Author + information
- Anthony N. DeMaria, MD, Editor-in-Chief⁎ ()
- ↵⁎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
There seems to be little question that we are currently in a trying period worldwide, and many factors are influencing the environment in which we live. The sluggish economy is, perhaps, the most prominent factor. There is also considerable political instability, especially in the Middle East. Medically, the growth of chronic noninfectious illnesses, such as cardiovascular disease, is an increasing issue for developing countries. A number of issues are also affecting the environment for medical journals. I thought it would be worthwhile to discuss some of these issues that are present in the current milieu.
An important factor influencing the milieu in which journals exist is the proliferation of publications. More than 80 cardiovascular journals are currently being published in the English language alone, and more are appearing on a regular basis. It is apparent, therefore, that no one person could read everything that is being written. In fact, readers are generally overwhelmed and liken keeping up with the literature to trying to drink from a fire hose. Busy physicians have limited time to devote to journals, and are asking us to publish, or at least clearly identify, the information that they absolutely have to know. In this context, editors are struggling to balance that information that one needs to know with that which is nice to know. In addition, it is becoming more important than ever to ensure that as much information is packaged into every paper as possible and that slicing of data into multiple papers is avoided.
The proliferation of journals is being accompanied by an increased number of manuscript submissions. Certainly, the creation of new research information could only be viewed as a positive. However, the greater number of manuscripts, many being reviewed by multiple journals, has resulted in an explosion in the need for reviewers. In fact, it seems clear that we are experiencing a significant degree of reviewer fatigue. Reviewers are increasingly declining requests to evaluate articles, and when they accept, they are often providing briefer critiques. These appraisals, which are of great value to the editors, are also of critical importance to the author. It should be noted that editors are not immune to the fatigue generated by handling so many submissions, a factor that undoubtedly influences their enthusiasm to work with authors to improve manuscripts so that they can ultimately be accepted.
A number of financial factors also exist that are contributing to the environment in which medical journals are published. Libraries are under increasing financial pressure to limit the number of periodicals to which they subscribe. Therefore, the potential exists that the information contained in a journal may not be obtainable by readers, not for lack of value, but for lack of resources. This means that the availability of institutional licenses to access journals online is extremely important. Simultaneously, advertisers are also experiencing financial pressures and are re-evaluating or reducing their expenditure for advertisements. It is obvious that the cost of journals to readers would be much greater without the subsidy provided by advertisements. In addition, journals often provide important monies for the professional societies that they represent. In the absence of advertisements, a new model for funding journals would undoubtedly result in a marked increase in expenditures by both readers and authors.
Another factor contributing to the milieu in which journals exist is the changing emphasis upon conflict of interest. Although conflict of interest is a complex topic that could easily occupy an Editor's Page itself, it is clear that there is a more intense focus upon avoiding the introduction of bias into either the production or review of a manuscript. Although conflict of interest is sometimes called “relationships with industry,” indicating a financial component, it has been my experience that professional considerations are often more important in introducing bias. In any event, journals are under more pressure than ever to police submissions for possible conflicts, and authors, reviewers, and even editors are being scrutinized more closely for potential conflicts. For example, editors now often find it necessary to read in detail both the submitted manuscript and the research protocol filed in a public database to ensure that the endpoints and adverse effects reported in the paper are not incomplete. It has also been suggested that editors should go online to verify that an author's disclosure of relationships with industry is indeed accurate. While many are concerned that this emphasis upon conflict is contributing to a “presumption of guilt rather than innocence,” it is absolutely crucial that journals ensure that the medical literature is free of bias and self-interest if we are to keep the trust of our readers and society.
A final issue that is affecting the setting in which journals exist is the march toward online publication of virtually all information. The Internet is a powerful tool that is ubiquitous and can bring forth new information virtually instantaneously. This ability has already influenced journals. For example, the findings at meetings are freely available online within hours of their presentation, frequently with accompanying slides, authoritative reviews, and interviews with the authors. Therefore, journals must focus on being the definitive peer-reviewed presentation of the information. Of greater consequence is the online publication of journals themselves. For many years, it has been dogma that print versions of medical publications will completely give way to electronic, but this transition has yet to take place. However, the advantages of online presentation of content are considerable, and the availability of electronic readers, such as the iPad, have brought us much closer to the reality of an “online book.” As we make this transition, medical journals must adjust to exploit the benefits of online publication, including the acquisition of related material, such as videos, access to associated guidelines, and author interviews. We at JACC have taken a leadership role in this change, but the path forward is not clearly delineated (e.g., the advertizing model is uncertain), and we continue to work on the print version while developing the online alternative.
Medical journals have a long history of serving as the vehicle of new information for physicians, and they can be anticipated to do so for the foreseeable future. However, the environment in which journals exist will continue to change, and the publications will have to evolve to maintain this position. A number of issues are currently present that affect the environment in which medical periodicals now exist. As is nearly always the case, these issues present both challenges and opportunities. The ultimate role of medical journals in being the pre-eminent provider of new knowledge will depend upon our ability to respond to the changing environment.
- American College of Cardiology Foundation