The NLM's List of journals indexed in Medline named 92 journals from Italy and 926 from the UK. Of the journals from Italy, 20 were excluded: 8 had ceased publication and no editorial information was found, 1 was only selectively indexed, 4 were not research journals, and 7 lacked an Italian editor or publisher. Four additional Medline-indexed Italian journals were included: 1 was absent from the NLM list, 1 was incorrectly listed under Germany and another 2, published by Elsevier (Netherlands), were edited in Italy and represented at least one Italian medical association. Although these latter two journals are not published in Italy, they were selected to better represent journal editing in Italy. Thus, 76 Italian research journals were included in the study, as were 76 journals from the UK (Appendix S1
). To identify these latter journals, 180 candidates were randomly screened and 104 (58%) were excluded, mostly for being edited outside the UK. This exclusion rate permits an estimate of 389 journals edited and published in the UK. Therefore, the 76 UK journals in this study comprise 20% of all Medline-indexed research journals edited and published in the UK.
The two groups were similar in terms of the numbers of journals publishing research involving both humans and animals (biomedical), involving only humans (clinical), or not involving humans (e.g. animals or plants) (). However, Italian journals published fewer articles annually (median, 60 vs. 93; p
<0.006) and were older (p
<0.001) than UK journals. In particular, 8 Italian journals had been started since 2000 compared to 20 UK journals. These results suggest different trends in innovation and turnover. Almost all UK journals had an international editorial board and, although 47 Italian journals also did, this difference was significant (p
<0.001). Most articles published in UK journals had a non-national first author, whereas only 37% of examined articles in Italian journals were authored internationally (p
<0.001). These results suggest that UK journals can be considered international, while Italian journals have a tendency to being international, as also evidenced by their preference to publish exclusively in English. Concerning use of the Internet, Italian journals less frequently had online archives or links from PubMed to the archives. In particular, 17 of 43 Italian journals with online archives lacked PubMed links, vs. 6 of 74 UK journals. Despite being older, Italian journals offered archives covering fewer years (median, 6 vs. 10; p
<0.001). However, Italian journals were more likely to offer open access and less likely to impose an embargo period, a phenomenon almost exclusive to UK journals. Regarding type of articles, journals from the two countries published similar, low percentages of letters to the editor (p
0.070), but in Italian journals clinical trials were less frequently randomized and controlled (p
0.029). Regarding citation, fewer Italian journals were indexed for IF (28 vs. 54, p
<0.001) and those indexed had a lower median IF (1.2 vs. 2.7, p
<0.001). All UK journals and 75 Italian journals were indexed in the SCImago database. Italian journals scored significantly lower in SCImago journal rank, H index and number of citations per document (p
<0.001). Together, these results show that Italian journals are “smaller” and score lower for quality than UK journals.
Characteristics of all Italian (IT) research journals and a randomly selected group of UK research journals indexed in Medline.
Each journal's instructions to authors and editorial policy statements were examined to assess the editorial leadership demonstrated towards authors (). Italian journals were significantly more likely than UK journals to declare to adhere to URM (27 vs. 11, p
0.003). However, 24 Italian journals cited an outdated version (1997 or earlier) and 3 provided no reference; only 3 linked to the ICMJE website. UK journals also failed to cite the current version (5, no citation; 6, outdated versions) but 7 provided links. Fewer Italian journals based authorship on a “substantial contribution” or “scientific responsibility” (p
0.019) or required that manuscripts specify authors' contributions (p
0.005), funding or sponsorship (p
<0.001), and competing or conflicting interests (p
<0.001). For journals publishing human research, similar low numbers required that manuscripts state that research adhered to the Declaration of Helsinki: 9 Italian journals referred to outdated versions (1983 or earlier) and only 1 Italian and 6 UK journals referred or linked to the current version. Fewer Italian journals inquired about ethics committee review (p
<0.001). Some inquiry about informed consent was made by 16 Italian and 42 UK journals (p
<0.001). Of these, 7 Italian and 20 UK journals required informed consent for the publication of personal data, and 7 and 9 journals, respectively, required informed consent for patients' participation in clinical trials. No Italian journal required registration of clinical trials vs. 20 UK journals (p
<0.001). For journals publishing animal research, fewer Italian journals inquired about adherence to animal research laws (p
0.082). No Italian journal adopts CONSORT or QUOROM, while 15 UK journals follow CONSORT and 11 QUOROM. No Italian journal but 33 UK journals adhere to the guidelines of COPE. These results document that Italian journals show less editorial leadership than their UK counterparts, but that UK journals have room for improvement.
Editorial leadership demonstrated by Italian (IT) and UK journals indexed in Medline, as apparent from instructions to authors and other editorial policy statements. Values are numbers of journals.
To further examine the relationship between editorial leadership and quality and to understand the impact of potential confounders inherent to a cross-cultural comparison, multiple regression analysis was performed for the 73 Italian and 69 UK journals that published research on humans (). When SCImago journal rank was used to define quality, the 12 parameters of editorial leadership considered as predictors explained about 37% of the variance in quality among the journals (multiple R
<0.0001). Each potential confounding variable added singly to the model had a minimal effect, and when all 5 confounders were added the ΔR2
was only 6.2%. With SCImago “cites/doc” as the definition of journal quality, editorial leadership explained almost 50% of the variance; again, the possible confounding factors had a small effect and together increased R2
by 13.8%. Finally, for the subset of journals indexed for IF, editorial leadership explained 49.9% of the variance in this parameter and confounders increased this to 57.4%. These results suggest that editorial leadership is intimately associated with journal quality as assessed by various citation statistics, and that the impact of variables such as country of origin, publishing language and internationality is not strong.
Multiple regression analysis of the impact of editorial leadership and of potential confounding parameters on journal quality, for 73 Italian and 69 UK journals that publish research on humans.
Finally, regarding the participation of journals in associations for editors, one Italian and 20 UK journals are affiliated with WAME. Similarly, one Italian and 12 UK journals have editors or staff who are members of EASE. Only one UK journal has staff listed as member of CSE. Thus, Italian journals have few means of learning about the latest international standards and trends in biomedical publishing, but many UK journals are also missing this opportunity. The lower participation of Italian editors may have contributed to the lower performance of Italian journals on parameters of editorial leadership examined in this study.