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The start of a new journal
Editorials The Start of a New Journal his issue brings to fruition several months of preparation for a new adventure in gastroenterology and hepatology. The American Gastroenterological Association’s decision to embark on a new journal was contemplated for several years and finally taken by Dr. J. Thomas LaMont and the Publications and Informatics Committee at the direction of the Governing Board. Clinical Gastroenterology and Hepatology is the new, official clinical practice journal of the American Gastroenterological Association (AGA). AGA members will receive this new journal, as they do Gastroenterology, as a benefit of membership. At a time when there are so many journals in biomedical science, why embark on this initiative? Indeed, why did the appointed editors seize the opportunity to step forward and offer to serve the organization and its membership in this endeavor? The AGA is well served with the premier subspecialty journal in our discipline. Gastroenterology has gone from strength to strength. Over the years, in parallel with the perception that Digestive Disease Week is the premier conference for our specialty on the world stage, the AGA’s official journal has also become the prime venue for publication of the best work. Its impact as a scientific journal has led to an inevitably intense competition for space in Gastroenterology. Successive editors have noted with regret that many highly meritorious papers could not be accommodated in the journal because of space limitations. During the last decade, technological advances and novel insights in biomedical science have also expanded the concepts and skills that are essential for the members of the AGA to stay at the cutting edge, to serve their patients, to satisfy the need for self-directed learning, and
T
to fulfill required credentialing standards. Yet, there has been a growing perception that many of these practical goals required new educational mechanisms in addition to the rigorous scientific publications in Gastroenterology. Few would dispute the fact that reductionism, or narrowing of an academic field, deepens the understanding to microscopic or subcellular specificity. However, this process may also make the resulting research and scholarship more insular, so that communication becomes more the province of sub-subspecialists conversing solely among peers. Members of the AGA have broader needs. Thus, we believe there is an unmet need to provide a forum where communication can address the “big picture” of relevance to the needs of a broad spectrum of the AGA’s members. With this in mind, we aim to bring the best of original clinical research that is relevant to the practicing gastroenterologist in a format that is readily accessible. We perceive that members are eager to enhance their clinical practice with evidence-based approaches, new technology and endoscopy, based on the fundamentals of greater knowledge of the pathophysiology of disease and novel therapeutics. However, we also understand the need to address issues of office or practice management, education, as well as the assessment of techniques to evaluate the educational responsibilities of gastroenterologists and hepatologists. Thus, issues of Clinical Gastroenterology and Hepatology will include sections on key reviews, original articles, editorials, outcomes research, technology and endoscopy, education, policy, and practice management. In keeping with the broad interests of the AGA, we intend serving all constituencies by publishing articles in all disciplines in gastroenterology and hepatology. We shall proactively launch series of articles with special focus as the need arises, and we plan
to work with experts as series co-editors to ensure we serve the diverse educational needs of those engaged in the practice of gastroenterology and hepatology. The lifeblood of any journal is the original articles that it receives and publishes. Although we will commission key reviews in the journal, we are committed to ensuring sufficient space for the publication of novel findings in peer-reviewed original articles pertaining to mechanism, diagnosis, and management of gastroenterologic disorders and diseases. As with all editors, we are eager to publish novel and original observations, to usher in new treatments and diagnostic modalities; yet, replication and confirmation of results have an important role in the development of the evidence basis for our practice. In fact, we would argue along the lines of the German philosopher Georg Hegel,1 who said, “It is a matter of perfect indifference where a thing originated; the only question is: ‘Is it true in and for itself?’” This search for truth and clinical applicability of information will be apparent from the first issues of the journal. Our readers need to apply to their practice the information they read in the journal. Lifelong, selfdirected learning is the mark of successful clinicians and academics, and we will enhance that education by illustrating the principles of evidence-based medicine. We are pairing with our sister journal Gastroenterology in several ways. The electronic platform, the mechanics of the review process, and the formatting of articles are identical by design. We are also committed to review papers that have undergone initial review at Gastroenterology in 2 weeks or less to provide a decision on publication in Clinical Gastroenterology and Hepatology. However, we will not assume the opportunity to consider
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2003;1:1–2
EDITORIALS continued
such papers without the approval of the corresponding authors.2 We are energized by the task ahead of us and the responsibility placed on our shoulders. We commit to deliver to the AGA a viable journal that is indexed from the first issue and has a creditable impact factor by the end of our term. We commit to serve the needs of our members with content that reflects the needs of practicing gastroenterologists and hepatologists. We are determined to serve authors with fair and expeditious reviews and decisions through the efforts of an engaged group of Associate Editors. We are supported by members of the Editorial Board, who have kindly rendered their academic imprimatur to our effort. We can only succeed if authors contribute articles for publication and if readers inform us of how to improve the initial directions and approaches we have selected. We look forward to facilitating healthy debate in the correspondence section of the journal. We are heartened by the excellence of the articles in response to our call for submissions. Such excellence can only confirm the sagacity of the AGA’s Governing Board to start a new journal, Clinical Gastroenterology and Hepatology—a timely idea! We are ready to serve with humility and enthusiasm. MICHAEL CAMILLERI, M.D. Editor FRANK A. SINICROPE, KEITH D. LINDOR, JOSEPH A. MURRAY, WILLIAM J. SANDBORN,
2
M.D. M.D. M.D. M.D.
