Announcing the Winners of the Investigational Cardiac Radiosurgery Publishing Competition!

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The SIQ scoring period has ended and the scores have been tabulated. Without further ado, the winning article is…

‘Cost-Effectiveness of Cardiac Radiosurgery for Atrial Fibrillation: Implications for Reducing Health Care Morbidity, Utilization, and Costs’ by Nikhilesh Bhatt, Mintu Turakhia and Thomas J. Fogarty (7.17 SIQ)

We’d like to extend a big thank you to the Cureus community for their efforts in reading and scoring competition articles over the past few months. Without you, this competition would not be possible.

And remember – even though the competition is over, you can still access and score all of the articles. Thanks for your support!

– Cureus and CyberHeart

Frameless Stereotactic Radiosurgery: Winning Articles Announced!

Eighteen published articles. More than 300 SIQ scorings. Over 10,500 views. And now, three winning articles!

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Congratulations are in order for the following authors – as their articles

  1. 1st place: ‘3D-Printing of Arteriovenous Malformations for Radiosurgical Treatment: Pushing Anatomy Understanding to Real Boundaries’ by Conti, Pontoriero, Lati, Marino, La Torre, Vinci, Germano, Pergolizzi and Tomasello
  2. 2nd place: ‘Prognostic Value of MR Imaging Texture Analysis in Brain Non-Small Cell Lung Cancer Oligo-Metastases Undergoing Stereotactic Irradiation’ by Nardone, Tini, Biondi, Sebaste, Vanzi, De Otto, Rubino, Carfagno, Battaglia, Pastina, Cerase, Mazzoni, Buonamici and Pirtoli
  3. 3rd place: ‘Robotic Radiosurgery for the Treatment of Intramedullary Spinal Cord Metastases: A Case Report and Literature Review’ by Garcia, Sallabanda, Santa-Olalla, Guerra, Aviles, Sallabanda, Rivin and Samblas

In addition to the winning articles listed above, the competition has produced 15 more high-quality articles from around the world, all of which are available free of charge on the competition page.

We’d like to extend a big thank you to the Cureus community for their efforts in reading and scoring competition articles over the past few months. Without you, this competition would not be possible.

And remember – even though the competition is over, you can still access and score all of the articles. Thanks for your support!

– Cureus and Accuray

Publishing all credible science: Where do we draw the line?

Stemming from the belief that market-driven open access publishers are inherently predisposed to publish any article for which an author is willing to pay, there is a common prejudice that the scientific quality of such articles must be inferior to those published within non-open access journals. Whether true or not for other journals, this rationale certainly does not apply to a free publication model like Cureus.

For us, ensuring scientific quality is about preserving the brand of Cureus; by undermining credibility, bad science will, over the long term, inevitably diminish every conceivable measure of journalistic success. Destroying our reputation is the last thing Cureus leadership wants to see happen. However, working against this same concern is our journal’s philosophical commitment to publish all “credible” medical science; inevitably these two contradicting objectives require a delicate balancing act.

Despite (or as a sad result of) Cureus’ idealism, our journal sometimes receives questionable submissions: carelessly prepared manuscripts, sloppily presented results, poorly argued and unfounded conclusions, etc. Authors occasionally suffer from the misperception, perhaps due to our status as an open access journal, that we will publish whatever they submit and therefore they need invest only minimal effort.

Not so fast! I must caution against such thinking. Cureus is happy to publish articles that might be rejected elsewhere due to “political” or contrarian philosophical reasons, but like most quality journals, we will not abide substandard manuscripts. Cureus takes peer review and editorial oversight very seriously. Ensuring that authors do not abuse the easy-to-use Cureus submission system is quickly becoming a full-time job for editors who, frankly, have many better things to do.

Please do not confuse the ease of Cureus submission process with a willingness to overlook second-rate science. Does your article have a clear message and can it help interested colleagues in their daily clinical and/or scientific work? Put yourself in a reader’s shoes; if you were a reader, would you feel that the author in question has shown proper respect for your time? If you cannot answer yes, please do not submit your article to Cureus.

