The Long, Arduous Journey to Publication: It Doesn’t Have to be That Way

I recently co-authored an article submitted to Nature Urology, a subdomain of the Nature publishing group. It took roughly eight weeks of review before we received feedback from the editorial office. In December 2016 we were finally presented with several reviewer questions that had to be answered before a final decision could be made. After all outstanding questions and reviewer requests had been answered the article was finally, mercifully “accepted in principle” on February 3rd. That was far from the end of it, however, as another round of editing requests arrived on May 11th.

This time the requests came directly from the Nature editorial office. The majority of the requests concerned tightening up the narrative flow and bringing the article in line with their in-house style. At this time, we discovered that the edits already made by the editorial office were so extreme that the editors had to check with us to make sure the meaning of our words (and indeed the entire article itself) had not been altered by their editing process. All of this for arbitrary language and formatting issues.

On May 15th, with the article still unpublished, we were yet again asked to check affiliations and other minor aspects of the article. The article was finally published yesterday, May 23rd, roughly eight months after submission. (And it could have been worse!)

How does this kind of perfectionism serve the scientific community? Why does the editorial office of the Nature publishing group change the text of professional scientific authors in a way that even they are not sure if the scientific information is still correct? The editorial work of so-called high-end and high-ranking journals has reached a level where their interaction is beyond thoroughness. It is absurd to edit every paragraph, every sentence, and even every word. This does not serve the scientific community. Instead it unnecessarily prolongs the publication process to guarantee the house style of a specific journal. The scientific message does not change with this heavy editing, but an article may look better and therefore may be better sold by the publisher based on the work of scientific authors.

The process (and underlying philosophy) are different with Cureus. In short, we rely on the individual capabilities of our authors, who also retain their copyright. We want to make the publishing process fast and efficient, so while we provide a certain level of support to our authors, we do not intend to alter their scientific message. Instead, we appeal to their own sense of pride and responsibility for adequate language and general accuracy.

In the end it is the scientific community that will evaluate if the article is scientifically sound, informative and correct. If it is not, the article will be met with heavy criticism, both via a low SIQ score and negative comments attached to the article. This system is not only much faster but also unbiased and transparent. We want to keep the focus of scientific publishing on what we feel is most important – the fast, fair and uncomplicated dissemination of interesting findings around the world.

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Cureus Peer Review Just Got a Heck of a Lot Easier

We’re pleased to announce the launch of our brand new, built-from-the-ground-up peer review tool! Any article submission started today will utilize the new system while in peer review.

Previously, we had used a third-party software tool called Crocodoc for article peer review. Our team has been hard at work creating our own proprietary system that makes reviewing an easier, more intuitive experience.

Similar to Google Docs or Microsoft Word, this new system enables reviewers to highlight text and leave comments. Each reviewer’s comments will be displayed via a unique highlighted color, while also allowing for overlapping comments.

Adding a comment
Adding a comment

Only articles created and submitted after the release will utilize this new system. All articles created before the release will still use our original peer review system. As such, please don’t be alarmed if your review experience changes from article to article!

Viewing a comment
Viewing a comment

Between the peer review and submission systems, we have now overhauled the entire publishing process in the past five months. We’re confident that submitting and reviewing articles with Cureus is easier than it has ever been, but we won’t stop working to make your experience better. Stay tuned for more exciting updates as we continue to tweak and enhance the Cureus Journal of Medical Science. Thanks for your support!

– The Cureus Team

Questions about the new peer review system? Drop us a note at support@cureus.com and we’ll get back to you ASAP.

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.

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!

The Gross Inefficiencies & Politics of Peer Review

A junior colleague described to me a review he was recently asked to perform for one of the leading journals in neurosurgery.  After a careful review he reported that the paper “sucked” and he recommended that it not be published. A few months later a revised paper was sent back to him, despite his rejection, leading him to again recommend that the paper be rejected. The next communication was a letter from the editor-in-chief asking my colleague to write a commentary of the paper in question which was to be published alongside the now twice-rejected article. Eschewing a discussion of whether this paper merited ultimate publication or not, I do question the entire peer-review charade that this vignette exposes. The reality is that too often reviewers have little say in whether a paper gets published or not. Instead journal politics and the discretion of the editor-in-chief is transcendent throughout the peer-review process. My lament is that if the editor-in-chief is intent on publishing a paper from the start, why not say so and at least ensure that the process is efficient; this is of course the Cureus process of peer review!

