The number needed to read—a new measure of journal value

Abstract

The ranks of journals facing outward near its portal signify the purpose of a professional library—a sense of order, of collection, of scholarship, of respect, ultimately, for the written word. Behind, not all is well with serials. The best-known problem is money. Journals are priced on the basis of an annual subscription, and the prices of these have been rising at well above inflation for many years. Publishers point to the fact that the overall cost per page is falling. and while this is welcome, it doesn't help libraries, whose budgets are unable to meet the year-on-year increases in the cost of subscriptions. There is also concern about equity and access. The present UK government may not set much store by it, but the case for open access to published research (and to unpublished trials commissioned by pharmaceutical companies) is strong. It is hard not to interpret initiatives such as PatientINFORM,1 as a tacit admission by publishers that the case for public access to research findings is now won. The landscape of journal publishing is therefore changing, and a new level of accommodation between the various stakeholders will establish itself. Journal inflation may slow; consortium purchasing will drive down costs but bring new problems; there will be a shift towards document delivery rather than subscription; and open access will continue to develop as research funders insist on free access—the recent initiative by the University of Southampton is both innovative and pragmatic. There are two further concerns—the quality and relevance of academic journals. Before this can be discussed, there is need to clarify a fundamental point—the right for librarians to comment on the quality of a journal. What right to second guess an editorial board about their choice of papers? What right to make decisions on the relevance of a journal? Librarians are entitled to comment on quality as they are always making choices. These choices can be based on the eminence of the journal, its impact factor, its price or some measure of user demand. Of these, only the journal impact factor (JIF) has much in the way of objectivity about it and, to a degree, JIF does measure quality. But, ultimately, JIF is a measure of prestige, and is more useful to health-care researchers than health-care practitioners. Another measure is emerging called the Number Needed to Read (NNR). This measure could be more useful to health-care libraries than JIF. NNR is an index of how many papers in a journal have to be read to find one of adequate clinical quality and relevance. McGibbon and colleagues reviewed 60 352 articles in peer-reviewed journals and found that only 3059 met a standard set of quality criteria.2 The overall NNR was 20; and some journals will have a higher NNR than others. It is proposed that health libraries should set a maximum threshold for NNR and, either not subscribe to any journals whose index is above that threshold, or alternatively offer to pay a lower subscription fee. A charge of censorship could be made, but this approach is about selecting journals for their clinical relevance and challenging monopoly pricing. In any case, articles needed by users can be obtained through a document delivery service. This could possibly save money by reducing the number of journals subscribed to from library funds. It is also likely that clinicians would find a library service that implemented an NNR policy acceptable. There has been a lively debate about why clinicians don't read research papers in the last few months, and many of the respondents agreed that most papers are irrelevant. One of the contributors quotes Richard Smith, former editor of the British Medical Journal, as saying that only 5% of published papers reached minimum standards of scientific soundness and clinical relevance, and in most journals the figure was less than 1%.3 The library that used NNR as a guide to its journal collection would show various features. There would probably be fewer journals on display. Collection policy would be focused on low NNR journals and collections of clinically relevant systematic reviews such as the Cochrane Library and Clinical Evidence. There would be more use of tools such as clinical query filters in medline and specialist current awareness services such as McMaster's MORE.4 Above all, the NNR library would rely on the skills of the librarian to advise, train and support users in critical appraisal. Concerns could be expressed that the use of NNR would amount to a form of restriction. But access to the whole body of biomedical journals could be maintained through medline and Table of Contents Services, and enhanced by introducing a common underlying architecture for online services such as the Common Information Environment. There needs to be a degree of militancy too. Librarians should be at the forefront of the campaign for open access. Maybe libraries should start trying to negotiate variable pricing. As Andrew Odlysko has argued,5 variable pricing for information is inevitable in the future. The journal Brain is worth more to a neurology institute in a University than to an National Health Service (NHS) hospital with a neurology unit. But both have to pay the same amount if they want a copy on their library shelf. We welcome recommendations to move towards seamless procurement across higher education (HE) and the NHS because it will reduce complexity and bureaucracy for users. But there has to be some recognition of the variable value of journals in different sectors. One way to achieve this would be for the NHS as a whole to be treated as a Joint Information Systems Committee (JISC) Band A Institute (or a double Band A institute) in pricing academic journals, and for the NHS to continue to bear the whole cost of access to clinically focused resources such as Clinical Evidence.

Cite this work

No public copy is stored for this record, so only the metadata is cited.

Stored only when both papers are in the corpus — 21 citations exist upstream.