Auditing BMJ decision making

Auditing the British Medical Journal

The purpose of this study was to audit the outcome in terms of change in practice of the published research from one volume of the British Medical Journal. All original papers and short reports from one Volume 296 of the British Medical Journal ( BMJ) 1988 were read and classified into theoretical only, practical and theoretical and practical. Those papers with any practical message were reviewed by one of a panel of specialists in the subject of the paper to assess if the recommendation made by the paper had become common clinical practice. The results show that most papers originated from teaching centres and research institutes in the UK. Only 8% of main papers and 6% of short reports had a solely practical application, although a further 18% and 22% had practical elements. The majority of the recommendations aimed at changing practice were of relevance to hospital specialists rather than general practitioners (GPs). Of the papers with any practical implications 48% (12% of the total) of main papers and 41% (11% of the total) of short reports were considered to be current practice. The reasons why the papers failed to change practice are discussed. In conclusion, the majority of the original research papers published in the BMJ in 1988 were of a theoretical nature and only about 20% of papers made recommendations for a change in practice. About 50% of the recommendations are now current practice.