Anyone who intends to submit a shoddy article (and yes, you know who you are), be prepared to be blocked during editorial review. And should anyone choose to abuse Cureus’ generous spirit more than once, they should expect to be banned from our platform for an eternity. Meanwhile, the vast majority of conscientious authors, who both respect their potential readers and do their utmost to produce a quality manuscript, will be amply rewarded with a hassle-free submission process, and, once published, a large, appreciative audience of readers.

Ultimately we at Cureus like to think that a beautiful article of science is in itself, the best reward possible. Thank you for your understanding, cooperation and support.

Scholarly Roulette: Impact Factor & Scientific Quality

A friend and colleague referred me to a recent publication that represents a major indictment of the peer-reviewed journal cartel.

This article summarizes a blog published by what is arguably a Cureus competitor, the open access-publishing house, Frontiers, which in this study could find no correlation between rates of rejection and journal impact factor.

Just for argument’s sake, let’s assume that impact factor does correlate with scientific quality. So if this study is correct, it means by extension that the rate of rejection also doesn’t correlate with quality. In turn this means that the standard peer review process (which totally dominates the journal industry) has no bearing on article quality. In other words, getting published, or not, appears to be a random event.

Accepting this fact (parenthetically one which I already subscribe to) means that despite all the process and rituals of scientific journal publishing, and the huge importance of this matter to society and academic tenure decisions, there is currently no objective index for assessing research article quality. Of course if one believes that impact factor is not a measure of quality, then the above random publication process is even more random than I implied in my argument! Based on this observation, I would like to sarcastically suggest we should rename this current process “scholarly roulette.”

Clearly there are huge shortcomings to the Frontiers study, such as selection bias and the non-medical nature of many scholarly journals. However, to a huge research community that has invested so much of their lives into the existing peer review process these type of findings must be dispiriting. Nevertheless, this current set of observations does resonate with our philosophy at Cureus, where we subscribe to the belief that as long as the medical science within is credible, there is no reason not to publish an article. In other words, we believe that we are, on average, no better equipped to discern quality than any other journal.

A big part of our confidence stems from Cureus’ unique post-publication SIQ scoring system. Although we are no smarter in finding scientific quality up front, we do believe that it is quite possible for the medical community-at-large to find quality over time, post publication. Nevertheless, to make this a reality, every reader has a role to play, which of course includes you!

Exceptional Responders in Oncology: Winning Case Report Announced!

51 published case reports. More than 1,200 SIQ scorings. Over 12,000 views. Only 1 winner.

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Congratulations to Mark ZakiPam LaszewskiNatasha RobinetteHusain SalehNaweed RazaAmmar Sukari & Harold Kim! Their case report, entitled ‘Unresectable Extraskeletal Myxoid Chondrosarcoma of the Neck: Early Tumor Response to Chemoradiotherapy,’ received the highest SIQ score, with an 8.2 (which has since risen to a stellar 8.5).

In addition to the winning article, we received dozens of high-quality case reports from around the world, all of which are now published and available free of charge.

We’d like to extend a big thank you to the Cureus community for their efforts in reading and scoring dozens of case reports over the past few months. Without you, this competition would not be possible – you’ve helped shine a spotlight on dozens of interesting cases of exceptional responders in oncology.

And remember – even though the competition is over, you can still access and score any of the 51 case reports. Stay tuned for news about our next competition – launching soon!

The Anecdote is the Antidote for What Ails Modern Medical Science

Today I read with great interest an article in Vox.com entitled: “Fleming’s discovery of penicillin couldn’t get published today. That’s a huge problem.” As a long time academician and Co-Editor-in-Chief of Cureus, I could not agree more! Not only would Fleming’s discovery go unreported, but Jenner’s discovery of the first small pox vaccine or Connecticut dentist Crawford Long’s discovery of ether anesthesia would also be dismissed as trivial curiosities and anecdotes.

In a rapidly changing world of medical science, the process of peer-reviewed publishing has never been more important for validating medical knowledge, yet at the same time the arcane processes of peer-reviewed journals have never been more at odds with potential societal benefits. The altruism that is supposed to drive the publication of scientific research has been almost entirely co-opted by the peculiar needs of academic promotion and tenure, as well as the pecuniary demands of the scholarly publishing industry; the public good of medical knowledge has been reduced to a mere after-thought by both academia and the publishing industry. These two interest groups only seek seemingly important “big science,” and actually decry any role for mere clinical observation, which Cureus has in the past and the Vox authors now in the present both refer to, in a somewhat ironic, self-deprecating manner, as “small science.”

