Engagement Evolution: How Metrics and Enhanced Publication Content Shape Readership

Nov 19, 2024 | News and Trends

Alexa Holland, MSc, Costello Medical, Manchester, UK; Hamish McDougall, BSc, Sage, London, UK; Radhika Bhatia, PhD, UCB, Slough, UK; Sarah J. Clements, PhD, CMPP, Costello Medical, Cambridge, UK

Email your questions and comments on this article to TheMAP@ismpp.org.

Key Takeaways:

  1. Novel metrics should support comprehensive journal evaluation: Despite known limitations, traditional publication metrics like impact factor still influence both healthcare professional (HCP) engagement with scientific publications and the choice of journal to publish their own research. Whilst top-tier journals have their place, where these are not suitable, authors should embrace novel metrics for a comprehensive evaluation of potential journals to reach their desired audience.
  2. Enhanced publication content (EPC) elevates engagement: EPC, such as plain language summaries and graphical abstracts, plays a pivotal role in drawing HCP interest towards publications and aids in simplifying complex information for patients. However, development time, strict journal guidelines or lack of acceptance of EPC altogether by journals often hinders its uptake.
  3. Learnings for publication professionals: For HCPs to utilize EPC to its full potential, publication professionals should work towards integrating EPC within standard publication practices. EPC should be accessible, tailored, and impactful to enhance HCP knowledge of medical information for the benefit of patient care.

The Metrics Evolution

With >1 million medical articles being published annually,1 HCPs can struggle to keep up to date with the ever-expanding medical literature, especially considering how little time they may have to engage with a medical publication (on average less than 2 minutes).2 This also translates to identifying target journals for publication of their own research to ensure it is impactful and read by the intended audience. HCPs consider peer-reviewed journal articles as the gold standard for staying up to date,3 and time-poor HCPs must carefully consider which articles to prioritize reading and where to publish their research.

Key findings from a recent survey, which was conducted by some of the authors for this article [Clements SJ, Holland A, Clarkson E, et al., presented at the 2024 European Meeting of ISMPP], revealed a continued reliance on traditional metrics for evaluating the quality of scientific literature. Notably, 57.9% (n=245/423) of HCPs who responded to the survey indicated that a journal’s impact factor remains a critical criterion for deciding whether to engage with an article, as well as deciding where to publish their own research, whilst 25.3% (n=107/423) indicated that they use the journal citation indicator.4, 5

These results underscore a persistent reliance on conventional indicators, despite their acknowledged limitations in reflecting the true value or impact of research (Figure 1). Since impact factor is directly related to journal scope, those with a broader subject coverage are likely to have higher impact factors than more specialized journals. Furthermore, this metric can be heavily influenced by a small number of highly cited studies and is not a consistent measure of the quality across all articles in a given journal.

Figure 1. Impact factor: What is it and what are the limitations?6-8

Drawing on these conclusions, publication professionals should advocate for a shift towards more innovative, transparent and robust metrics for research assessment, echoing sentiments from the Declaration on Research Assessment (DORA). The core objective of DORA is to advance a more comprehensive and equitable system for research assessment, shifting emphasis away from traditional metrics like journal impact factors and evaluating research on its merit and significance rather than relying on the journal in which the work is published.

There are numerous resources available that provide guidance on appropriate publication metrics to consider and tips for maximizing the readership of articles:

Publication professionals are urged to use these resources to help encourage HCPs to engage with a variety of articles, select the most appropriate journal to publish their own work in order to reach the audience of interest, and foster the use of open access to optimize reach. Whilst high-impact journals and their accompanying wide-reaching networks may be desirable for publication of pivotal primary data, where these are not suitable, authors should embrace novel metrics for a more comprehensive and transparent evaluation of alternative journal options to reach their desired audience.

Additionally, as publication readership is becoming more varied and wide-reaching, this highlights a clear need for more qualitative metrics to explore the type of attention an article receives. Through such assessments, stakeholders will have a deeper understanding of the impact of key publications, or publication plans as a whole, by recognizing whether that work drives innovation, influences clinical guidelines, instigates behavioral change in clinical practice, and ultimately improves patient outcomes. This shift advocates for a more comprehensive assessment of the correct journal choice for a publication, to ensure the data are discoverable and accessible by the intended audience. Assessments should also be made based on the impact of previous journal choices, in order to inform decision-making for future publications.

Transforming Clinical Practice with Enhanced Publication Content

EPC includes plain language summaries, graphical abstracts, video summaries, and podcasts and is becoming increasingly prevalent as a tool to summarize and simplify article content. However, we need to know whether these materials are reaching, and being utilized by, HCPs. By understanding these factors, publication professionals can work to ensure that the right content reaches the right audience, and that publication enhancements are both tailored and accessible to their target audience.

EPC has emerged as a substantial factor in increasing HCPs’ likelihood to read publications, with 38.8% (n=164/423) of HCPs confirming this in the abovementioned survey.4, 5 This finding is further supported by an additional targeted literature review conducted by some of the authors of this article [Hews C, O’Neill E, Holland A, et al., presented at the 2023 European Meeting of ISMPP], which found articles published with enhanced content to be associated with higher Altmetric Attention Scores and number of citations versus those without, particularly in the case of those reporting primary data.13

Additionally, it has been reported that the inclusion of graphical abstracts with original research articles resulted in significantly greater Altmetric Attention Scores and social media attention in comparison with articles of similar topics without such enhancements (p<0.001); addition of a visual abstract to articles can result in eight times more shares on social media than a text-only summary and three times more visits to the article on the journal website.14, 15 This also underscores the need for evaluation of the impact of EPC itself by capturing metrics distinct from the overall article in order to understand the true effect of such enhancements.

