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Become an EMJ reviewer

18 Oct, 16 | by scarley

peer

The EMJ, like most journals relies on peer review to help the editorial team make decisions on submitted papers.You can have a look at the list of people who have reviewed for us here, and we are always looking for more.

Now peer review has had some tough times of late. Ex editors of major journals have described it as ‘A flawed process at the heart of journals’ and it is true that it is not a perfect process. However, it has also been argued, also by Richard Smith that it there is no obvious alternative and that is respected by the scientific community.

Personally I am a sceptic when it comes to peer review and am increasingly an advocate of a blend of pre and post publication review. I particularly like the idea of post publication review facilitated through social media and of course we encourage letters and comments through any of our social media outlets on papers published in the EMJ.

However, for now, peer review is here to stay prior to publication and that means we need the brightest and best people to help us make decisions for the EMJ. So, if you are good at critical appraisal, if you have expertise in an area of EM practice and/or research design and if you want to help the EMJ publish the best papers then get in touch.

Contact us here and send us your details. Help us make the world a better place.

vb

S

@EMManchester
Peer review: a flawed process at the heart of science and journals Richard SmithJ R Soc Med. 2006 Apr; 99(4): 178–182. doi:  10.1258/jrsm.99.4.178 PMCID: PMC1420798

BMJ Blogs on peer review

What’s the future of medical journals?

10 Jul, 16 | by scarley

The future of medical publishing

I had the pleasure of joining a panel discussion at the recent SMACC conference on the future of medical journals. I was delighted to share the stage with some real big hitters such as Richard Smith (ex editor of the BMJ) and Jeff Drazen (current editor in chief of the NEJM), together with some amazing researchers such as Sara Bassin Flavia Machado, Kathy Rowan, John Myburgh, Simon Finfer and Kath Maitland.

As with all panel discussions there was a degree of entertainment generated by our host Simon Finfer, but this is a significant matter. Journals and the publishing process have a huge role and influence on the conduct, funding and dissemination of science. The panel was assembled with deliberately discordant views to challenge the status quo and to look to what may be a fabulous, or perhaps a more dystopian future.

Richard Smith is a vociferous proponent of a post journal world and you can read his thoughts here. It’s really worth a read as a challenge to how we deliver knowledge from primary research out to those that actually need it and then out to practice, and more importantly to those that will benefit from it i.e. our patients.

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I found myself at one end of the on stage sofas with Rob MacSweeney who many of you will know from the Critical Care Reviews website, and with whom I share many views. I think we played our role as challengers to the status quo pretty well. Rob in particular is a fantastic exponent of getting research to the bedside in an ethical and fair way. If you’re not following his blog, and getting his newsletter at critical care reviews then follow the link and think about joining in.

There was too much on the day to summarise here, but I’d ask you to have a think about some of the ideas raised on the day. Right or wrong the panel were challenged on the following.

  1. Publishing in high impact journals is a key to academic promotion. Should it be?
  2. Universities are using a proxy measure (impact factors) to determine promotions. That’s outsourcing a really important measure to a system that has huge flaws.
  3. Similarly, funding organisations measure success in terms of publications in high impact journals. Journals thus have a huge influence on research funding priorities and success. Is this right?
  4. Peer review has been repeatedly shown to have huge flaws, fails to detect fraud, fails to detect poor quality and is prone to interpersonal bias and politics. Can we find a better way?
  5. Social media has the potential to produce post publication review, but is it any good, and can we collate it?
  6. Should we have open publishing, followed by widespread open peer review and then publication, and would this be better at detecting fraud, bias and error?
  7. Some journals make their papers open access after a period of time (e.g NEJM) and this is a good thing, but it would be better if it was sooner. Should all funding agencies demand open access (as many now do)?
  8. The relationship between researchers seeking publication, impact factors, promotion and future funding is complex and arguably at risk of a ‘mutualism’ relationship that does not directly benefit patients. How do we break that relationship (and do we need to)?
  9. Many journals believe that they are providing a service by filtering the poor quality out and only presenting research that is worthy of attention. The question was raised as to whether we need ‘other people’ to do this for us. Do we really need journal editors to be our filters and guides or can we do it for ourselves?
  10. Patients enter trials on the understanding that they will benefit healthcare in the future. Is it therefore unethical that that information is behind a paywall and not widely distributed?