KENNETH K. WANG, M.D. Associate Editors
References 1. Hegel G. The philosophy of history. 1837:pt 3, sct 3, ch 2. 2. Brenner DA, Camilleri M. Joint statement on missions and submissions of papers to AGA journals. Gastroenterology 2002; 123:877– 878. doi:10.1053/jcgh.2003.49999
A Series of Articles on Evidence-Based Medicine
A
dvances in medicine are generally driven by observation, technology, and validated methods with clinically meaningful end points. The importance of experimental observation as part of the scientific method has been revered for centuries; Isaac Newton stated “. . . there is no arguing against facts and experiments.”1 A noted editorialist stated that as recently as 25 years ago, “in those ancient and primordial days of medical science, case reports, observational studies of a few dozen patients and physiologic experiments ruled journals pages . . . studies that have intermediate endpoints rather than meaningful clinical outcomes.”2 The principles of evidence-based medicine have been introduced to internal medicine residency programs.3 Most gastroenterologists and hepatologists in practice have not been formally exposed to these principles. Evidence-based medicine is based on 4 core competencies: (1) recognition of a clinical problem and construction of a structured clinical
question; (2) a literature search to retrieve the best data available to answer the question; (3) critical appraisal of the evidence; and (4) integration of the evidence to answer the question. Clinical Gastroenterology and Hepatology will feature a series of 6 articles on the application of evidence-based medicine methods to address important clinical questions regarding diagnosis, treatment, natural history, and meta-analysis. Each article will have 2 authors; one will have expertise in the methodology, and the second will be an expert in the topic chosen to illustrate the application of the methodology and to integrate the evidence. Our goal is to provide a scholarly appraisal of a theme of clinical interest while illustrating the method particularly in the crucial stage of critical appraisal of the studies and determination of which studies are admissible and hence impact the integrated outcome of the scholarly exercise. PHILIP S. SCHOENFELD MICHAEL CAMILLERI
References 1. Brewster D. Memoirs of Sir Isaac Newton. 1855. 2. Kassirer JD. Reflections on medical journals: has progress made them better? Ann Intern Med 2002;137:4648. 3. Green ML. Evidence-based medicine training in internal medicine residency programs: a national survey. J Gen Intern Med 2000;15:129 –133. doi:10.1053/jcgh.2003.50000
T
to fulfill required credentialing standards. Yet, there has been a growing perception that many of these practical goals required new educational mechanisms in addition to the rigorous scientific publications in Gastroenterology. Few would dispute the fact that reductionism, or narrowing of an academic field, deepens the understanding to microscopic or subcellular specificity. However, this process may also make the resulting research and scholarship more insular, so that communication becomes more the province of sub-subspecialists conversing solely among peers. Members of the AGA have broader needs. Thus, we believe there is an unmet need to provide a forum where communication can address the “big picture” of relevance to the needs of a broad spectrum of the AGA’s members. With this in mind, we aim to bring the best of original clinical research that is relevant to the practicing gastroenterologist in a format that is readily accessible. We perceive that members are eager to enhance their clinical practice with evidence-based approaches, new technology and endoscopy, based on the fundamentals of greater knowledge of the pathophysiology of disease and novel therapeutics. However, we also understand the need to address issues of office or practice management, education, as well as the assessment of techniques to evaluate the educational responsibilities of gastroenterologists and hepatologists. Thus, issues of Clinical Gastroenterology and Hepatology will include sections on key reviews, original articles, editorials, outcomes research, technology and endoscopy, education, policy, and practice management. In keeping with the broad interests of the AGA, we intend serving all constituencies by publishing articles in all disciplines in gastroenterology and hepatology. We shall proactively launch series of articles with special focus as the need arises, and we plan
