October 12, 2010
October 11, 2010
Does the Impact Factor give your research the impact it deserves?
The impact factor (IF) is a measure of the frequency with which the “average article” in a journal has been cited in a given period of time. Traditionally this value has a high relevance for scientists as high impact papers enhance the academic reputation in their respective field. Particularly European scientists rely on the power of the IF to support their academic career. However, there must be concerns on the validity, manipulation and misuse of this measurement. For example, the impact factor is highly discipline-dependent. A physician specialized in neurosurgery cannot collect IF’s at the level researchers in internal medicine or immunology can do. Furthermore, in the short term – especially in the case of low-impact-factor journals – many of the citations to a certain article are made in papers written by the author(s) of the original article. This means that counting citations may be independent of the real “impact” of the work among investigators.
Manipulation is of concern in Journals publishing a larger percentage of review articles which generally are cited more than research reports. Therefore review articles can raise the impact factor of the journal and review journals will therefore often have the highest impact factors in their respective fields. Which types of articles are considered “citable” is largely a matter of negotiation between journals and Thomson Scientific. As a result of such negotiations, impact factor variations of more than 300% may occur.
There are different options Journals can influence their impact factor significantly. For example, Editorials in a journal are not considered to be citable items and therefore do not enter into the impact factor calculation. However, citations to such items will enter into the calculation, thereby inflating the impact factor. In addition, if such items cite other articles (often even from the same journal), those citations will be counted and will increase the citation count for the cited journal. This effect is hard to evaluate, for the distinction between editorial comment and short original articles is not always obvious. “Letters to the editor” might refer to either class.
The impact factor is often misused to evaluate the importance of an individual publication or evaluate an individual researcher. This does not work well since a small number of publications are cited much more than the majority – for example, about 90% of Nature’s 2004 impact factor was based on only a quarter of its publications, and thus the importance of any one publication will be different from, and in most cases less than, the overall number. The impact factor, however, averages over all articles and thus underestimates the citations of the most cited articles while exaggerating the number of citations of the majority of articles. Interestingly, the Higher Education Funding Council for England was urged by the House of Commons Science and Technology Select Committee to remind Research Assessment Exercise panels that they are obliged to assess the quality of the content of individual articles, not the reputation of the journal in which they are published.
These and other examples show clearly how manipulated and flawed the current IF system operates. Ironically highly educated scientists fail to scrutinize this obviously corrupt and manipulated system and rather adapt to the current status quo. Peeremed.com is very different at this point. The individual manuscript is rated by a variety of experts and therefore the paper of concern is not biased by other published works in the same medium. The value of the rating will depend on the specific scientific background of the respective researcher to the topic of concern. Everybody can rate an article but only credible scientists will decide on the true impact – the so called SIQ – of an individual peeremed publication. This is the only way a scientist can be sure about a fair and balanced evaluation of his work and because of this fact, SIQ should become the new standard to evaluate your scientific work and give your research the true impact it deserves.
Alex Muacevic, MD
August 29, 2010
If You Have No Conflicts, We Have No Interest
Since the time honored peer review process has always required intellectual honesty to function appropriately, conflicts of interest (COI) are legitimate concerns for all scientific publications. Given human nature, perverse incentives can skew both the preparation of manuscripts and the process of scholarly review. Although personal financial concerns tend to dominate most discussions of the subject inside academia, I have always found this to be incredibly near sighted, and perhaps not surprisingly, also self serving. The potential financial incentives that come from an author needing to either get grant support for their scientific research or promote their academic clinical practice tend to be all too conveniently ignored. Furthermore, while the individual financial conflicts of interest of authors are carefully scrutinized, significant institutional (e.g. medical school royalty) conflicts are glossed over, even though such situation present many investigators with very real, albeit indirect, opportunities for personal reward.