What the above story calls into question is  just what exactly constitutes peer review? What is its function? The stalwart champions of peer review argue that it alone uniquely enforces scientific quality. The “acceptance” of one’s scientific work by potential critics and academic rivals, represents the highest measure of personal and scientific integrity. It is hard to argue with such a high-minded proposition, but is it grounded in reality?

In my own, and many of my colleague’s considerable experience, the realities of peer review are nothing like the above idealistic notions bandied about by proponents. Gross inefficiency is often embraced in the name of scientific integrity by rivals who are in no rush to see the accomplishments of scholarly competitors lauded. Many reviews are little more than cursory reads by time-harried reviewers resulting in a thumbs up or down. Ironically when all is said and done this may not be the worst outcome!

Too frequently reviews become meaningless intellectual battles, which at their core are little more than exercises in power and ego. These many skirmishes are often expressed in the to-and-fro volleys between reviewers and authors centering around secondary or even tertiary measures of paper quality. Time-wasting reviewer obsessions with incautious conclusions, inadequate words of self-criticism (at times almost Marxist in nature), failure to reference important (reviewer?) publications, by the letter ethical processes, inconsequential statistical measures, etc. often mask the importance, and strip away the beauty, of science. Given human nature and a subjective system that deliberately selects reviewers from the pool of intellectual competitors, is it not too surprising that baser self-interested emotions too often trump fairness, or at least efficiency? There has to be a better way! Because we at Cureus believe there is, we invite you to learn more about our peer review process.

Building Your Professional Reputation With Posters

Building Your Professional Reputation With Posters

It used to be that building a professional reputation as a physician was just a matter of working hard, publishing and speaking to demonstrate your thought leadership while also developing strong word of mouth from well treated patients.

No longer! A physician’s reputation is increasingly built and displayed online. The web is now the largest source of information for physicians AND patients. When your colleagues want to know more about you…they turn to the web.

Writing is one of the most powerful ways a physician develops his or her reputation and publishing medical posters is often the first experience most physicians have with publishing.

Cureus is hosting our first international poster competition for many reasons among which are the opportunity for authors to showcase their works to the world rather than a few people at a conference. Additionally, it’s a way to begin building one’s “Digital CV” while possibly making connections with other authors with similar interests.

With that context, I want to offer some very simple advice to every medical student and physician author…spend a little time building out your profile. People connect with people first then they connect with content. The Fall 2012 Poster Competition site traffic has shown very clearly that those authors who create a full profile along with a picture are far more likely to generate poster views and votes.

Realize this is not specific to Cureus — as you move forward in your career, don’t short-change your work and expertise by not taking advantage of the tools at your disposal. This may include personal or practice web sites, LinkedIn accounts and more.

As for generating maximum readership of your posters on Cureus…take a few extra minutes now to add a picture, list awards you may have earned, your address etc. Our data shows that these steps work!

One Week Extension for Poster Contest Submissions

One Week Extension for Poster Contest Submissions

As a result of requests from several medical schools and residency programs to extend the poster contest deadline, the Cureus editorial staff has decided to change the submission deadline to October 12 at 5PM PST.

We are pleased to see that more and more programs have been getting involved in the competition with entries from medical schools all over the United States, Europe and now the Middle East. As of this post, top honors go to:

  • Stanford
  • Johns Hopkins
  • Penn
  • UW
  • Case Western
  • University of Central Florida
  • Washington University in St. Louis

The schools from the eastern half of the US are definitely dominating those from the west to this point with the exception of Stanford and UW. Where are USC, UCLA, OHSU, UC San Diego? Time to get moving!

Note: voting is open once a poster is submitted, so the authors who get their posters submitted before the deadline and begin promoting them have a head- start toward finishing among the top 10 finalists. The Cureus editorial board will select the top 3 winners from among the 10 finalists.