to work with experts as series co-editors to ensure we serve the diverse educational needs of those engaged in the practice of gastroenterology and hepatology. The lifeblood of any journal is the original articles that it receives and publishes. Although we will commission key reviews in the journal, we are committed to ensuring sufficient space for the publication of novel findings in peer-reviewed original articles pertaining to mechanism, diagnosis, and management of gastroenterologic disorders and diseases. As with all editors, we are eager to publish novel and original observations, to usher in new treatments and diagnostic modalities; yet, replication and confirmation of results have an important role in the development of the evidence basis for our practice. In fact, we would argue along the lines of the German philosopher Georg Hegel,1 who said, “It is a matter of perfect indifference where a thing originated; the only question is: ‘Is it true in and for itself?’” This search for truth and clinical applicability of information will be apparent from the first issues of the journal. Our readers need to apply to their practice the information they read in the journal. Lifelong, selfdirected learning is the mark of successful clinicians and academics, and we will enhance that education by illustrating the principles of evidence-based medicine. We are pairing with our sister journal Gastroenterology in several ways. The electronic platform, the mechanics of the review process, and the formatting of articles are identical by design. We are also committed to review papers that have undergone initial review at Gastroenterology in 2 weeks or less to provide a decision on publication in Clinical Gastroenterology and Hepatology. However, we will not assume the opportunity to consider
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2003;1:1–2
EDITORIALS continued
such papers without the approval of the corresponding authors.2 We are energized by the task ahead of us and the responsibility placed on our shoulders. We commit to deliver to the AGA a viable journal that is indexed from the first issue and has a creditable impact factor by the end of our term. We commit to serve the needs of our members with content that reflects the needs of practicing gastroenterologists and hepatologists. We are determined to serve authors with fair and expeditious reviews and decisions through the efforts of an engaged group of Associate Editors. We are supported by members of the Editorial Board, who have kindly rendered their academic imprimatur to our effort. We can only succeed if authors contribute articles for publication and if readers inform us of how to improve the initial directions and approaches we have selected. We look forward to facilitating healthy debate in the correspondence section of the journal. We are heartened by the excellence of the articles in response to our call for submissions. Such excellence can only confirm the sagacity of the AGA’s Governing Board to start a new journal, Clinical Gastroenterology and Hepatology—a timely idea! We are ready to serve with humility and enthusiasm. MICHAEL CAMILLERI, M.D. Editor FRANK A. SINICROPE, KEITH D. LINDOR, JOSEPH A. MURRAY, WILLIAM J. SANDBORN,
2
M.D. M.D. M.D. M.D.
KENNETH K. WANG, M.D. Associate Editors
References 1. Hegel G. The philosophy of history. 1837:pt 3, sct 3, ch 2. 2. Brenner DA, Camilleri M. Joint statement on missions and submissions of papers to AGA journals. Gastroenterology 2002; 123:877– 878. doi:10.1053/jcgh.2003.49999
A Series of Articles on Evidence-Based Medicine
A
dvances in medicine are generally driven by observation, technology, and validated methods with clinically meaningful end points. The importance of experimental observation as part of the scientific method has been revered for centuries; Isaac Newton stated “. . . there is no arguing against facts and experiments.”1 A noted editorialist stated that as recently as 25 years ago, “in those ancient and primordial days of medical science, case reports, observational studies of a few dozen patients and physiologic experiments ruled journals pages . . . studies that have intermediate endpoints rather than meaningful clinical outcomes.”2 The principles of evidence-based medicine have been introduced to internal medicine residency programs.3 Most gastroenterologists and hepatologists in practice have not been formally exposed to these principles. Evidence-based medicine is based on 4 core competencies: (1) recognition of a clinical problem and construction of a structured clinical
question; (2) a literature search to retrieve the best data available to answer the question; (3) critical appraisal of the evidence; and (4) integration of the evidence to answer the question. Clinical Gastroenterology and Hepatology will feature a series of 6 articles on the application of evidence-based medicine methods to address important clinical questions regarding diagnosis, treatment, natural history, and meta-analysis. Each article will have 2 authors; one will have expertise in the methodology, and the second will be an expert in the topic chosen to illustrate the application of the methodology and to integrate the evidence. Our goal is to provide a scholarly appraisal of a theme of clinical interest while illustrating the method particularly in the crucial stage of critical appraisal of the studies and determination of which studies are admissible and hence impact the integrated outcome of the scholarly exercise. PHILIP S. SCHOENFELD MICHAEL CAMILLERI
References 1. Brewster D. Memoirs of Sir Isaac Newton. 1855. 2. Kassirer JD. Reflections on medical journals: has progress made them better? Ann Intern Med 2002;137:4648. 3. Green ML. Evidence-based medicine training in internal medicine residency programs: a national survey. J Gen Intern Med 2000;15:129 –133. doi:10.1053/jcgh.2003.50000