[Good ending and better beginning. What future for medical journals?]

Scientific journals play an increasingly important role in the dissemination of research results, but also in the adoption of pharmaceutical innovation and technology in medicine. Healthcare decision makers are strongly influenced by the academic literature and for this reason medical journals should retain their independence and autonomy, preventing conflicts of interest. In a recently published editorial, the editor of the New England Journal of Medicine seems to be pleased with the results achieved. On the contrary, according to the editor of a respected specialized cardiovascular journal, Harlan Krumholz, journals are facing a number of important challenges. Medical journals are too expensive, too limited, too unreliable, too focused on wrong metrics, too powerful, too parochial, too static, and too dependent on a distorted model of business. In conclusion, medical journals do not seem to be the most appropriate educational tool in a scientific context that assigns value to transparency and sharing.