Twenty top papers—the ones that got away and the results of the top six poll

Many thanks to all our readers, authors, friends, and colleagues past and present who nominated their most memorable paper for this article.1

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).

Mike’s nomination is about feedback. After GP Craig Brown’s wife died of a secondary brain tumour, he and his family had concerns about her care and decided to complain. At first his children had mixed feelings about this. 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.2

I often describe Peter Arnold as one of the first readers in the world to see our weekly print issue online. Peter is based in Australia and is regularly in touch. He nominated three papers.3 4 5

Peter was not alone in nominating more than one paper. We were flattered that some readers openly told us they were struggling to nominate a single paper and mentioned others when they submitted their nomination. There were several “ones that got away.”6 7 8 9

Unsurprisingly, Richard Smith had suggestions from his time as editor. Like Jocalyn Clark,1 he wanted to highlight papers about death: “Death has been seen as the great enemy by doctors, but this article (and 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 healthcare.” After asking what is a good doctor,10 he went on to ask what is a good death?11

He also submitted a study of general practitioners’ reasons for changing prescribing behaviour,12 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 picked up Muir Gray’s “too much medicine” theme1 in citing the print issue published while he was editor.13 It marked a point he added, “when modern medicine began to over-reach itself.”

Finally, he mentioned 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.” The paper on reducing cardiovascular disease by more than 80% contributes to the discussion, he concluded.14

As part of our 20th online anniversary celebrations we ran a poll that asked readers to nominate which paper The BMJ should be most proud of publishing.

We confined the poll to Web of Science’s top six most highly cited papers from the list of 20 articles. The poll ran from 7 to 15 July 2015 and attracted 576 votes across 55 countries.

Altman’s editorial on poor medical research was the clear winner, attracting 252 votes, almost 44% of the total votes.15

A study on knowledge management in primary care came second (89 votes; 15.45% of total).16

Establishing a standard definition for child overweight and obesity came third (69; 11.98%).17

Multiple imputation for missing data in epidemiological and clinical research came fourth (61; 10.59%).18

A trial of zinc supplementation for diarrhoea in Bangladeshi children came fifth (57; 9.9%).19

A qualitative study of what worries parents when their preschool children are acutely ill came sixth (48; 8.33%).20

Many thanks to all those who voted and to readers who responded to the article with other papers that they think have had a major impact.