiol Infect. 2016; 22: 960-967Abstract Full Text Full Text PDF PubMed Scopus (50) Google ScholarSystematic review684646 Improving outcomes of severe infections by multidrug-resistant pathogens with polyclonal IgM-enriched immunoglobulins [13]Giamarellos-Bourboulis E.J. Tziolos N. Routsi C. Katsenos C. Tsangaris I. Pneumatikos I. et al.Improving outcomes of severe infections by multidrug-resistant pathogens with polyclonal IgM-enriched immunoglobulins.Clin Microbiol Infect. 2016; 22: 499-506Abstract Full Text Full Text PDF PubMed Scopus (35) Google ScholarArticle3149042 Suddenly everyone is a microbiota specialist [10]Dix A. Vlaic S. Guthke R. Linde J. Use of systems biology to decipher host-pathogen interaction networks and predict biomarkers.Clin Microbiol Infect. 2016; 22: 600-606Abstract Full Text Full Text PDF PubMed Scopus (29) Google ScholarCommentary3241541 Risk of stroke and transient ischaemic attack after herpes zoster [14]Kwon S.U. Yun S.C. Kim M.C. Kim B.J. Lee S.H. Lee S.O. et al.Risk of stroke and transient ischaemic attack after herpes zoster.Clin Microbiol Infect. 2016; 22: 542-548Abstract Full Text Full Text PDF PubMed Scopus (28) Google ScholarArticle535327a Downloads.b Altmetric score. Open table in a new tab Although people and institutions are looking at these indicators (citations, downloads, altmetric scores) the indicators are only indirect measures for the kind of impact we would like to have. Because we are in the business of clinical microbiology and infectious diseases, we would like to know whether our publications improve patients' management and outcome; whether we improve workflow and costs; and whether we improve understanding. On our site (www.clinicalmicrobiologyandinfection.com) you will see a new metric: PlumX. PlumX shows usage (e.g. downloads), citations, social media and other activities on the web. Of special interest is the capture of citations in clinical practice guidelines (http://plumanalytics.com/telling-story-clinical-impact/). This is a step towards answering the question of whether a publication has a real impact. We would like to measure whether our publications (at least some of them) are improving the management of patients, or even better, their outcomes. Ultimately this is the impact we are hoping for. It is difficult to see how such a metric—to measure real impact on practice—can be devised, but this is what we need. Editorial note: not peer-reviewed.