The previously mentioned survey further revealed how HCPs utilize EPC in clinical settings, with almost half of respondents using these resources at least once a month in their discussions with patients (Figure 2), predominantly to demystify complex information. The most commonly used EPC formats were graphical abstracts (40.2%; 170/423) and plain language summaries (35.5%; n=150/423).4, 5

Figure 2. Frequency of EPC use during HCP interactions with patients

This research underscores the value HCPs place on EPC;4, 5 however, changes in journal policies to improve accessibility (e.g. EPC being indexed on PubMed or available open access) are necessary. Hosting EPC directly with articles on journal websites, rather than in supplementary materials or on a third-party platform, could significantly enhance adoption of EPC, improve discoverability and increase engagement with medical publications.

Findings from the previously mentioned survey also pointed to existing barriers to authorship of EPC, resulting in a notable 42.3% (n=179/423) of respondents never having authored publications incorporating EPC.4, 5 Barriers identified included the development time required, especially if data need to be published swiftly, and many journals simply not accepting EPC. Careful consideration should be made when contemplating the inclusion of EPC alongside publications and its potential to increase the impact and reach of a publication over and above the perceived prestige of a journal.

These data suggest potential areas for intervention in order to improve EPC production and utilization:

  1. Educating HCPs on the value of EPC, as well as how to go about authoring such content
  2. Advocating for EPC with journals that do not currently support this type of content
  3. Encouraging all journals to adopt a consistent approach to publication of EPC, including indexing the enhancements so they are discoverable and accessible

Future research should focus on deepening our understanding of how the increasing availability of EPC influences clinical practice. This should include assessment of whether HCPs are utilizing EPC to aid decision-making processes or patient education, and whether the timing of such use occurs at specific points within a patient’s care pathway. This will aid in patients accessing and digesting the information contained within articles more easily and encourage shared decision-making between patients and HCPs, particularly for complex diseases and treatments. Through such research, we can also begin to understand the real-world impact of EPC on patient outcomes and aim to refine its application to maximize its impact. By guiding development of future enhancements, publication professionals can help to ensure that all published materials are accessible, tailored, and impactful for HCPs, to help achieve the ultimate goal of improving patient outcomes.

References

  1. Landhuis E. Scientific Literature: Information Overload. Nature 2016;535:457–458.
  2. Burd G, Strangman NS, Caitlin , Sarcar S, et al. Original Abstract from the 19th Annual Meeting of ISMPP: What Do Doctors Really Do on the Internet. Current Medical Research and Opinion 2023;39:5–39.
  3. Salinas GD. Trends in Physician Preferences for and Use of Sources of Medical Information in Response to Questions Arising at the Point of Care: 2009–2013. Journal of Continuing Education in the Health Professions 2014;34:S11–S16.
  4. Clements SJ, Holland A, Clarkson E, et al. Original Abstracts from the 2024 European Meeting of ISMPP: Influence of Metric and Enhanced Content on Healthcare Professional Engagement With Publications. Current Medical Research and Opinion 2024;40:41–57.
  5. Clements SJ, et al. Poster presented at ISMPP EU 2024. Available at: https://www.pathlms.com/ismpp/courses/62031/sections/69650/documents/94136.
  6. Garfield E, (1994). Impact Factor. URL: https://clarivate.com/webofsciencegroup/essays/impact-factor/. Accessed: August 2024.
  7. Grzybowski A. Impact Factor – Benefits and Limitations. Acta Ophthalmologica 2015;93:201–202.
  8. Dimitrov JD, Kaveri S, Bayry J. Metrics: Journal’s Impact Factor Skewed by A Single Paper. Nature 2010;466:179–179.
  9. Your Guide to Choosing the Right Journal for Your Article. Available at: https://engraffo.com/p/DUnZyRhYiK [Accessed October 2024].
  10. Hardman TC, Krentz AJ, Wierzbicki AS. Ten tips for promoting your research. Cardiovasc Endocrinol Metab 2020;9:30-5.
  11. Research Impact. Taylor & Francis Author Services. Available at: https://authorservices.taylorandfrancis.com/research-impact/ [Accessed October 2024].
  12. Biosemantics Journal/Author Name Estimator. Available at: https://jane.biosemantics.org/ [Accessed October 2024].
  13. Original Abstracts from the 2023 European Meeting of ISMPP. Current Medical Research and Opinion 2023;39:41-58.
  14. Kunze KN, Vadhera A, Purbey R, et al. Infographics Are More Effective at Increasing Social Media Attention in Comparison With Original Research Articles: An Altmetrics-Based Analysis. Arthroscopy 2021;37:2591-2597.
  15. West CC, Lindsay KJ, Hart A. Promoting your research using infographics and visual abstracts. Journal of Plastic, Reconstructive & Aesthetic Surgery 2020;73:2103-2105.

Author Disclosures

AH, SJC: Employees of Costello Medical.

HM: Employee of Sage.

RB: Employee and shareholder of UCB.

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