Despite the above spectrum of bias, current peer reviewed medical journals have opted to focus almost entirely on the personal financial conflicts of authors and reviewers. While most of these journals claim to welcome even manuscripts for which the authors have conflicts of interest, one would never realize it from the bureaucratic hurdles placed before the authors. In this regard, the International Committee of Medical Journal Editors has promoted its Uniform Disclosure Form for Potential Conflicts of Interest as the gold standard to reporting. This four page document, which is supposed be filled out by every author upon paper submittal and again upon acceptance, seeks to comprehensively root out all conceivable personal financial conflicts of interest, with absolute regulatory purity. In a world of purported science, there is ironically no evidence to support that this documentation achieves its declared goal. Meanwhile, why would a scientist who took liberties with a scientific publication, especially a truly psychopathic individual, not also be inclined to do the same when it comes to filing a COI disclosure form? Given the current logic why not require audited and notarized financial disclosures? In a rapidly changing world of medicine and science that relies on peer reviewed publication, is this cumbersome process really necessary? Isn’t science by definition self correcting over time? Moreover sane investigators realize that discredited science always bestows dishonor upon every author and opens up possibilities for academic censure and even civil penalties.
Because we at peerEmed.com are grown up and think it is a myth that one can eliminate all bias, there is less of a fixation on conflicts of interest. In fact we presume that virtually EVERY author and reviewer has some intrinsic interest in the subject at hand, if only to motivate their participation in the publication process. We adhere strongly to the adage, “No conflict, no interest!” Rather than waste a lot of time and energy on defining a broad spectrum of inevitable biases, most of which are not financially-based and therefore difficult to characterize, peerEmed.com simply asks all authors to declare any significant conflict of interest within their published papers….period! Once a paper is published we encourage all readers to comment on any significant omission in the author’s disclosure statement if they deem it relevant to the integrity of the science. Since such comments are public, there is nowhere for an author to hide. Ultimately, should there ever be a question about flagrant academic misconduct, peerEmed.com editors reserve the right to remove a published paper, similar to what is practiced with other peer review journals. Once again, in a world of mushrooming regulation, we at peerEmed.com, have opted to go against the grain!
John R. Adler, MD
July 5, 2010
Is it Time to Rediscover Clinical Research?
Over, the past few decades important tools such as genetic sequencing, PCR and more recently stem cell isolation have greatly expanded our understanding of human biology and disease. Despite this explosion of knowledge, progress in treating nearly all major diseases has been stubbornly difficult, in large measure because underlying biologic processes are so diverse and complex. This later belief has been responsible for the continued generous government and charitable support for biomedical research after more than a generation of significant prior funding. Importantly, the vast majority of such funds are spent understanding basic biologic pathways and teasing out the genesis of human diseases, primarily through the use of cell culture and animal models. Despite the ongoing enthusiasm for such research, the biologic basis of many diseases is understood at a much more sophisticated level than reflected by current medical practice. It is increasingly being recognized that substantial medical innovations that stem from the above research never see the light of day in the clinic, and instead have been trapped in the so-called “The Valley of Death”. A series of recent publications have delved into this phenomenon, among them being, A Decade Later, Genetic Map Yields Few New Cures and Desperately Seeking Cures.
When the world is literally crying out for new treatments for so many diseases, it seems both ironic and strange that important therapeutic options might be going unrecognized? Patients clearly want to be cured or have their symptoms palliated. Meanwhile, given the basic altruism of medicine it is hard to believe physicians would hold back important treatments from patients? As a consequence, one would think that if patients and their doctors were by nature always eager to embrace improved therapies, “The Valley of Death” could not possibly exist. Unfortunately there is a wide array of societal forces for whom improvements in the actual treatment of patients is not an important concern. Government regulatory bodies like the FDA which regulates both the marketing of drugs and hospital IRBs are a perfect case in point. But other entities including hospitals, insurance companies, medical schools and even disease-related charities contribute, either consciously or unconsciously, to the widening chasm between knowledge and better treatment of patients. In my experience such interference in the advancement of clinical practice stems from money, politics and paternalism. Nevertheless, I contend here that current peer reviewed medical journalism is yet another force which is sometime aligned against the improvement in patient care.
The peer review process in contemporary medicine purports to seek scientific truth and nothing more. However, in reality, medical journalism is a big business, and like all business, is driven by financial concerns.
