Last week the New England Journal of Medicine announced that a survey of readers selected the 1842 publication of a paper by Henry Jacob Bigelow, reporting the first use of anesthesia, as the single most important paper in the 200 year old history of the journal.
Given the future implications of what was being reported in this paper, especially as we now look back over the medical landscape 150 years later, I cannot disagree with the selection. However, what I do find more than a little bit ironic is that such a paper, if submitted today, would stand almost no chance of being published in the NEJM, or virtually any so-called high impact journal.
As the Bigelow paper wended through the review process, this in-hindsight completely transformational paper, would be rightly criticized (and surely killed) as being little more than anecdote.
There is certainly no randomized blinded trial with rigorous statistical measures that ensures the quality of findings live up to the highest “scientific standards”. Moreover, lacking an IRB stamp of approval would certainly invalidate the paper for publication right out of the gate.
So I ask, have the standards of the NEJM and nearly all modern journals become so obtuse and elevated that the findings they now report are irrelevant to truly novel clinical innovation?
Also last week, I was advised by one of the journals for which I have long served as an editor, that future observational studies, if they are to even be considered for publication, must now assiduously adhere to STROBE guidelines.
Such STROBE guidelines represent the consensus of a 2004 big funded workshop, i.e. self appointed committee, composed of editors and sundry luminary academics who, presumably with the best of intentions, felt compelled to improve the reporting of observational studies.
But what started as well meaning “guidelines” have (perhaps not surprisingly) now morphed into a compulsory directive enforced by the editor in chief. Will the quality of the journal articles now being published under the STROBE guidelines truly benefit from this new set of regulations? Surely the editor in chief and politically-connected self-appointed STROBE experts would argue yes, but notably these sacrosanct “guidelines” have themselves never been subjected to any empirical test.
What I am quite confident about is that the journal in question has put up yet another barrier to authors reporting potentially interesting, and even ground breaking, clinical studies. As a result is it possible that that today’s equivalent to the good Dr. Bigelow’s reporting of anesthesia will go undiscovered because of the sheer hassle of publishing in the peer reviewed literature?
Is it possible that STROBE processes might drive some of today’s clinical innovators to just throw up his or her hands and say no thank you to reporting their findings? This leads to the bigger question, should the process of publishing a paper trump the power of scientific ideas within?
Readers of Curēus are well aware of our Journal’s bias in this regard!
John Adler, MD, Professor of Neurosurgery, Stanford University; Editor-in-Chief, Curēus, has published a new editorial on the variety of issues associated with the centuries-old industry of peer reviewed scientific publication.
In today’s internet age, can the status quo peer review system provide value to our society – or is there a better way for “establishing scientific validity” and dissemination of knowledge?
Dr. Adler highlights some of the serious hurdles with current traditional peer review (i.e. fraud, and reviewer bias) and proposes to re-imagine peer review to become more suitable to our internet age. In a digital platform, the space limits within paper journals are gone. Without having to ration the space, there is no need to “kill” papers and artificially limit the number of papers published in a given month.
And to assess the quality of these papers Adler proposes crowd sourcing. To tap into the collective intelligence via Curēus’ Scholarly Impact Quotient (SIQ). The SIQ is an “evolving, yet enduring reflection of a paper’s true scientific impact.”
Dr. Adler founded Curēus “to address the challenges I have observed first-hand as an editor of numerous journals and an academic physician who has published and reviewed for years. We can do much better by authors, reviewers and certainly patients. This is the mission of Curēus.”
The Curēus team dropped by the Badia Hand To Shoulder Center in Doral, Florida and talked with renowned hand and upper extremity surgeon, Alejandro Badia, M.D., F.A.C.S.
Dr. Badia studied physiology at Cornell University and obtained his medical degree at NYU, where he also trained in orthopedics.
He runs an active international hand fellowship, serves on the editorial board of two hand journals, and organizes a yearly Miami meeting for surgeons / therapists that is devoted to upper limb arthroscopy and arthroplasty.
Dr. Badia maintains an intensely academic practice in order to “effect change and make care more efficient.” Dr. Badia joined Curēus as an Editorial Board member earlier this year.
Curēus stopped by to talk to Olga Afanasiev, a pathology graduate student at the University of Washington. Olga has begun her thesis in the laboratory of Dr. Paul Nghiem. The focus of her research is on studying a rare, and often lethal, neuroendocrine skin cancer, Merkel Cell Carcinoma (MCC) She entered her poster into the Curēus Fall 2012 Poster Competition on the same topic.