Despite the above dire (my word) situation in medical publishing, just maybe the proverbial pendulum is about to swing the other way. For example, the conventional wisdom is that we are entering an era of “personalized medicine,” a concept which at its core recognizes the unique genomic, proteomic, metabolomics and demographic, etc. profile of every patient. Embodied within this concept is the understanding that each of us will as patients undergo a unique clinical experience, not necessarily predicted by a priori knowledge, and that such observations will need to be documented if we are to build new scientific understandings. Assuming that to be true, the future of medical publishing may well be found in observational “small science.” If this is true, the important medical publishing of the future may be about to shift from “the few” elites reporting big science, to the power of the many, within the trenches of medicine, collectively reporting their humble clinical observations? For the record, Cureus aspires to lead this transition into the new world of small, yet very powerful, medical science.

Intellectual Fascism

I have been Co-Editor-in-Chief of Cureus for about three years and in this time I’ve learned a lot about how peer-reviewed journals function. It’s often said that in water polo the real game happens beneath the surface of the water. Similarly with journals, sometimes the serious action goes on behind the scenes. From its inception, Cureus was designed to minimize the role of politics in scientific publishing by way of its post-publication SIQ scoring process. Despite these ambitions, politics have occasionally crept into our efforts to publish great medical science. So it was with one recent article, and boy did the Cureus editorial staff learn a lot through this experience!

The article in question was written by several very accomplished clinical neuroscientists and involved a complex intersection of multiple scientific fields. Despite being evaluated by three reviewers, a clear error was noted in the published article by a reader; the error was of a political nature and not scientific in the least, but still an unambiguous error. An erratum was being prepared when a big hullabaloo broke loose in social media. Two individuals, whose specialty overlapped the erroneous article, attacked the article for its political misstatement, and by extension, Cureus’ journalistic integrity for missing this error during our pre-publication review process.

I immediately invited these critics to set the record straight via our liberal comment and scoring processes, but in a series of personal (and necessarily confidential) emails, the critics refused, insisting on remaining anonymous. Over the next several days they recruited a chorus of similarly-minded colleagues who insisted that the article in question represented serious scientific misconduct and demanded it be retracted… period! In light of these demands, Cureus, by virtue of its status as a peer-reviewed journal, was obligated to investigate under ICJME (International Committee of Medical Journal Editors) guidelines.

I personally oversaw the investigation, which started by recruiting seven truly world-class domain experts, who after reading both the original and the proposed corrected manuscripts, were to advise me; I deliberately included a couple of researchers suggested by the critics of the article. In parallel, I stumbled upon the existence of a listserv community of likeminded researchers including the two critics, whose major modus operandi is to fiercely act en-mass, hyena-like, oftentimes via social media, when certain partisan political issues arise, such as the article Cureus had unwittingly published.

If ever I witnessed intellectual fascism, this was it; the only thing missing was a goose-stepping mustached man. However, this was also to be a moment of truth for our young journal. Pending the advice of the seven domain experts, would Cureus stand up for open scientific discourse? Or would we join the ranks of cowering researchers?

After almost one month of analysis by the aforementioned unimpeachable panel of experts, some of whom are at the very pinnacle of their respective fields, it was determined that the Cureus article had erred badly (yet seemingly inadvertently) in misstating a political reality. However, the science itself was credible. As a result, an erratum addressing the erroneous facts was published and the original article retracted.

Ultimately this experience reminds me, and by virtue of this blog should remind all readers, that standing up for open and honest scientific discussion, devoid as much as possible from political considerations, is a constant struggle even in our supposedly democratic world. In fact I invite the very critics of the article in question to now publish their own scientific concepts with Cureus, which perhaps might even refute the published paper. The function of journals is not to anoint “scientific truths,” but to provide a forum for scientific truths to be discovered, and refuted.

We at Cureus are especially fortunate to have such a liberal post-publication comment and scoring system. This process, which is available to everyone, is intended to provide a voice for even the most contrarian scientific ideas. The power of the Cureus community-at-large remains a great potential strength. Please don’t be afraid. Step up and use it!