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Reply to “Ten Simple Rules for Getting Published”

  • Eric Grosch

Reply to “Ten Simple Rules for Getting Published”

  • Eric Grosch

Rule 10 for getting published [1] carries advice to publish in journals of high impact (high citation rate). Riding the coat-tails of eminent, high-impact journals is good marketing, but the task is easier said than done, because the higher the impact is the greater is the competition for print space and the more likely the editor is to offer unhelpful feedback, such as a statement on a form letter that he rejects many worthwhile manuscripts for lack of space. Good science may appear in the pages of journals of many degrees of impact. In support of that notion, current impact factors [2] appear in Table 1 for each of the journals (or successor—Am J Epidemiol continued J Chron Dis) cited in this essay (see References).

Yet, a journal's high eminence and high impact may bespeak its rigid orthodoxy, rather than its high quality. Rule 10 may hold for journals, such as PLoS Computational Biology, in which objective science, evidence, and the GIGO (“garbage in, garbage out”) principle count for something. Eminence-based medicine [3,4] too often substitutes—and poorly—for evidence-based medicine [5]. Altman deplored poor medical research [6], which too often appears in high-impact medical journals, and suggested, “incorrect procedures . . . can be hard to stop . . . from spreading . . . like a genetic mutation” [7]. Consensus in medicine [8] too often permits false doctrine to masquerade as “standard of care,” just as an ad blitz may build a public consensus on specious claims that favor sale of a certain brand of snow tire [9]. Medical science and its “opinion-leaders” were arguably tardy in complying with Rule 6, good science [1], in recognizing Helicobacter pylori in peptic ulcer disease [10,11], thrombolytic therapy for myocardial infarction [4,12], questioning post-menopausal estrogen [10,13], and preventing thousands of crib deaths by rejecting Benjamin Spock's high-impact advice to lay babies prone [14], among other instances [15].

In medical journals, eminence-based medicine [3,4] predominates, and censorship by editors, in attempts to save face, may impair the vitality [16] and self-correction [17,18] of science and the protection of “the literature and the reader from identifiable error” [19], despite editorial lip service to “evidence-based medicine” [5].

Helpful first steps to remedy the current malaise might consist of prompting editors of scientific journals, of all levels of impact, to improve peer review by encouraging substantive dialogue [20], by adhering to logic [21,22] and to valid statistical inference [2325], by encouraging authors to provide readers access to raw data [7,2631], the better that readers might verify or challenge published conclusions, by issuing to editorial peer reviewers a “plea for rigor” [32] and diligence [33] by requesting them to “state the rationale, and present the evidence, for exceptions taken to the manuscript” [32], and by incorporating the dialectical scientific brief [34], rather than by perpetuating current inequities: a) for each hour put in by a journal reviewer or editor, the author puts in about seven hours... [35]; b) the average time spent reviewing a paper is less than two hours in medicine [36]; c) the editor invariably defends the reviewer's call. After all, who are we to question the decision of someone who may have devoted much time to the manuscript [37]?

High-impact medical journals too often nurture sacred cows by taking in and putting out orthodox garbage and rejecting innovative pearls. Then the Institute of Medicine wonders why 44,000 to 98,000 patients per annum die of preventable medical errors in the hospitals of the United States [38].


