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- Anthony N. DeMaria, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology⁎ ()
- ↵⁎Address correspondence to:
Dr. Anthony N. DeMaria, Editor-in-Chief, Journal of the American College of Cardiology, 3655 Nobel Drive, Suite 400, San Diego, California 92122
As an editor, I am frequently asked for insights as to how to get a manuscript accepted for publication. Implicit in this request is the concept that the presentation of a manuscript may determine the decision to accept or reject independent of the contents. Also implied is that certain characteristics of the presentation of a paper markedly enhance the chance of acceptance, and some can be very detrimental. Although I am sure that the latter is true, I am very skeptical of the former. In my opinion, much of the credit attributed to presentation is merely a reflection of good study design and execution. Whereas I agree that a poor presentation can sink a good study, I do not think an excellent presentation can rescue one that is fatally flawed. Nevertheless, there is a widely held suspicion that the “packaging” of a study is as important as the contents.
The other interesting aspect of the request for advice is the assumption that being an editor endows one with near perfection as an investigator/author. Although it is intuitive that someone immersed in the evaluation of research should be knowledgeable about the subject, critiquing an investigation is different from conceiving and performing it. Just as people follow the advice of stock brokers who are often unsuccessful at selecting profitable stocks for themselves, so too the experience of evaluating papers does not necessarily translate into infallibility in producing them. In fact, I have had and continue to have papers rejected for publication, and I know the same is true of other editors. Nevertheless, the current JACCeditors have now processed over 20,000 submissions, and over time patterns have emerged and a number of characteristics, both good and bad, have been repeatedly observed and catalogued.
I was recently asked to give a lecture at a major meeting on the topic of how to get a paper accepted in a competitive journal. I approached this by soliciting from each associate editor a list of the 10 most common factors they encountered that led to the acceptance or rejection of a manuscript. As might be expected, some variability existed in their responses; however, a number of themes recurred. The talk was well received, and I was encouraged by attendees to put it into print. Stimulated by this encouragement and the frequent requests for insights, I decided to write about the “consensus” opinions of the editors as to the most desirable characteristics of a manuscript. Because the material is more than one Editor’s Page, this one and the next will be devoted to the topic.
The first, and undoubtedly most important, insight that can be provided is that the preparation of the manuscript begins with the planning of the project. It is axiomatic that a well-planned project will inherently address most of the recommendations the editors advanced for preparing a research paper. As previously stated, poor presentation can ruin a great study, but great presentation cannot salvage one that is flawed. However, there was also a consensus that presentation could indeed make a difference in whether a paper is published or rejected. Given our acceptance rate of 10% to 15%, acceptable papers of comparable scientific quality may be distinguished by the caliber of presentation.
As a general statement, there are three qualities that characterize superior research papers and are carefully sought out by the editors. We seek manuscripts that are novel (new), accurate (true), and important (clinically or investigationally relevant).
Far and away the first and most important characteristic we look for in a manuscript is novelty. This, of course, is a difficult attribute to achieve, because there are very few things that are truly new “under the sun.” The most desirable expression of novelty is to be the first report on the subject. However, being the definitive data in a previously reported area in which controversy exists is also valuable. If a study is neither new nor definitive, there is still merit in extending prior findings or presenting the largest study of the question, although such papers are often critiqued as incremental. The lowest level of novelty is the confirmatory study, especially if presented as data from a special population or “in the current era” when there is no reason to believe that the findings should differ in that setting.
The second characteristic that is scrutinized is accuracy. It is not that accuracy is less important, but rather it is easier to achieve than novelty and, therefore, more anticipated to be present. A careful evaluation is done of the characteristics of the study group, the presence of controls and power calculations, and the specifics of the protocol. The methodology employed must be capable of answering the question, validated, reproducible, and sufficiently precise. Confounding variables must be absent. In terms of marker and genetic/genomic studies, separate validation and prospective confirmation cohorts are sought.
The final general characteristic that is crucial is the importance, or relevance, of the findings. In this regard, studies with implications for management are best, and account for the “star” quality of the randomized prospective clinical megatrials. In fact, we generally give expedited review and publication to studies that impact the management of disease. Close in importance are studies that develop or validate a method to establish a diagnosis or quantify severity. Papers that have implications for neither therapy nor diagnostic evaluation often have importance due to establishing mechanisms or defining prognosis. Obviously, data on prognosis are less relevant for conditions for which no effective interventions exist. Finally, editors and reviewers often assign high priority to manuscripts containing data that are hypothesis-generating. A paper has a fatal characteristic if it provokes the question “so what?” after being read.
Surely there is nothing surprising in the aforementioned comments. No one sets out knowingly to examine a question that has already been answered or is of no importance. Neither does anyone purposely use inaccurate methodology. Nevertheless, it is surprising how often this actually occurs. Of greater importance, it is noteworthy how often manuscripts fail to establish and emphasize their novelty, accuracy, and relevance. Knowing that these are the characteristics that are being sought, authors would be expected to go to great lengths in the manuscript to establish their presence. To this end, in forthcoming Editor’s Pages, I will discuss 10 specific actions, termed “strategies,” culled from the opinions of the associate editors to achieve this goal and to produce the strongest possible manuscript.
- 2007 American College of Cardiology Foundation