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Rapid response to:

Feature at 20

Twenty top papers to mark The BMJ’s two digital decades

BMJ 2015; 351 doi: (Published 06 July 2015) Cite this as: BMJ 2015;351:h3660

Rapid Response:

Twenty top papers - the ones that got away

Many thanks to all our readers, authors, friends and colleagues past and present who nominated their most memorable paper for this article. Please vote for the top cited 6, and/or submit alternative papers by posting a response.

Sadly we couldn't include everybody because of the "20" theme, but I wanted to mention this nomination by Utah medical librarian Mike Nielson. Mike is great at giving us constructive feedback about the website (he often notices when things aren't working before we do!)

In fact, Mike's nomination is about feedback. After GP Craig Brown’s wife died of a secondary brain tumour he and his family had had concerns about her care and decided to complain. At first his children had mixed feelings about it. They feared it would remind them of a bad experience and have no effect. Brown wanted to make a "compassionate complaint" and to avoid projecting his family's grief on to them. The complaint was well received and he and his family hope it will lead to improvements.

A compassionate complaint about hospital care made a difference
(BMJ: 2015;350:g7823)

I often describe Peter Arnold as one of the first readers in the world who sees our weekly print issue online. Peter is based in Australia and is regularly in touch. He nominated three papers.

Peter nominated these:

Sharing the raw data from medical research
(BMJ 2009;338:b1252)

How to treat a Pirahã: medical ethics and cultural difference
(BMJ 2015;350:h850)

Why the GMC should set up a central registry of doctors’ competing interests
(BMJ 2014;348:g236)

Peter was not alone in nominating more than one paper. We were very flattered that some readers openly told us they were struggling to nominate a single paper, and mentioned others in passing when they submitted their nomination.

Here are "the ones that got away:"

Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study
(BMJ 2007;335:136)

Collusion in doctor-patient communication about imminent death: an ethnographic study
(BMJ 2000;321:1376)

How can research ethics committees protect patients better?

(BMJ 2003;326:1199)

How to read a paper : getting your bearings (deciding what the paper is about)
(BMJ 1997;315:243)

Unsurprisingly, Richard Smith had other suggestions from his time as editor.

Like Jocalyn Clark, he wanted to highlight papers about death: "Death has been seen as the great enemy by doctors, but this article (and again the accompanying articles in the theme issue) was important in recovering the recognition that a good death is one of the most important things in health care."

He included A good death as a second suggestion.
(BMJ 2000;320:129)

He also submitted this study of general practitioners' reasons for changing their prescribing behaviour (BMJ 1996;312:949), adding: "I couldn’t claim that this article has had a big influence, but it’s one that I find I return to more than any other. It showed how doctors are human rather than scientific in how they change their practice."

Richard also picks up Muir Gray's "too much medicine" theme in citing the print issue published while he was editor,
Too much medicine (BMJ 2002;324:859) .

It marked a point he added, "when modern medicine began to over reach itself. "

Finally, he mentions the polypill which, in his words, is slowly but surely having a global impact, adding: "It's important to realise that there will be many polypills (off patent drugs with different actions combined into one pill) for many conditions."

This paper A strategy to reduce cardiovascular disease by more than 80% (BMJ 2003;326:1419), contributes to the discussion, he concludes..

Competing interests: No competing interests

07 July 2015
David R Payne
Digital Editor
Tavistock Square, London WC1H 9JR.