• Blogging vs. peer review

    Something rare happened to me on Wednesday. In the span of a few hours a post I co-authored with Aaron Carroll published on JAMA’s blog, and a commentary I co-authored with Henry Aaron published in NEJM. This turned out to be a great, admittedly small sample, natural experiment of blogs vs. journal publication.

    Both pieces were short, ungated, and accessible to a general health policy audience. Both were promoted in essentially the same way on the authors’ end (emails to journalists after the pieces appeared, announcements on this blog [here and here] and on Twitter). But one received a lot more attention, as measured by links from prominent journalists and institutions, than the other. Can you guess which?

    The answer is that the blog post at JAMA received more attention. It’s not surprising, actually. The JAMA piece was in sync with the media;  it was about the State of the Union Address, which had occurred the night before. Aaron Carroll (I have to use his full name in posts that also mention Henry Aaron) had drafted it just after the Address on Tuesday night, and he and I refined it Wednesday morning. JAMA approved and posted it by early Wednesday afternoon. The wider media was still interested in the subject that afternoon, evening, and the next day.

    In contrast, the NEJM piece with Henry Aaron was not on a topic of immediate interest, premium support. When Henry and I wrote it, in December, premium support was more topical. The holidays and the process of review and preparation for publication delayed its appearance until a time when premium support wasn’t as hot. It published at 5PM on Wednesday. That’s not NEJM’s fault. It’s just the way peer-review, journal publishing works. It takes time.

    Had President Obama mentioned in his speech on Tuesday anything about Medicare that hinted at a political contrast over premium support, the issue might have been current enough for the NEJM piece to garner some attention. But, to my surprise, he did not. Again, not NEJM’s fault. The editors could not have known the issue climate at the time of publication. That’s my point. Journal articles basically come out randomly with respect to the timing of policy debate. Blogs can be better timed.

    Premium support will be hot again, and I trust that, in time, the NEJM piece will get its due. Nevertheless, this was a beautiful example of how blogs can disseminate relevant information much more efficiently than journals. That’s not to say traditional journal publication, or something like it, is not important. Slower, deliberate, peer review is important. I would not want to lose it, or something like it. But there is a cost.

    There’s a gain too. I get to list the NEJM piece in the peer-reviewed portion of my CV. It counts for promotion. Blog posts don’t, or if they do, they count much less. In the long run it matters more, at least to me, that I have a peer-reviewed piece in NEJM (or anywhere). But in the short-term the JAMA blog post got the attention of the day. When that’s important, if that’s important, blogging wins.

    AF

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