Cureus Conversations: Q&A With Editor in Chief Dr. John Adler

Cureus Conversations: Q&A With Editor in Chief Dr. John Adler

Dr. John Adler is the Editor in Chief of the Cureus Journal of Medical Science and Dorothy and Thye King Chan Professor in Neurosurgery Emeritus at Stanford University.

In your opinion, what is wrong with the current system of medical publishing? 

So much of publishing is presently geared towards a small elite community of academic physicians who understand the rules of the process and have the most time to engage in the publishing “game”. This means that the ideas from these academics, many of whom are not necessarily accomplished clinicians in the real world, are most widely circulated. Of course much of this process is intended to support the academic tenure process, which needs to create at least the illusion that certain ideas are innovative as opposed to merely being the product of an observant physician. Part of this stems from an excessive reliance on statistics.

Why are some slow to embrace the Open Access philosophy?

For the above reasons, academic physicians who have dominated journals for generations are loath to see publishing democratized. Democratization threatens their exclusivity/power in communicating medical science to the world.

What motivated you to start the Cureus Journal of Medical Science?

Having spent a lifetime in academia I could see that many truly clever, experienced and innovative physicians living in the trenches of medicine had no voice within the broader world of healthcare.

“Ask Me Anything” with Dr. John Adler
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How do you measure success at Cureus?

The number, quality and reach of the articles we publish, as well as how engaged readers are with the content within.

Why should doctors and researchers publish in Cureus?

Cureus’ makes it easier and cheaper to publish a peer reviewed article than was ever possible before.

What makes a strong approval editor? What do the Cureus editors look for when critiquing medical science?

Ultimately Cureus’ most important duty is to our readers. It is somewhat ironic that Cureus’ responsibility to readers transcends that of our physician “customers”, with whom our editorial team primarily interacts. With this understanding in mind, I like it when an approval editor understand this hierarchy of accountability, approaching an article first and foremost from the reader’s perspective. Their job is not to kill/reject articles but to make sure that by reading carefully they suss out any “BS”, so that the reader has less work to do. Having said that every article, every time, by every reader should be approached with some measure of skepticism. There are no absolute truths in science. This is why our mantra is to publish “credible” science allowing the best science to “pass the test of time”.

Are you currently working on any research?

As a matter of fact, I just co-authored the following article published in Cureus: Neuromodulation via Focal Radiation: Radiomodulation Update

Since When is “Fast and Efficient” a Shortcoming?

This past winter, I was notified in a short email that a scientific journal directory intended to drop Cureus from its list of preferred Open Access journals. No matter how specious any claim to exclusivity might be, who doesn’t crave getting past the big burly doorman guarding “The Club”? I reached out to this burly “Editor-in-Chief” of a “fraternity of journals” asking him how and why he arrived at his decision. After six email requests over nearly five months, I finally received a terse three-sentence 72-word response. In the eyes of the “Editor-in-Chief”, Cureus’ primary shortcoming was “submission to publication times are extremely short and you advertise your speed.” Basically, as I interpret this email rejection, Cureus’ sin is that it’s just too damn fast and efficient. Ahh… yeah, I guess Cureus is guilty as charged.

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The Covid-19 Pandemic: Not a Surprise!

Right now it is impossible to ignore the financial markets panicking, the breathless coverage by news media, the fearful buying at Costcos everywhere, and so many friends and family now worried about the emerging Covid-19 pandemic. Predictions of what might come next raise the specter of an historic pandemic that could literally kill millions or dare I say tens of millions before it runs its course. We are clearly living in an “interesting” time.

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Is it Time to Pull Back the Curtain from Peer Review?

Double-blind and single-blind processes continue to dominate academic peer review. Too often this results in a ‘black box’ – a system without sufficient transparency for authors, readers and reviewers alike. Hopefully one day fully transparent (and even public) peer review will come to be seen as acceptable throughout the world of academic publishing. For now we must take small steps to break down this barrier, just as Cureus works to break down barriers to publication.

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A Handless Surgeon? It’s Not as Crazy as it Sounds.

