[The "impact factor" and the impact of medical journals].

Original articles published in scientific journals are important parameters for committees when they evaluate academic promotions or research grant applications. The analysis usually tries to give each paper a qualitative/quantitative assessment. An article's citation by others is accepted as a fair estimate of the value assigned to its originality and importance. A main determinant of every citation index is the international relevance attained by the journal where the article appeared. The "impact factor" of journals enlisted in the mainstream literature, as defined by the Journal Citation Reports (ISI), is being used by many assessors worldwide. But this index appears to be an unfair unit of measurement for journals that, although included in the main international data bases, are published in non-English languages. Furthermore, some local journals that are not enlisted by the Institute for Scientific Information apply external peer review to select their publications. In contrast, those same journals may have great relevance for their contributing authors and a high impact in their readers. The Editor's proposal is to classify original articles published in biomedical sciences, clinical medicine and public health topics using a three steps scale: a low score to articles published in local journals that use the peer review system, even though they were not enlisted in international data bases; a higher score to articles published in journals included in the mainstream literature, without considering their "impact factors" as differential values; and the highest score to articles published in journals recognized as international leaders in biomedicine, general medicine or in the subspecialties. Therefore, mainstream journals published in non-English languages would not be discriminated from other journals having higher "impact factors" mainly due to their use of the English language.