While the internet has transformed, and in the process badly damaged the financial prospects of, a range of storied publications ranging from the New York Times to Newsweek, peer review medical journals haven’t skipped a beat. In fact a plethora of new medical journals have been created in recent years, as the internet has dramatically lowered the cost of journal production. Regardless, this financial juggernaut of peer reviewed journalism has in the modern world been (typically) grafted to medical societies for whom concerns about power and also money dominate; I have been amused but also dismayed to see the infighting that goes on among individuals seeking to lead a medical journal. Does the pursuit of truth underlie such fights? Of course not! The reality is that senior editors wield substantial power in the medical world by influencing in subtle but significant ways which papers ultimately get published. The existence of such behavior reinforces my contention that peer reviewed journalism remains unduly political, and by virtue of such, prevents the timely publication of many significant clinical findings. When one wraps human pettiness (snobbery, elitism, old boys club, call it what you may) around a financially driven entity like a medical journal, the resulting perverse incentives also contribute to “The Valley of Death”.
PeerEmed.com was created to address the very issue discussed above. With this peer reviewed journal there are no financial incentives or disincentives or human pettiness that will ever get in the way of a sincere investigator reporting what they believe to be important clinical findings. If an observation or study is important enough for you to spend the time writing it up, chances are it is important to some reader searching the medical literature. PeerEmed even gladly welcome papers reporting negative findings which can potentially help another investigator from going down the same blind alley. Regardless, PeerEmed believes that fewer barriers to research communication can significantly facilitate better patient care. We contend that it is even probable that important new treatments for disease already exist in the world but medicine is blind to their existence because of the previous realities of peer-reviewed publication? Through its innovative design, PeerEmed is committed to ensuring that the process of peer review no longer contributes to “The Valley of Death”.
January 19, 2010
Are we just a bunch of chumps?
Glossy print journals are dead! From a practical standpoint peer reviewed journals printed on paper are going the way of the dodo. The current existence of such a print format is largely a testament to tradition, the reading habits of older physicians and perhaps the belief among the leadership of sponsoring societies that paper copies represents tangible evidence to society members that that they get something for their not inconsiderable dues. Along with the glossy paper and society sponsorship, authors, reviewers and readers also get politics on top of politics, a ponderously slow publication process and ever growing landfills. If being uncompensated for the literally hundreds of hours required to create a quality paper is not enough of an insult, publishers then have the audacity to turn around and demand additional publication fees should your paper include a “color figure”. The current system also expects you the author, and the most important worker, to forgo all copyrights; so should you actually want to give out copies of your paper to others; you are expected to pay for the privilege. The non-medical and scientific worlds are amazed to hear how medical journalism works, and many think we must all be a big bunch of “suckers”! Are we? Maybe it is time to mix things up a little and actually for the first time, reward those who are doing all the work to make peer-reviewed medical journalism a reality?
I understand that for many, if not most authors peer-reviewed medical is an altruistic act, one for which no tangible return is expected. I can completely respect such a philosophy, and at peerEmed we have no intention of undermining your idealism. However, I see no reason that idealism has to be equated with being a chump! Even if you as an author or reviewer don’t want to be personally rewarded for your altruism, what about the revenues you generate going to your research fund or some other charity? Or perhaps, the huge dues collecting medical and professional societies, as well as publishers Springer-Verlag, Kluwer etc. are your charity of choice? If not, consider peerEmed. A primary objective is to be the first peer-reviewed journal that aspires to directly compensate authors and reviewers, or a designated charity, for their irreplaceable contribution. Realistically our new journal is just getting going and it will be a couple of years from having the technology and processes in place to fairly allocate earnings. However, peerEmed is committed to seeing that 50% of all advertising generated profits generated through the years will by design go to authors and reviewers; the other half will go to investors and the journal’s professional staff. I challenge the current journal system to join us in our efforts to financially compensate medical authors and reviewers, and in doing so fully acknowledge their all important contribution. Until they can meet this challenge, I urge you to publish your next paper on peerEmed.com. The old order is dying, welcome to the peerEmed revolution.