  1. 1. Bourne PE (2005) Ten simple rules for getting published. PLoS Comput Biol 1: e57.
  2. 2. Science journals impact factors. Available: Accessed 17 August 2007.
  3. 3. Issacs D, Fitzgerald D (1999) Seven alternatives to evidence based medicine. Br Med J 319: 1618.
  4. 4. Chalmers I, Haynes B (1994) Reporting, updating and correcting systematic reviews of the effects of health care. Br Med J 309: 862–865.
  5. 5. Evidence-Based Medicine Working Group (1992) Evidence-based medicine: A new approach to teaching the practice of medicine. JAMA 268: 2420–2425.
  6. 6. Altman DG (1994) The scandal of poor medical research. Br Med J 308: 283–284.
  7. 7. Altman DG (2002) Poor-quality medical research: What can journals do? JAMA 287: 2765–2767.
  8. 8. Skrabanek P (1990) Nonsensus consensus. Lancet 335: 1446–1447.
  9. 9. Eddy DM (1990) Practice policies: Where do they come from? JAMA 263: 1265–1269. Additional page: 1272.
  10. 10. Genuis SJ, Genuis SK (2006) Exploring the continuum: Medical information to effective clinical practice. Paper I. Towards aetiology-centred clinical practice. J Eval Clin Pract 12: 49–62.
  11. 11. Anon (1983) Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1: 1273–1275.
  12. 12. Davidoff F (1999) In the teeth of the evidence: The curious case of evidence-based medicine. Mt Sinai J Med 66: 75–83.
  13. 13. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, et al. (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the Women's Health Initiative randomized controlled trial. JAMA 288: 321–333.
  14. 14. Chalmers I (2001) Invalid health information is potentially lethal. Br Med J 322: 998.
  15. 15. Skrabanek P (1990) Why is preventive medicine exempted from ethical constraints? J Med Ethics 16: 187–190.
  16. 16. Metz M (2002) Criticism preserves the vitality of science. Nat Biotechnol 20: 867.
  17. 17. Harnad S (1982) Editor peer commentary on peer review. Behav Brain Sci 5: 185–186.
  18. 18. Grouse LD (1982) Dealing with alleged fraud in medical research. JAMA 248: 1637–1638.
  19. 19. Forscher BK (1980) The role of the referee. Scholarly Publishing 11: 165–169.
  20. 20. Commoner B (1978) Peering at peer review. Hosp Practice 13: 25, 29.
  21. 21. Shand J (2000) Arguing well. London: Routledge.
  22. 22. Ingle DJ (1972) Fallacies and errors in the wonderlands of biology, medicine and Lewis Carroll. Perspect Biol Med 15: 254–281.
  23. 23. Glantz SA (1997) Primer of biostatistics. 4th edition. New York: McGraw-Hill.
  24. 24. Bailar JC (1976) Bailar's laws of data analysis. Clin Pharmacol Ther 20: 113–119.
  25. 25. White SJ (1979) Statistical errors in papers in the British Journal of Psychiatry. Br J Psychiatry 135: 336–342.
  26. 26. O'Fallon JR, Dubey SD, Salsburg DS, Edmonson JH, Soffer A, et al. (1978) Should there be statistical guidelines for medical research papers? Biometrics 34: 687–695.
  27. 27. James NT (1996) Scientific method and raw data should be considered. Br Med J 313: 169–170.
  28. 28. Mainland D (1984) Statistical ritual in clinical journals: Is there a cure?—I. Br Med J 288: 841–843.
  29. 29. Klein DF (2002) Peer review and data access. Cortex 38: 412.
  30. 30. Meguid MM, Shenkin A (2003) Introduction: Nutritional supplements and the quest to improve human performance—The need for the strictest standards and rigor when reporting clinical trials. Nutrition 19: 955–956.
  31. 31. DeMaria AN (2002) Peer review: Better than the alternatives. J Am Coll Cardiol 40: 1017–1018.
  32. 32. DeBakey L (1990) Journal peer reviewing. Anonymity or disclosure? Arch Ophthalmol 108: 345–349.
  33. 33. Grosch EN (2003) Reviewer diligence? Br J Sports Med 37: 187.
  34. 34. Stamps AE (1997) Using a dialectical scientific brief in peer review. Sci Eng Ethics 3: 85–98.
  35. 35. King DW, McDonald DD, Roderer NK (1981) Scientific journals in the United States. Stroudsburg (Pennsylvania): Hutchinson Ross.
  36. 36. Stehbens WE (1999) Basic philosophy and concepts underlying scientific peer review. Med Hypotheses 52: 31–36.
  37. 37. Raine CS (2003) A reviewer's lot is not a happy one. J Neuroimmunol 141: 1–2.
  38. 38. Kohn LT, Corrigan JM, Donaldson MS, editors. (1999) To err is human: Building a safer health system. Washington (D.C.): National Academy Press.