Submissions of scientific papers should not become a sophistication

Submissions of scientific papers should not become a sophistication

Journal of Clinical Epidemiology 60 (2007) 535e536 LETTERS TO THE EDITOR Submissions of scientific papers should not become a sophistication We read ...

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Journal of Clinical Epidemiology 60 (2007) 535e536

LETTERS TO THE EDITOR Submissions of scientific papers should not become a sophistication We read with interest the recent article by Guyatt and Haynes [1]. Their suggestions are intended to especially address scientists who are ‘‘early in their academic careers’’. Their paper contains many good advices. However, we believe that some of their suggestions do not serve the ultimate goal of scientific publications: the communication of valid scientific results. Other comments appear to be misleading. Guyatt and Haynes state ‘‘if it is appropriate that you seriously think of submitting to a top journal it means that your research has been well-planned, and well-implemented.’’ First, even top journals include research that is poorly planned and implemented. Second, lower ranking journals are not necessarily the addressees of less wellplanned and implemented research. Their venous thromboembolism example is misleading. The study question was reformulated in the ‘‘introduction accordingly’’ after the manner of result presentation has been chosen. It should be quite the opposite. We start with a study hypothesis and could even write the introduction and material and methods sections without having started the field study. Whether the results nicely fit our initial hypothesis or not should not guide us to reformulate or reframe our original study question post hoc to maximize the readers’ attention. It is not marketing but science that should guide us in writing scientific papers. We disagree with Guyatt and Haynes view on reviewers’ comments. They state that ‘‘unless the reviewers’ suggestions will make the paper substantially worse, go along with it.’’ They continue, ‘‘Even if the original is superior, if the suggested change is marginally less attractive, we are ready to go ahead’’. First, it is not the attraction of our manuscripts that should motivate us to publish papers. Attraction is misleading in any way. One of the most prominent consequences of ‘‘attractiveness’’ in the biomedical literature is publication bias. Second, if we have good arguments that the reviewers’ suggested changes would worsen the quality of the paper (even to a small extent), we should not follow the reviewers’ arguments despite the risk of a manuscript rejection. Instead, we should provide a clear scientific rational why we do not want to change the paper accordingly. For example, there appears to be a popular misunderstanding about confounding in observational studies among some reviewers. If an exposure is considered to be a risk factor for a disease based on a priori knowledge, then this factor does not necessarily qualify as a confounder 0895-4356/07/$ e see front matter Ó 2007 Elsevier Inc. All rights reserved.

in a given study. Risk factors have to fulfill several conditions before they can operate as confounders. Adjustment for putative confoundersdas often requested by reviewers in our experiencedcan decrease the precision or even introduce bias of the effect estimates [2]. Therefore, if a risk factor in a given study does not fulfill the confounder conditions it should not be adjusted for. A reply letter that accompanies the revised manuscript might include a causal diagram that illustrates the authors’ argument. Guyatt and Haynes talk about reviewers who have not taken the time to read the paper thoroughly and suggest a change that is already in the paper. These reviewers obviously did a poor and sometimes irresponsible job. Instead of pointing out the reviewers’ negligence, they suggest a flowery phrase to avoid any conflict with the reviewers. Editors of large journals cannot always overview the quality of reviews from every reviewer. Therefore, authors who receive flawed and invalid reviews should inform the editors to optimize the quality of the peer review process instead of using misleading flowery phrases. The general recommendation to ‘‘always end off by thanking reviewers for their helpful comments that have improved the quality of the paper’’ is in conflict with the idea of quality assurance of the peer review process. If a review is thoughtless and invalid, we should not ‘‘thank the reviewers for their helpful comments that have improved the quality of the paper’’. Andreas Stang Member of the Editorial Board of the Journal ‘‘Herz’’ and Section Editor of the Journal ‘‘TumorDiagnostik & Therapie’’ E-mail address: [email protected] (A. Stang)

Andrea Schmidt-Pokrzywniak Clinical Epidemiology Unit, Institute of Medical Epidemiology Biometry and Informatics, Medical Faculty Martin-Luther-University of Halle-Wittenberg Magdeburger Street 27, 06097 Halle, Germany

References [1] Guyatt GH, Haynes RB. Preparing reports for publication and responding to reviewers’ comments. J Clin Epidemiol 2006;59:900e6. [2] Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology 1999;10:37e48. doi: 10.1016/j.jclinepi.2006.11.001