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- William W Parmley, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology*
- ↵*Send correspondence to: William W. Parmley, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology, 415 Judah St., San Francisco, California 94122
One of the most distressing things that can happen to an author is to have a manuscript rejected by JACCdespite the fact that the reviews seem fairly positive. As the editor of JACC, I am the recipient of phone calls, letters, faxes, and e-mail that ask some form of the question: “Why did JACCreject my manuscript?” Although the reasons are always related to the manuscript in question, there are other general factors that are also important. These are outlined below in the hopes that disappointed authors may better understand some of the reasons for rejection:
1 The numbers
The number of manuscripts received by JACCcontinues to rise in the face of an essentially fixed number of pages. Thus, our rejection rate must continue to rise. Since we first took over editorship of JACCeight and a half years ago, our acceptance rate has steadily dropped from 30% to its current level of about 17%. This is a daunting number. The dilemma of what to accept is evident each Tuesday morning when I meet with the Associate Editors to review those manuscripts that we think are potentially worthy of publication in JACC. Each week we can select about eight manuscripts that we expect to have revised and eventually accepted for publication. However, after our presentations and discussions, we may have up to 16 manuscripts that we consider of sufficient quality to publish in JACC. We then must undergo the painful task of paring the 16 down to 8, rejecting 8 good manuscripts per week. This decision is usually based on our “priority” overview of the potential importance of the manuscript to the field and how many of JACC’s readers would find the paper interesting. These decisions reflect our best collective judgment but are no consolation to an author whose manuscript is rejected. One fall-back position is to hold over one or more of these manuscripts for a week to see if they compete more favorably with next week’s batch. Experience has taught us, however, that the chances for a held-over manuscript are rarely better the next week.
The membership of the ACC are mostly adult cardiologists; therefore, the bulk of the articles are directed to that constituency. However, we need to keep a proper balance among the many different areas of cardiology. Because our membership is mostly clinically oriented, only about 10% of our papers come from the animal laboratory, and these should have an obvious relationship to clinical cardiology. During our tenure, we have also decided not to accept case reports. These content issues play an important role in our overall decision making.
3 Science and the importance of the question
The most important consideration in accepting a manuscript for JACCis that the question be important and the scientific method be strong. Ideally such a manuscript would either: 1) report a large, prospective, randomized, double-blind, placebo-controlled trial that is addressing a very important clinical question; 2) make a compelling demonstration of the efficacy of a new procedure; or 3) present experimental studies that illuminate underlying mechanisms of cardiovascular disease and therapy. We appreciate that these types of studies are not frequent enough to fill the pages of JACC. Accordingly, we also consider observational studies or pilot studies worth publishing if their content is deemed to be of great interest to clinical cardiologists. Sometimes we accept a controversial or provocative manuscript, which may spur other investigators to validate an unexpected new finding. We are less interested in “methods” papers, but they rank more highly if they are used to answer a clinical question. We are almost always subconsciously asking ourselves the question, “What do our readers want?” I am also trying to judge whether our readers will exclaim, “Wow, that was interesting!” after reading a specific article.
One of our associate editors (SG) carefully examines the statistical methods of a manuscript to assure us that the results are valid and meaningful. Although there is sometimes an in-depth criticism of statistical methods, requiring substantial revision of the manuscript, rarely does this alone disqualify a manuscript.
5 The reviews
We routinely solicit at least two reviewers for each manuscript. When the initial reviews differ markedly, we frequently obtain a third or arbiter review. There are three important parts to a good review of an article. First is a ranking of the originality, methodology, and presentation; and an overall priority rating (top 10%, top 25%, top 50%, bottom 50%, reject.) The second are the confidential comments to the editor, which can be very helpful in judging the manuscript. Frequently these are not totally consistent with what the reviewer writes to the authors. The third are the comments of the reviewers that are sent back to the authors. Not uncommonly, a manuscript may have a rating of bottom 50% or reject, and yet it may have fairly benign comments to the authors. For example, a study may be well done but mostly confirmatory of previous work and, therefore, be of lower priority. Although the review system is not perfect, we are heavily influenced in our decisions by the evaluations of expert reviewers.
Although the above are not the only elements that enter into our decision making, they describe the major factors. We apologize in advance if we reject some of your good work because we do not have the space to publish every meritorious manuscript we receive; but we look forward to publishing studies of yours that are of the high quality we are trying to attain in JACC. As always, we invite your comments and suggestions regarding the editorial process.
- American College of Cardiology