The impact factor of a journal depends on the citations of articles in the first two years after publication. Obviously, this is a debatable criterion, which has generated a lot of discussion in the literature. Indeed, citations may not reflect the quality of a paper, may also be used to disqualify previously published articles, or can be subject to (excessive) self-referencing. On the other hand, it has been shown that journal impact factors correlate with Hirsch factors of board members and impact of articles, as judged by experts in the field. Other factors that may determine relevance, such as downloads of full-text articles from a journal's website, seem to correlate well with the impact factor, as has also been shown for the Netherlands Journal of Medicine.
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