We covered many more topics and I’d recommend a listen when it is eventually released from the SMACC website. For me, straddling the traditional world of journals as an EMJ editor, and also as proponent the new world of #FOAMed it was fascinating. I think it’s increasingly difficult to see how journals can survive in their current format with the rise of easy e-publishing and the ability to engage with a much broader audience across the internet. However, thinking that journals will remain as they are and not adapt to a changing world would be similarly naive. Journals will have to adapt and change and I’m sure they will.

My thoughts are that the role of journals as sole publishers of original research will diminsh, taken over by an open publication, hive-mind reviewed, open multi peer review process (I can dream). This will not mean that journals will die. Arguably there will be an increasing need for the  collation and interpretation of science, and arguably this will be a more effective and useful service for readers. The signs of such a change are already here. For example the BMJ has changed format over the years and now serves original research in a more summary style within the paper version. The detail is available, but not in the paper copy. It seems that accessibility, engagement and interpretation are increasingly valued, and that’s no bad thing. Here at the EMJ the primary survey and the podcasts serve a similar purpose and they are popular.

What then is the future of medical publishing? I’m not sure but I’m fairly confident that the status quo will not continue. What do you think?

vb

S

EMJ Editor and Editor at St.Emlyn’s virtual hospital, blog and podcast.

PS. The debate was fuelled by some rather fabulous on stage drinks. The 25 year old Bushmills as recommended by Rob was truly stunning.

Conference season

24 Jun, 16 | by scarley

Are conferences dead_

Having just returned from Dublin and the SMACC conference, and a few weeks earlier having travelled to the wonderful IFEM conference in Cape Town it’s time to reflect on the worth of the travel, expense and family disruption that ensues. Our work families too have to pull extra shifts and adapt to those of us lucky enough to get away for a few days away from the department.

In an era of web based technologies, podcasts, vodcasts and associated social media it’s questionable whether we need conferences at all. There are surely cheaper, less expensive and more convenient ways of communicating and in an era of social media it is ever easier to make those connections across the planet.

We should of course not forget the enormous environmental impact of many conferences, notably those large international conferences where 100s of tons of jet fuel are burned into the atmosphere to fuel knowledge dissemination that might so easily have been delivered online.

This is a theme we touched on in the EMJ in a paper looking at the future of conferences where the case for future more environmentally aware and better disseminated conferences was explored.

Innovation in the field of medical conferences.

So are conferences dead?

My experience last week and in South Africa would suggest not. Take the SMACC conference which has gained a bit of a reputation for blending social media, education and entertainment. The participants are almost all involved in online learning and so might be expected to shun the traditional travel to meet and great type affair.  Yet it is precisely this audience of online engaged clinicians who seek out the ability to meet, to network, to share, to laugh, cry and share together. This year the conference sold out in a matter of hours with competitions being held for the remaining tickets. The interest and anticipation to meet with like minded enthusiasts from across the globe was palpable and at times a little over the top and uncomfortable. The demographic was young, multicultural and multiprofessional. This is not typical behaviour for medical conferences, and perhaps is more akin to pop concert tickets. It’s a situation that makes some feel uncomfortable, but there is no doubt that it is engaging a worldwide population of learners.

A paradox perhaps, that the conference espousing an online socially connected world is one that sells out in hours and has a waiting list of those wanting to attend.

I’ve not quite got my head round this yet, but I think there may be at least two elements at work. Firstly there is a natural human desire to connect and conferences allow that, online interactions are good, but they are not the real thing and it’s great to meet in person, to explore ideas and to satisfy a human need to put faces to names. Secondly, although I find the online education world fascinating, there is only so much it can do. A live presentation of high quality is unsurpassed as a learning experience and you simply can’t do some things online.

Take the on stage discussion at SMACC on the future of medical journals as discussed by Richard Smith (ex BMJ editor). That was a great session that simply could not work as well in any other setting. A blend of science, politics, fun and entertainment with some really important discussion points and views.

Richard Smith: What will the post journal world look like?

So, the conference is far from dead, but it is changing. It’s role as a prime means of delivering information is perhaps waning, but as an opportunity to form and build social links, collaborations and understanding it is surely on the rise.

