A one-year audit of topics and domains in the Journal of the American Medical Association and the New England Journal of Medicine

Background: The relative emphasis that major medical journals give to topic areas has a potential effect on priorities in patient care, policy decisions, and public awareness. We measured the distribution of topics in two journals, by disease categories and domains, over a calendar year. Methods: All original investigations, reviews, editorials, and special articles published in 1998 by die Journal of the American Medical Association and the New England Journal of Medicine were classified by article type, disease category, and domain. The 12 domains ranged from basic science to health policy, and included primary and secondary pre prevention. Results: The 1159 articles published in 1998 included 889 (77%) articles about specific diseases-590 falling within eight specialties-and 190 (16%) articles on generic topics. Eighty (7%) articles concerned the behaviors that cause disease. Primary prevention and screening were the subject of 71 (6%) and 29 (3%) articles, respectively. Most of these concerned uncommon issues in patient care. Although 27 (2%) articles dealt with essential health promotion (e.g., diet, exercise), and none included a study on how to help patients to exercise, stop smoking, or eat a healthy diet. In contrast, 451 (39%) articles concerned the diagnosis and treatment of patients with disease. Conclusions: The relative emphasis that journals gave to prevention during the sample period seems discordant with its importance to patients and public health. Potential explanations include poor volume and quality of submitted research and editorial concerns about importance and reader appeal.