Context: Journal editors are responsible to many publics, and their choices of articles to publish are a frequent source of dispute.
Objective: To assess the extent of agreement between topics identified by experts and by JAMA readers as most important for publication.
Design and participants: Modified Delphi process of polling of JAMA Editorial Board members and senior staff (ie, experts) in 1996, and masked direct mail survey of a stratified sample of JAMA readers in late 1996 and early 1997.
Main outcome measures: Agreement between experts and readers on the topics most important for JAMA to deal with in 1997.
Results: Of 55 experts polled, the 40 respondents (73% response rate) proposed 178 topics. Editing to combine similar topics left 73. The same 55 persons were asked to stratify all 73 alphabetically arranged topics on a scale of 1 to 5 (85% [47/55] response rate). They were then given the results of this ballot and asked to vote again (76% [42/55] response rate). Of the 55 experts, 40 attending the annual editorial board meeting were given all results; 39 attendees voted on the final topics. In response to the mail survey, a single pass of the same 73 topics yielded a response rate of 41.6% (208 returns). Nonresponders were roughly equivalent to responders demographically. Readers agreed with the experts on only 3 of the top 10 subjects: managed care, cancer, and aging.
Conclusion: Expert opinion and the opinion of readers as to what JAMA should emphasize vary widely.