Getting Your Article Published: The Mysteries of Peer-Review and the Decisions of Journals Howard Bauchner, MD, FAAP, FRCPCH Editor-in-Chief, ADC Professor of Pediatrics & Public Health Vice-Chair, Academic Affairs Boston University School of Medicine/ Boston Medical Center

ADC  First published in 1926  Official publication of Royal College of Paediatrics and Child Health  Jointly owned by by RCPCH and BMJ Publishing Group Ltd  2007 Impact Factor - 2.8; F/N  Circulation 11,000  Monthly PDF files downloads – 300,000

Copyright ©2006 BMJ Publishing Group Ltd. Valman, B Arch Dis Child 2006;91: Figure 1 A selection of ADC covers

Helpful hints !!!  Correct journal  Instructions  Rejection without review  Paper reviewed  Peer-review  Editors  Responding to reviews  Keys to success

Is it the correct journal?  This is critical issue for ALL journals  Can be far more subjective than you think  Beware case-reports  Is the topic hot or sexy  Most journals can reject without review  Is it worth shooting high, but failing (impact factor)

Impact Factors*  NEJM – 53  Cell – 30  Nature – 29  Science - 26  Lancet – 26  JAMA – 25  AIM – 16  BMJ – 10  Pediatrics – 4.5  JOP – 4.0  US Archives – 3.7 * No. of citations to 02/03 articles / no. substantive articles published in 02/03 (NEJM – 28696/744 = 38)

Follow the instructions!  Article type – original, review, etc.  Cover page – title, word count  Length – critical issue (less is more)  Abstract – single most important page  Speak with editor(s) first

A good abstract  90% of us read ONLY abstract  Structured  Concise  In English  Some data  Not all data  Beware which data  Conclusions  Best to have outside reader

Structure of an article  Introduction  2-3 paragraphs  Methods  3-5 paragraphs  Results  5 paragraphs  Discussion (structured)  Principal findings  Strengths and weaknesses  Strengths and weaknesses vis a vis other studies  Meaning of study  Unanswered questions/future research  References, tables, figures, support, acknowledgements

Rejection without review  Usually editors/sometimes committee  US Archives (2005) -  750 submissions per year  20% rejected with out review  Acceptance rate about 22%  ADC (2008) -  1700 submissions per year  1100 original research articles submitted  Rejected without review 35%  Acceptance rate of original articles 22%  JAMA (2006) –  5354 major manuscripts  Rejected without review 60%  Acceptance rate 8%

Reject without review – why?  Wrong journal – journals have biases  Not new or novel  Poorly written abstract  Poorly designed/wrong analysis  Sweeping conclusion  Case-report  Editor having a bad day (this happens) !!!

Paper accepted for review  Assigned to editor (not EIC)  Most editors have areas of expertise  Editors may send article out for review (rejection without review can occur here)  No magic number of reviewers – 1-3  Statistical consultation can be requested by editor and/or peer-reviewers

Peer-reviewers  You can recommend reviewers to editor (and individuals not to review – plus/minus)  Recommended reviewers score paper the same as others, but more often recommend acceptance  Chosen from “list” of reviewers that journal generally uses  Some subject areas difficult to find reviewers – editors search reference list or OVID  Process takes 1-3 months

Peer-review  Little science – a fair amount of research  Quality varies, best reviewers are 35 to 45  Time – 2-4 hours depends upon manuscript  Not much difference between blinded and unblinded reviews

What do reviewers assess?  Importance  Clarity  Design and analysis  Should review abstract, text, tables, figures, references, acknowledgements/support  Make recommendation to editor  Opinions of reviewers are not binding  Usually provide comments to authors and separate comments to editors

Editors  Review paper  Review peer-review  May request statistical help  Make recommendation to auction/editorial board (judgment day)  Accept; accept with revision; reject with revision; reject; short report; research letter  Discussed vis a vis importance and validity

Responding to reviews  Do not be argumentative, respectfully disagree  Reviewer A says go left; reviewer B says go right – ask editor  You do not have to respond to every issue, but must articulate why not  Follow directions – i.e. number responses, indicate changes in manuscript and where they can be found  Long explanations to editor in cover letter is not the same as modifying the text

Keys to success  Clarity (abstract)  Brevity (2500 words)  Novelty (why a ADC)  Modesty (some)

Important issues  Ensure it is the correct journal  Rejection without review is usually quick (BMJ occasionally occurs in minutes)  Correspond with journal if permitted  Suggest reviewers  Be patient – 6-8 weeks for review  After rejection – speak with responsible editor  Do not just send out paper again, revise

Getting your article published  Revise revise revise – 10 drafts (date drafts, provide deadlines, circulate as complete manuscript)  Senior colleagues are critical  Clarity  Uniqueness  Larger context