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- Anthony N. DeMaria, MD, 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 630, San Diego, California 92112
Since the Editorial Office of JACChas moved to San Diego there has been a progressive increase in the number of articles submitted to the Journal. This increase has particularly accelerated in recent months. While discussing this at a meeting with Elizabeth (Liz) Wilson, Senior Director of Publications at the American College of Cardiology, she wondered out loud, “Where's it all coming from?” This query prompted me to reflect on this issue, and has resulted in the current Editor's Page.
As can be seen in the Table 1,submissions to JACChave been and are on the rise. In the year before the current editors took over responsibility the journal received a total of 2,515 papers, of which 2,374 were original research articles. The number of submissions increased to 4,570 in 2007, of which 3,915 were original research. In 2008, a year in which several new cardiovascular journals were launched, we received fewer manuscripts, 4,081. However, our daughter journals, JACC: Cardiovascular Imagingand JACC: Cardiovascular Interventions, received 1,054, raising the total for the family. As of the last week in August 2009, JACChas been the recipient of 4,000 articles, of which over 3,000 present original research. Pro-rated, we are on track to evaluate over 6,000 papers this year, 4,000 of which will be original research. The daughter journals are on track to review an additional 1,184. In aggregate, the volume of manuscripts considered for publication will have nearly tripled since we assumed the editorship.
I am unaware of the specifics regarding the number of submissions received by other cardiovascular journals. However, based upon informal discussions, none seem to have experienced a decline, and most indicate an increase. This has occurred despite the appearance of new publications in the field. These startling (to me at least) facts lead one to wonder how to explain this phenomenon.
The most encouraging and optimistic explanation, of course, is that the quantity of productive cardiovascular research being performed is increasing. As has been consistent throughout my years as Editor, approximately two-thirds of all submissions originate from outside the U.S. So, a good portion of the new manuscripts result from an expansion of the research enterprise abroad. We are reviewing more material from Eastern Europe and the rapidly developing countries in Asia as well as from the traditional foreign sources of manuscripts. However, the volume of submissions from the U.S. is also rising. While we celebrate the fact that more effort is being directed to the generation of new cardiovascular knowledge, we should acknowledge that other factors are likely playing a role in the increased submissions.
The plethora of clinical trials being carried out in cardiovascular disease is certainly the source of much additional material. However, the paper reporting the primary end points is now just the beginning of the publications that come forth from a given trial. Multiple substudies frequently follow, many of which are pre-specified, presenting the results in subgroups such as diabetic patients, the elderly, women, and so on. Many trials submit manuscripts describing the protocol or data from pilot studies. Additionally, many papers describe sequential temporal findings: separate 30-day and 1-, 3-, and 5-year reports are not rare. In the process, a single trial accounts for many manuscripts.
In our experience, other factors contribute to the enlarging amount of submissions. Papers are often received that do not address a new question, but report findings with the “largest” population or “in the current era.” The “first-in-man” results are followed by the first report of a very small group and subsequently by reports of larger cohorts. The greater computerization of medicine has led to an ease of forming registries and constructing databases that frequently examine a previously studied issue in a slightly different population. The research enterprise emerging in many countries often yields observations that are unique primarily in pertaining to the inhabitants of that country. The results of comprehensive research projects are often presented separately: mechanisms or instrument developments are described in one paper, followed by initial clinical results in another.
As is apparent from the previous examples, although there is much new important research data being generated, the mode of reporting findings also contributes to the mass of articles currently being produced. My predecessor, Bill Parmley, referred to the “MPU,” or minimal publishable unit, as the least amount of data necessary to constitute a single paper. Regrettably, the pressures of academic medicine and career building provide a powerful incentive for the MPU. Unfortunately, given the time pressures on readers, and now the burden on reviewers, repetitive or minimally incremental manuscripts represent an impediment to the transmission of new knowledge.
Of the schemes that have been proposed to address the MPU, one that caught my eye was to limit the number of papers an author could submit or have accepted over a given period of time. In response to an increasing number of submissions, the American Heart Association limited the number of abstracts an author can apply to present at the annual meeting. If journals agreed to such a policy, authors could be incented to include as much information in every article as was possible, not as little. The devil would clearly be in the details in devising such a system. Would it specify submissions or acceptances? How many? Over what time? Would all journals participate? And so on. Nevertheless, a lesser number of papers brimming with important and comprehensive data would be of value to clinicians, investigators, and certainly to journals.
The increasing volume of manuscripts submitted to JACCand other cardiovascular journals is surely a good thing. It undoubtedly represents the abundant productivity of an expanding worldwide research enterprise. The multiplying number of manuscripts received results in important new knowledge that is of benefit to patients and is brandished by the journals as a sign of their vigor and success. However, amidst our celebration, we should acknowledge that the rising number of papers produced may also reflect an emphasis upon quantity. They have “come from” both innovative investigation and crafty data parsing. There is clearly some point at which we will exceed the capacity of readers, reviewers, and editors; many may think that we are at that point already. In order to avoid this occurrence, it will be critical to limit repetitive or minimally incremental reports. It is perhaps time to consider policies and procedures that would accomplish that goal.
- American College of Cardiology Foundation