Harold C. Sox, MD, Editor
Sox H.; Medical Journal Editing: Who Shall Pay?. Ann Intern Med. 2009;151:68-69. doi: 10.7326/0003-4819-151-1-200907070-00013
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Published: Ann Intern Med. 2009;151(1):68-69.
This issue of Annals is my last as Editor and an occasion to describe some lessons learned. Here are 3: Spotless research is a rare exception; editors and statisticians who labor to improve reports of clinical research are a national treasure; and clinical journals can provide a unique public service if they ensure that research methods are correct, reporting is accurate and complete, and conclusions are appropriately cautious. These lessons will emerge as I discuss the question that haunts me as I leave Annals: Who will pay for this public good that clinical journals provide?
Journals occupy a pivotal place in the chain that links research to better medical practice. The chain begins with a manuscript that describes new research. Journal editors evaluate the manuscript, work with the authors to make it better, and sometimes publish it. With rare exceptions, no single research report changes practice. Rather, the report becomes part of the body of evidence that does drive practice. Along with marketplace processes, the true shapers of practice are guideline panelists, insurance coverage decision makers, and the authors of the systematic reviews that summarize the evidence. These decision makers need journals to insist on complete reporting and good statistical practice. Sometimes, researchers reanalyze a pivotal study whose data set is publicly accessible, a trend that Annals has promoted (1). However, the published report is usually the final public record.
The Research Center for Medical Sciences, The 3rd XiangYa Hospital
July 16, 2009
Medical Journal Editing: Who Shall Pay?
To the Editor,
The editorial paper "Medical journal editing: who shall pay? (1)" by Dr. Sox, revealed the exact processes a manuscript goes through during editing at the Journal. The Journal has a responsibility to the readers, and thus their patients as well. As the readers, we admire you for your efforts to make the articles published in the Journal as precise and accurate as possible by incorporating statisticians in the editing team and for the positive outlook when it comes to working closely with authors.
By integrating statisticians into the decision making team, you guaranteed the high scientific value for the papers published in the Journal. In fact, the incidence of the statistical errors in some other medical journals may be up to 88%, with some errors resulting from lack of statistical knowledge and some introduced intentionally to obtain desired outcomes (2).
By clarifying the statistic issues and working closely with the authors, the editors potentially saved many research papers that have important significance, which may have been simply rejected by other journals. Your efforts to be responsible to the authors and readers have also been clearly demonstrated by the rejection letter as well as the published papers. In the past we have always received specific comments from the Journal to explain the rational for the decision not to publish a manuscript in the Journal, while other journals send the same rejecting letter repeatedly for more than ten years. In addition, in the author center of the website of the Journal, when an article was rejected for publication, it is noted as "not accepted for publication", whereas many other journals simply inform us with one word "rejected", generating a completely different feeling when we see them. These kinds of differences in the details of treating authors can not be simply attributed to lack of time of the editors of the other journals, but rather a reflection of the editors' attitude to the authors. Obviously, the editors of the Journal are the true champions of research.
In summery, the readers of the Journal and accordingly their patients, the public, as well as the researchers themselves have benefited from the work of the editors of the Journal. It is thus clear who should pay for the editing. We suggest the Journal keep an account open to the public as well as the authors for donation. There must, of course, be a ceiling for each donation to prevent some individuals from donating an extreme amount of money in an effort to influence the decision of the editors.
1. Sox HC. Medical Journal Editing: Who Shall Pay? Ann Intern Med 2009;151 68-69.
2. He J, Jin Z, Yu D. Statistical reporting in Chinese biomedical journals. Lancet. 2009;373:2091-3.
Marvin E Gozum
Jefferson Medical College
July 17, 2009
Why is public good a private concern?
A key issue that could be raised for funding journal editing is why a private organization provides a public service, if indeed, journal articles are released for the public good? Are journals a form of philanthropy for the ACP if information is inevitably put into the public domain for free, and as mandated by US law? I am sure the Annals has exhaustively explored alternative funding models that could include annual monetary grants and endowments from charitable organizations. However, the amount of philanthropy varies with the economy, yet the output of studies remain at least constant. Its clear a funding strategy must exist proportionate to the volume of studies themselves, as it is a problem affecting all the journals.
I have not seen universality in embedding the cost of publication within a grant writing proposal nor a standard cost that could be entered into a grant proposal, the model proposed by open access publications. Maybe its time publication charges be standardized and made proportionate to the complexity of study design so it can be properly justified, especially to the NIH. This does not solve the editorial requirements of letters, reports, and unfunded studies all made with limited resources, but its very likely such reports are equally less complex to review, compared to large studies.
While accessing websites appear free, it is the server owner's responsibility for maintaining the servers and network, which are not free (1, 2). The publication charges would also subsidize resources to make information available for free.
1. Davis PM, Lewenstein BV, Simon DH, Booth JG, Connolly MJ. Open access publishing, article downloads, and citations: randomised controlled trial. BMJ. 2008 Jul 31;337:a568.
2. Gozum ME. Internet Access. Science. 1996 Apr 19;272(5260):335c.
Xuan Wu Hospital
August 31, 2009
We were surprised by the financial situation of the Journal, as in our mind medical journals can be highly profitable (1). There are numerous ways for a medical journal to generate revenues. For example, promoting drugs and charging authors by the pages they publish in the journal. For well- known journals the former method is very effective, whereas for the under-known journals the latter is attractive. One of the expected outcomes is that medical journals are too close to drug companies (2). The other is that, in order to make the greatest profit, some journals print their papers in extra large fonts with unusually wide margins and charge astonishing prices. The Journal has done nothing like this, and even does not charge anything for articles published in it. By doing this, the Journal maintains its independence, integrity and reliability and has long been admired by the medical community. However, in order to keep its high quality, it is essential to retain the editing staff. To solve the financial problem of the Journal, we suggest that the Journal charge authors at a reasonable price for articles published in it. We believe that it is not only acceptable but also welcome.
1. Angell M. A farewell. N Engl J Med. 2000;342:1989.
2. Smith R. The trouble with medical journals. J R Soc Med. 2006;99:115-9.
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