Steven Kpaka, Nathalie Krou-Danho, Safiatou Lingani, Aboua
Lucien, Bondo Monga, Delphine Chia N’guessan, Déborah
N’Guessan-Yao, Jean Louis N’Jampo, Patricia Patindé, Albert
Seri Sekou, Odette Tossou, Leo Weakland, Christiane Wondji
Gozo.At the US Centers for Disease Control and Prevention,we
thank Eliane Dogoré for help with coding; David Fluker,
Eleanor McLellan, and Robert Strotman for software support;
and Thomas Peterman, Marc Bulterys, Richard Jenkins,
RJ Simonds, and Monica Nolan for commenting on earlier ver-
sions of the manuscript. We also thank two BMJ reviewers for
their useful comments and suggestions. This study was
presented in part at the XIIth International Conference on
AIDS and STDs in Africa, Ouagadougou, Burkina Faso, Decem-
ber 9-13, 2001 [abstract 10BT2-6].
Contributors: See bmj.com.
Funding: The research project was funded by the Centers for
Disease Control and Prevention (CDC). All of the authors were
employed directly or indirectly by the CDC during the design,
collection and analysis of data, and write-up of findings.
Competing interests: None declared.
Ethical approval: Ethics committee of Côte d’Ivoire’s Ministry of
Public Health and the Institutional Review Board of the US
Centers for Disease Control and Prevention.
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NewYork: Plenum Press,
Relation between online “hit counts” and subsequent
citations: prospective study of research papers in the BMJ
Thomas V Perneger
Evaluation of published medical research remains a
challenge. Two classic yardsticks are the citation count
(the number of times a given paper is cited by
others)1 2and the impact factor of the journal that
published the paper (which reflects the average
number of citations per article).2 3However, the
citation count can be assessed only several years after
publication, and the impact factor is not paper specific
and is thus virtually meaningless in assessing any
obtained rapidly and is paper specific, is the “hit
count” (the number of times a paper is accessed
online). Whether this count predicts citations is
unknown. I examined this issue prospectively in a
cohort of papers published in the BMJ.
measure, whichcan be
Methods and results
The study used articles published in volume 318 of the
BMJ (1999) in sections titled Papers, General Practice,
and Information in Practice. The hit counts (full text
articles, HTML version) for the main body of each arti-
cle within a week of publication were provided by a
BMJ staff member because the “hit parade” posted on
the journal website was found to be unreliable for
1999. I obtained the number of citations on 24 May
2004 from the ISI Web of Science, an internet service
to which the local medical library has a subscription.1
I also recorded for each paper the study design and the
number of pages.
Nine papers were excluded because they did not
report research (but reported discussions of, for exam-
ple, NHS management and statistics methods). The
remaining 153 papers comprised 29 randomised trials,
Logarithm of internet hits
Logarithm of citations + 1
Relation between citations and internet hits for 153 papers in volume
318 of the BMJ (1999)
Institute of Social
Thomas V Perneger
professor of health
BMJ VOLUME 3294 SEPTEMBER 2004 bmj.com