So I guess I’ll probably see you in an auditorium soon. If you do then say ‘hi’. After all, the people are just as important as the presentations. Collaborations, discussions and developments come from interaction, not from powerpoint.

vb

S

 

DOI: I’ve had supporting expenses to travel to many conferences, including SMACC last week. I am unbelievably lucky and priviliged to do so. I’ve actively supported a range of innovative conferences and believe that the old model of boring lectures given by boring speakers on boring subjects is a waste of time.

Gallows humour at the hanging committee

24 May, 14 | by scarley

Have you ever submitted to the EMJ or to any other journal for that matter? If so then you will know the fear and trepidation that results as you wait for the answer from the editor. Will your paper be accepted (hurrah) or rejected (boo). I’ve experienced much pain at the hands of editors and reviewers over the years and I’m doing my best not to give any pain back, but to be honest being part of an editorial team is not a popularity contest. A key part of our role is to decide what’s in and what’s out, and it will ever be thus.

The editorial decision process will vary from journal to journal but here at the EMJ all papers initially go to the editor in chief, and then are disseminated to handling editors who recruit and then manage the peer review process. Once complete the handling editors advise the editor in chief on their decisions and opinions. Ultimately the buck stops with the boss, but the handling editors clearly play a key role. That’s my position in this organisation and in the most part the acceptance/rejection decision is fairly straightforward after careful reading of the manuscript in conjunction with the reviewer comments.

However, it’s not always straightforward. There are many circumstances where it’s just really difficult to make a decision on whether to recommend publication. Here are some examples.

  • A survey paper tackles a highly controversial and politically charged subject but has a less than perfect response rate. The information will be popular, interesting and controversial. This paper will be widely read by your subscribers, may attract media interest and (hopefully) some social media activity, but it’s not great science. Would you publish it?
  • A randomised controlled trial of a new drug fabulon is submitted. It is highly effective in treating madeupitis disease in South East Somewhere. It’s a great trial, but as far as you are aware this disease would rarely be encountered by your readership. Great science, but poor applicability. Would you publish?
  • An observational study of sedation in the ED is submitted and 4 reviews are returned. 2 reviewers recommend acceptance without correction, the other 2 recommend instant rejection. Both recognise flaws but the reviewer judgements are so distant that you wonder if they read the same paper. Would you publish?

So what next? As an author you may experience a pause in proceedings. It’s quite likely that the editorial team have referred you to a special place. It’s not somewhere where we flip coins to decide who gets in, nor do we throw darts at manuscripts on the wall, nor throw papers down the stairs and publish the ones on the top steps (honestly all of these accusations have been made by the disgruntled). No. Flipping coins or other arbitary methods of choice are considered very bad practice in the editorial world. It would be highly unfair to the authors so there must be another way and it’s entirely possible that you may have experienced a referral to THE HANGING COMMITTEE!!!

wikimedia

wikimedia

When I was first referred to a hanging committee I was rather shocked as I imagined my work and toil being led to the gallows. Should it pass the committee it might receive a pardon and be passed on to production for publication. Should it be found wanting then it would be hanged there and then, despatched, killed and never seen again.

In truth my perception of the hanging committee was quite wrong, the origin of the term not being the gallows, but the rather more enticing, pleasant and appreciative world of art. I was surprised to learn that the hanging committee term originates from the art world where decisions are made on which paintings will be shown to the public. A judgement is made in committee on what to hang for public consumption and of course at this point it all makes sense. In publishing as in art there are judgements to be made on what to present and how it should be presented. The analogy fits and so the EMJ team meets to hang papers on a regular basis. The hanging committee sits not to sentence and murder, but to view, read, appreciate and try to select the best for the hard pressed pages of the journal.

So, if you get a referral to the hanging committee it’s not a death sentence and there may well be a reprieve. Hold tight and wait to see what the decision is, you might just catch the eye of the committee and find yourself hung rather than hanged.

Hanging Committee, Royal Academy, 1892 by Reginald Cleaver Wikimedia

Hanging Committee, Royal Academy, 1892 by Reginald Cleaver
Wikimedia

vb

 

S

@EMManchester

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