Abstract
Despite the COVID-19
Since the year 2020, Breastfeeding Medicine has been a monthly publication, facilitated by a steady increase in the number of submissions. As a result, not only was there an increase in the pool and variety of articles being evaluated, but, also it allowed for a more selective review process of choosing manuscripts with an increased quality of research methodology. This process is confirmed by the journal's basic publishing statistics. For example, in the year 2017 there were 236 submissions and in 2021 this rose to nearly 400. Parallel to this was increase in the rejection rate that in 2017 was 49%, whereas in 2021 it was >62%!
As one would have expected, historically, the major source of articles submitted for publication was from the United States, in the past well >60%. As testimony to the increased international status and academic reputation of the journal is the fact that percentage of submissions from the United States dropped in 2021 to 40%. In contrast the countries from where there were increased submissions in this period were China, Turkey, Iran, India, Spain, and Brazil. More convincing evidence of the worldwide popularity of Breastfeeding Medicine has been the number of full text downloads. In 2016 there were 169,000 downloads, whereas in 2021 this rose to nearly 400,000!
Perusing the table of contents of journal articles of the first decade and comparing them with the mix of accepted articles of the past few years reveals a change of focus. Initially, the journal highlighted program descriptions of breastfeeding support and advocacy along with survey data as to breastfeeding rates in varied geographic locations. Thus, a typical article would describe a prenatal educational program that improved the knowledge base of the mothers and that resulted in higher scores of self-efficacy and possibly an increase in the rate of breastfeeding (be it initiation, exclusivity, or duration). These results usually were then compared with either historical controls or with mothers not offered this prenatal support program.
What would be required today is a more critical structured comparison of different programs so as to measure and quantitate what specific elements of the education program as opposed to others were critical and statistically significant in effecting change. In other words, evidence-based data from a properly randomized controlled study and not another Hawthorne effect phenomena.
For those not familiar with term Hawthorne effect, suffice to state its definition to understand the need for a more objective scientific evaluation of breastfeeding management procedures. The Hawthorne effect is the inclination of people who are the subjects of an experimental study to change or improve the behavior being evaluated only because it is being studied and not because of changes in the experiment parameters or stimulus per se. Thus, a low publication priority for program descriptions without properly matched controls.
To some, a more “objective” measure of a journals success is the Impact Factor (IF). In June 2021, the journal was notified that its 2020 IF Score was 1.817 reflecting a welcome steady increase from the 2015 score of 1.438. Again the basis of the calculation of this score is not fully understood. The 2020 score is based on the number citations of articles published in the years 2018 and 2019 divided by the number of citable items from that period. Citable items include research articles, reviews, and case reports, but do not include editorials, perspectives, President's Corner columns, journal news, and the like.
It is thus clear that there is a significant “lag” in the score and a narrow window for article to be cited. For example, an article published in December 2018 would only be “eligible” for 13 months to be included in the 2020 calculation and a score announced in 2021 is reflecting activity that may be of >3 years ago. As a result, to many there is an increasing concern that the IF is not reflecting fully or accurately the current status and the true impact of a journal.
Given this concern it is not surprising that a new score has been developed: the CiteScore. In contrast to the IF score the calculation of the CiteScore for a current year is based on the number of citations received by a journal in the latest 4 years (including the calculation year!), divided by the number of a broader range of types of articles (including Editorials) published in the journal in those 4 years. Thus, the 2020 CiteScore of 3.0 for Breastfeeding Medicine is based on citations from articles published in the years 2017–2020, and is thus considered by some to be a more up-to-date, comprehensive, and inclusive evaluation of a journal's academic status.
Breastfeeding Medicine has always published “special” issue and 2021 was no different. Under the excellent guidance and inspiration of Dr. Sahira Long who served as Guest Editor, the journal published a two-part series on “Breastfeeding and the Black/African American Experience: Cultural, Sociological, and Health Dimensions Through an Equity Lens.” Not only has the response to the publication been overwhelming, but also the series of articles have set a standard of concern in addressing these disparities and the pressing public health of the United States.
Yes, despite everything, 2021 was a success and we should in the future, in the words of the Psalmist (Chapter 90, sentence 8), only continue from “strength to strength” (m'Chayil el Chayil).
—Arthur I. Eidelman, MD, FABM
Editor-in-Chief
Breastfeeding Medicine