The word ‘impact’ is in peril of becoming hackneyed terminology. In modern parlance its meaning appears to have undergone more costume changes than Lady Gaga on a whistle-stop tour! And in the world of medical publishing the definition of ‘impact’ is nowhere more nebulous than where a ground breaking paper, and a review that merely cites a ground breaking paper, are measured using the same impact criteria.

How then does one judge the impact of a publication, both at the time and thereafter? For instance, in high turnover publications such as daily newspapers, initial impact may be phenomenal, although transitory, from front page scoop, to fish and chips wrapping in the space of a single day. When considering medicine, and particularly medical publications, presumably the desired impact would mean that manuscripts were read, information conveyed and subsequently adopted by the reader, and as …