ECONOMICS,EDUCATION, AND HEALTH SYSTEMS RESEARCH SECTION EDITOR RONALD D. MILLER Publications in Anesthesia Journals: Quality and Clinical Relevance Jakob Lauritsen, MD, and Ann M. Moller, MD Department of Anesthesia, Herlev University Hospital, Herlev, Denmark Clinicians performing evidence-based anesthesia rely on anesthesia journals for clinically relevant informa- tion. The objective of this study was to analyze the pro- portion of clinically relevant articles in five high impact anesthesia journals. We evaluated all articles published in Anesthesiology, Anesthesia & Analgesia, British Journal of Anesthesia, Anesthesia, and Acta Anaesthesiologica Scandinavica from January to June, 2000. Articles were assessed and classified according to type, outcome, and design; 1379 articles consisting of 5468 pages were evaluated and categorized. The most common types of article were animal and laboratory research (31.2%) and randomized clinical trial (20.4%). A clin- ically relevant article was defined as an article that used a statistically valid method and had a clinically relevant end-point. Altogether 18.6% of the pages had as their subject matter clinically relevant trials. We compared the Journal Impact Factor (a measure of the number of citations per article in a journal) and the proportion of clinically relevant pages and found that they were inversely proportional to each other. (Anesth Analg 2004;99:1486 –91) T he desire to perform evidence-based anesthesia is currently growing throughout the world. The practice of evidence-based medicine is founded on sound and well-conducted science. It requires clin- ical interventions to be investigated for clinically rel- evant outcomes. The retrieval of clinically relevant articles is, however, not always easy. The difficulty lies in knowing where one should search for relevant answers to clinical questions. Logically, one assumes that clinically relevant arti- cles of a high quality will be found in scientific jour- nals, especially those that are esteemed or most often cited. We chose to take a close look at five high impact anesthesia journals, to investigate the amount of clin- ical scientific content, and to review the methodolog- ical aspects of each article. We hoped to discern whether anesthesia journals actually supplied the an- swers to our clinical questions or were merely a me- dium for communication among scientists. The purpose of this review was to review all articles in Anesthesiology, Anesthesia & Analgesia, British Journal of Anaesthaesia, Anesthesia and Acta Anaesthesiologica Scandinavica and classify each article according to type and size compared to the total number of pages in the journal. We also looked at the validity of the Journal Impact Factor as a measure of the quality of journals by ap- plying our own quality criteria to the articles pub- lished in each journal. Methods Article Examination We examined all articles in five high impact anesthesia journals (Anesthesiology, Anesthesia & Analgesia, British Journal of Anesthesia, Anesthesia, and Acta Anaesthesiologica Scandinavica) published between January and June 2000. Articles were evaluated and classified according to type, outcome, and design. All relevant data from the articles were imported to Procite 5.0 (ISI ResearchSoft 1999; ISI, Philadelphia, PA) from the PubMed online database (http://www4.ncbi.nlm.nih.gov/PubMed). Articles that were missing in PubMed were manually added (e.g., books and multimedia reviews). Certain types of pages were not included in the database; e.g., abstracts from congresses and advertisements. Evaluation and Classification of Articles To ensure accurate classification of the articles, strin- gent criteria were defined before the first read- through. All articles were read twice and, when in doubt, a second opinion was sought by another re- viewer. Articles were described as either primary or secondary studies. Accepted for publication June 2, 2004. Address correspondence to Jakob Lauritsen, MD, Bakkedraget 18, 2. th, 3400 Hillerod, Denmark. Address e-mail to jakobl@dadlnet.dk. DOI: 10.1213/01.ANE.0000136468.92993.CF ©2004 by the International Anesthesia Research Society 1486 Anesth Analg 2004;99:1486–91 0003-2999/04