A comparison of the opinions of experts and readers as to what topics a general medical journal (JAMA) should address.

CONTEXT

Journal editors are responsible to many publics, and their choices of articles to publish are a frequent source of dispute.

OBJECTIVE

To assess the extent of agreement between topics identified by experts and by JAMA readers as most important for publication.

DESIGN AND PARTICIPANTS

Modified Delphi process of polling of JAMA Editorial Board members and senior staff (ie, experts) in 1996, and masked direct mail survey of a stratified sample of JAMA readers in late 1996 and early 1997.

MAIN OUTCOME MEASURES

Agreement between experts and readers on the topics most important for JAMA to deal with in 1997.

RESULTS

Of 55 experts polled, the 40 respondents (73% response rate) proposed 178 topics. Editing to combine similar topics left 73. The same 55 persons were asked to stratify all 73 alphabetically arranged topics on a scale of 1 to 5 (85% [47/55] response rate). They were then given the results of this ballot and asked to vote again (76% [42/55] response rate). Of the 55 experts, 40 attending the annual editorial board meeting were given all results; 39 attendees voted on the final topics. In response to the mail survey, a single pass of the same 73 topics yielded a response rate of 41.6% (208 returns). Nonresponders were roughly equivalent to responders demographically. Readers agreed with the experts on only 3 of the top 10 subjects: managed care, cancer, and aging.

CONCLUSION

Expert opinion and the opinion of readers as to what JAMA should emphasize vary widely.