During my halcyon college days, long before I knew I would “grow up” to be a surgeon, I was a huge fan of Star Trek. Although the ideas behind warp speed travel and teleportation were mind blowing, I was even more captivated by “Bones” McCoy’s Tricorder. This and other similarly nifty little medical devices could in the hands of the right doctor affect surgical-like cures for most any disease non-invasively and without pain.

Who wouldn’t want to embrace such a future for medicine?

Continue reading “A Handless Surgeon? It’s Not as Crazy as it Sounds.”

Medical Journals are Not Just for Docs in Ivory Towers

Why do we publish? As the editor-in-chief of a medical journal, I struggle a lot with this question. After more than 200 years, peer-reviewed journals have clearly established themselves as medicine’s best arbitrator of truth. They are, or at least ideally should be, at the center of everything we practice in our clinics. Yet somehow we physicians, even those of us in academia, are blind to many of the important roles that journals serve in medicine today.

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Hospital Rankings: Can Docs Make the Process Less Stupid?

It’s that time of the year. As Halloween decorations give way to Thanksgiving and now Christmas ornamentation, I, like many other American academic physicians, am sent an array of end-of-the-year email reminders from hospital and medical school leadership about sundry matters ranging from holiday parties to Press Ganey Scores. However none of these notifications stands out quite like being urged to update my membership with Doximity and thereby ensure my good standing with the social media network.

And what lofty academic or clinical function is being served? None other than the academic medical community’s best effort to get out the faculty vote for Doximity’s upcoming and all-important hospital and departmental yearly reputation scoring – a number which ultimately feeds into the even more important, annual hospital rankings among the US News and World Report.

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Fake Science: More Common Than You Think

Yet again the edifices of peer review were shaken by recent retractions in The New England Journal of Medicine and Cochrane Reviews. The article (and another “expression of concern publication”) retracted in the NEJM was authored by a Brigham and Women’s Hospital researcher (an institution of which I am a graduate), Dr. Piero Anversa, who has been implicated in the fraudulent publication of as many as 31 cardiac stem cell articles. Meanwhile, under seeming political pressures from a group of patient activists that decried an analysis entitled: “Exercise as treatment for patients with chronic fatigue syndrome,” deeming it a personal affront to their suffering, the editors of the prestigious Cochrane Reviews decided to withdraw it. The scientist who did the actual review for the journal lodged a bitter complaint about this “editorial” decision; it is hard to miss the irony here of Cochrane Reviews being a supposed impartial arbitrator of medical scientific quality that drives clinical decision-making. Fraudulent scientific results, politics trumping science, what is a reader to believe?

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Towards a Cureus Data Repository

*Co-authored by John R. Adler & Achim Schweikard

Most scientific articles come with some form of data. For Cureus, our data includes medical images, graphics, drawings and tables. Access to such data enables a reader to verify the content and credibility of an article while also better understanding it. Many types of data, provided they are findable via search, can have value to readers independent of the article with which it was originally connected; medical imagery and genetic sequencing information being cases in point. For example, with modern methods of machine learning requiring large data sets for training, journals are a logical repository for such information. Therefore a peer-reviewed article that provides access to data will oftentimes prove much more valuable than that same article without data. Especially for internet-based media with access to large amounts of digital storage space, data sharing between authors and readers would and should become a standard. As an example, instead of showing data for a single representative case in an article, which is typical for traditional journals, we could make data for all cases in this article available to readers. Readers could then download such enhanced data sets directly in electronic format.

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Conflicts of Interest and Financial Disclosures: It’s Time to Take a Stand Against Dishonest Authors

The recent announcement that the Chief Medical Officer of Memorial Sloan Kettering Cancer Center failed multiple times to report significant financial conflicts of interest in journal articles and letters authored or co-authored by him has justifiably stirred up quite a hornets nest of controversy.

Truth be told, I too am personally quite angry about his glaring oversight, which at its worst, involved opinions communicated broadly to the medical community via the New England Journal of Medicine. As a physician innovator, entrepreneur and scholar I have sought to play by these disclosure rules, which simply mandate transparency, because I think they are the best tools for fairly communicating possible bias to readers.

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