In which journals will pediatricians find the best evidence for clinical practice?

The objective of this study was to identify the journals that contain the best evidence relating to clinical pediatric practice, thus enabling general pediatricians and pediatric trainees to identify the best quality evidence more efficiently and to select journals for general reading more judiciously.

In the first of three strategies, journal citations from completed systematic reviews using topic headings of pediatric(s), child, infant(s), newborn, neonate(s), neonatology, and adolescent(s) in the Cochrane Database of Systematic Reviews (CDSR) in the 1997, Issue 4, Cochrane Library were collected. In the second strategy, journal citations from American Academy of Pediatrics' (AAP) policy statements from 1994 to 1996 found in the AAP policy reference guide were collected. In the third strategy, journal citations from the Canadian Paediatric Society (CPS) statements from 1990 to 1997 found in Pediatrics and Child Health were collected. Topics related to tertiary neonatology, nonphysician health care professionals, public health policy, ethics, and nonjournal citation sources were excluded. All statements with no references were excluded. Journal citations in CDSR with no pediatric subjects and citation of AAP policy statements cited in AAP policy statements were excluded. The number of citations from the journal cited most frequently, from journals that represented approximately 10% of all citations and from the 10 journals cited most frequently were expressed as a percent of total citations and a 95% CI was calculated.

Using all three strategies (CDSR, AAP, and CPS), the journal cited most frequently was Pediatrics. Using the CDSR strategy (n = 234), citations from Pediatrics represented 6.0% of the total (95% CI: 3.0%, 9.0%), using the AAP strategy (n = 930), citations from Pediatrics represented 11. 4% of the total (95% CI: 9.4%, 13.4%), and using the CPS strategy (n = 873), citations from Pediatrics represented 11.9% of the total (95% CI: 9.8, 14.1). Using the CDSR strategy, citations from the 10 journals cited most frequently made up 38.9% of the total citations (95% CI: 32.7%, 45.1%), using the AAP strategy, citations from the 10 journals cited most frequently made up 42.3% of the total citations (95% CI: 39.3%, 45.3%), and using the CPS strategy, citations from the 10 journals cited most frequently made up 60.6% of the total citations (95% CI: 57.4, 63.8). In the CPS strategy, citations from the Journal of Pediatrics represented 10.2% of the total citations (95% CI: 8.2, 12.2) and citations from New England Journal of Medicine represented 9.5% of the total citations (95% CI: 7.6, 11.5). A total of 7 journals were found to be among the 10 cited most frequently using all three strategies (in alphabetical order): Archives of Diseases in Childhood, British Medical Journal, Journal of the American Medical Association, Journal of Pediatrics, Lancet, New England Journal of Medicine, and Pediatrics.

This study provides the general pediatrician and pediatric trainee with a strategy to identify efficiently a significant proportion of the best evidence on pediatric practice by restricting searches and reading to a limited number of journals. It also highlights the fact that the best quality evidence on pediatric practice is found in a large number of medical journals.