Ruth Armstrong: Spies, IT guys and statistics

CHRISTMAS comes early for the MJA and her precocious progeny, MJA InSight. In alignment with MJA publication dates, this is the last InSight email and issue for 2012, although the “feedback” facility on each article will remain open in case you wish to keep talking amongst yourselves.

In my early days of medical journal editing we worked up the articles as best as we could, printed them in issues and posted them off to subscribers. A few also went on “the web”.

When controversy raised its head it was in the form of a letter to the editor or, heaven forbid, an irate phone call. Apart from this feedback, the odd reader survey and periodic citation data we had little knowledge of whether the articles in the Journal were looked at, let alone appreciated or disparaged.

Now, of course, all this has changed. The InSight web team (also known as the spies downstairs) has ways of monitoring the interest in our content, almost in real time.

Before you get nervous, this information isn’t traced to individuals, and we certainly don’t know if you need to lose weight or are in the market for a new set of blinds, but the articles you click on, the polls you choose to participate in, and of course your comments in the feedback section of the site tell us what content you find most engaging (or possibly most annoying).

When it comes to click-counts there are a few controversial topics that always put the InSight site into overdrive, as evidenced by our most viewed article this year — on homebirth — which gets a double gold star for also having the most poll participants.

Apart from a few hot topics, beloved of editors everywhere as a way to liven up a slow news day, InSight’s most popular articles can be divided fairly neatly into clinical and professional.

For clinical news we scan the research to bring Australian expert context to newly published studies, often about old dilemmas. Thus stories on warfarin for atrial fibrillation (number 2 on the most-clicked list below), Medicare Benefits Schedule listing of poorly evidenced clinical activities (3), overdiagnosis (9), and nodular melanoma (8) are in the top 10 click-garnerers this year. Polls on overdiagnosis (poll 9) and emergency department overcrowding (poll 4) also piqued your interest.

Looking at the articles on professional issues, the clicks went to mandatory review for older doctors (4) (backed by enthusiastic polling — poll 2), aggression in medicine (5), mandatory reporting of impaired doctors (6), pay-for-performance funding (7) and a provocatively titled article on dentists’ incomes (10).

Other popular polls included the place of complementary medicine in our universities and practices (polls 3, 5 and 6), questions about the AMA’s representation of doctors (poll 7), the length of medical training (poll 8) and the wisdom of treating family members (poll 10).

Having access to these statistics has helped us confirm and reaffirm our mission for InSight to be a place for informal-but-informed, rational discussion of issues that affect the medical profession and, indeed, all of health and health care.

We thank the experts who take calls from our medical writers for news story comments, and those who provide us with high quality, thoughtful comment articles, especially our regular columnists Jane McCredie, Aniello Iannuzzi and Sue Ieraci.

But we especially want to thank you. We love posting and reading your comments, gauging your opinions and all of the other spying, prying ways we garner your feedback.

And we look forward to doing it again in 2013.

Until then, the InSight team wishes you a relaxed and happy festive season — and thanks for all the clicks!

News click list

1. Homebirths data unreliable — 2333 unique page views
2. Warfarin still best AF option — 1691 unique page views
3. Call to delist low-value MBS items — 1543 unique page views
4. Older doctors may face mandatory review—1383 unique page views
5. Alarm at aggression in medicine —1278 unique page views
6. Defamation risk in reporting colleagues —1186 unique page views
7. Pay-for-performance closer —1183 unique page views
8. Nodular melanomas key to reducing deaths —1162 unique page views
9. Overtreatment backlash grows —1069 unique page views
10. Dentists are top earners —993 unique page views

Polls

1. Should the potential risk of long-term harm to a child override a mother’s low-risk request for a homebirth? 323 votes
2. Should mandatory performance testing be introduced for older doctors? 282
3. Do you believe that some alternative and complementary medicine disciplines have academic legitimacy? 197
4. Should ED doctors have the authority to admit patients directly to the wards? 185
5. Will registration of traditional Chinese medicine practitioners provide better protection for the public? 181
6. Should universities scrap all alternative and complementary medicine courses? 178
7. Do you believe the AMA is still the strongest voice to lobby for doctors’ interests? 176
8. Do you think a return to shorter medical training would affect the quality of patient care? 163
9. Do you think overdiagnosis and overtreatment are becoming problems in medicine? 159
10. Should doctors become actively involved in the care of seriously ill family members? 153

Dr Ruth Armstrong is medical editor of MJA InSight and senior deputy editor of the MJA.

Posted 10 December 2012