Dispatches for practitioners on the front line

Ian Balfour-Lynn assesses the strengths of a narrowly focused medical review.

Cystic fibrosis is an inherited life-limiting disorder that affects many systems of the body, but principally the lungs and the digestive tract. It affects more than 7,500 children and adults in the UK, and there is a journal devoted to the disease. The Journal of Cystic Fibrosis (JCF) is the official journal of the European Cystic Fibrosis Society (ECFS), and it was first published in March 2002. It appears quarterly (and will appear bimonthly from 2007) and publishes occasional supplements, including abstracts from the society's annual conference. It is available online and in print, and after two years it was accepted for full indexation on Medline and PubMed. The editorial board has an international flavour; although most members are from Europe, there are also representatives from Canada and Australia.

I can appreciate why the ECFS wanted its own journal, but is it truly necessary and does the intended readership need another one? There are already several established journals that regularly publish articles on cystic fibrosis. These are mostly respiratory-oriented, but it is not uncommon for them to publish papers on non-respiratory aspects of cystic fibrosis as well. Articles also appear in the many paediatric journals and sometimes other organ-specific specialised journals. Of course, papers of great significance will appear in the most prestigious publications.

However, a disease-specific journal may allow publication of more esoteric aspects of cystic fibrosis that would interest specialists but would not make it in the more competitive arena of the major journals.

The intended audience is wide and reflects the multidisciplinary team approach to the care of people with cystic fibrosis. Herein lies this journal's key advantage, which is to reach those wishing to keep up to date with the disease in a convenient manner. The problem is the publication hierarchy for those in academic medicine, whereby everything revolves around the impact factor and how much the peer-reviewed article is worth to a university.

This can mean that the publication does not reach the audience for which it is intended. JCF does not yet register on the citation index, so it is most likely that a paper will be sent to JCF only after it has been rejected by a number of other journals. Quality control and strict peer review is, therefore, vital for JCF to retain credibility. Most papers published are original scientific articles, although there are also short reports and case studies. In addition, there have been a number of good review articles (one on cystic fibrosis-related diabetes by A. L. Brennan et al. in December 2004 and another on faecal elastase by A. Daftary et al. in May 2006), which will be particularly helpful in encouraging cystic fibrosis specialists to read the journal. Publication of important consensus statements (usually from the ECFS) will also encourage a growing readership (for example, that on the role of immunisation by A. Malfroot et al. in May 2005 or the European consensus on standards of care by E. Kerem et al. in March 2005). Time will tell how popular the journal becomes, and gaining an impact factor is a high priority for JCF .

Ian M. Balfour-Lynn is consultant in paediatric respiratory medicine, Royal Brompton Hospital, London.