January 10, 2010
Revolutionizing Peer Review
January 10, 2010
Among medical scholars, the peer review process is sacrosanct. Steeped in a century of tradition and now enshrined with high measures of academic status and reward, it is virtually an article of faith that this process best, if not uniquely, reveals scientific truth. Meanwhile, within the contemporary world of medicine, powerful economic forces also serve to reinforce these institutions of medical journalism. Many sponsoring medical societies and nearly all their typically large corporate publishing partners reap significant financial rewards for their participation in the peer review process. While many journalistic titans in the secular world of newspapers and other periodicals are becoming ever less profitable, the business of peer reviewed medical journals keeps chugging along. The enduring financial success of medical journals stems in large part from a business model that is based significantly on unpaid labor (authors and reviewers), a situation buttressed by an underlying community philosophy that it is unseemly for medical researchers to profit from what must necessarily be “selfless” labor. It is puzzling how these institutions can reconcile their religious-like zeal, which seeks to promulgate a charitable peer review process, with their own substantial profitability? Regardless, the economics of the medical journalism business, when combined with an innate predilection of academic medicine to honor tradition, has over the years served to ever deeply entrench the position of many existing medical journals.
Despite a revered status in contemporary academic culture, the “conventional wisdom” among many physicians who are actually involved in peer review, is that the practice is badly broken. I have experienced firsthand and heard numerous times from many other fellow medical scholars that the process is all too often hugely inefficient in terms of time and money, and that political concerns frequently trump science. Manuscript reviews are slow to materialize, and rather than represent material analysis, are often dominated by the minor and self serving egotistical needs of reviewers; some reviewers feel an irresistible compulsion to demonstrate how smart they can be. Other times manuscripts, and the results within, are buried under a mountain of reviewer process, and in doing so, indirectly rejected. Any associated delays are explained away by a peer review establishment, with little appetite for self introspection, as being essential to preserving scientific integrity. Because they generally lack rigorous “scientific” underpinnings, nearly all criticisms of modern day peer review from outside the peer review world are suspect in the eyes of the medical journalistic establishment. Meanwhile, because of its unimpeachable stature, only data driven peer-reviewed studies are ironically deemed worthy of providing any basis for questioning its virtue among the community of medical scholars.
Are we destined to exist in this status quo indefinitely? At peerEmed.com, the answer is an emphatic, no! Medical journals have always been essentially a social network oriented around a specific medical these. Now in the era of the internet based social networks it has never been easier to organize a community of likeminded individuals. Moreover in an increasingly interdisciplinary world, areas of medical interest are constantly shifting and crossing traditional subspecialty and journal boundaries. On the internet it is growing ever easier to find one another. Therefore, I believe it is time to rethink what a medical journal and the entire peer review process can be. Hopefully the peerEmed.com experiment will serve to transform the medical journal landscape, and in doing so serve both patients and the medical community at large. I’d be interested to hear the thoughts of readers as we on embark on these uncharted waters.
John R. Adler , MD
January 8, 2010
Stereotactic Radiosurgical Neuromodulation for Chemical Dependency: A Theoretical Approach to Addiction Therapy
Chemical dependency is pervasive and difficult to treat; with current treatment options studies have shown relapse rates of approximately 77% after completing a private treatment program 13. Most chemically dependent individuals are never able to reach long-term sobriety, and many eventually die of their disease. The cost of drug addiction to society, manifested in drug-related illness, crime, lost productivity and premature death, was estimated at over $140 billion in 1998 in the United States alone 2. It is imperative that medical professionals gain a better understanding of addiction and its effective treatment. In this paper we make a two-part proposal: 1) the neural regions that are key participants in drug addiction can be visualized with current imaging technologies, and 2) activity of neurons in that region can be modulated, to therapeutic effect, with stereotactic radiosurgery. We will briefly review imaging findings indicating the effects and correlates of drug dependence, efforts at targeted modulation of brain regions and processes that appear to be importantly involved in drug craving and reward, and propose that stereotactic radiosurgery might be considered as another weapon in the fight against drug dependence.