A COMPARISON OF THE OPINIONS OF RECOGNIZED EXPERTS
AND ORDINARY READERS AS TO WHAT TOPICS
A GENERAL MEDICAL JOURNAL
SHOULD ADDRESS
George D Lundberg,1 Marshall Paul,2 and Helga Fritz1
1JAMA, 515 N State St, Chicago, IL 60610, USA;2HCI, Inc, Princeton, NJ, USA
Objective: To assess the extent of agreement between topics identified by experts and by JAMA readers as most important for publication.
Design: A: Criterion standard of editorial board members and senior staff (ie, experts), using Delphi process. In 1996, 55 recognized
experts were asked to propose the topics most important for JAMA to deal with in 1997. Forty (73% response rate) proposed 178 topics.
Editing for crossovers and groupings left 73 topics. The same 55 persons were asked to stratify all 73 alphabetically arranged topics
on a scale of 1 to 5 and separately to choose the top 7 (85% response rate). The same 55 persons were given the results of this ballot
and asked to vote again (76% response rate). A discussion was held after all results were provided to the 40 of the 55 who attended the
annual editorial board meeting; 39 attendees voted on the final topics (98% response rate). B: Masked direct mail survey of a stratified
sample of JAMA readers. A single pass of the same 73 topics yielded a response rate of 45.8% (208 returns). Nonresponders were roughly equivalent to responders.
Results: The final top 10 topics determined by the experts were (in order) managed care, death and dying, genetics, quality of care,
violence, aging, caring for the uninsured and underinsured, outcomes research, HIV/AIDS, and cancer. The final top 7 topics determined by the
experts were (in order) death and dying, aging, managed care, genetics, computers, cancer, and caring for the uninsured and underinsured. Reader
choices shared agreement with the experts on only 3 of the top 10 subjects, and on only 3 of the top 7 subjects.
Conclusion: Expert opinion and the opinion of readers as to what JAMA should emphasize varies widely.
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