|Year : 2016 | Volume
| Issue : 2 | Page : 157-160
Dear Editor: Why did you reject my paper?
Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
|Date of Web Publication||1-Mar-2016|
Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Banerjee A. Dear Editor: Why did you reject my paper?. Med J DY Patil Univ 2016;9:157-60
For the editor of a journal, this is one of the common queries in a day's work. The situation is more awkward when confronted with this question from a close professional acquaintance holding a senior faculty position. Publications for medical teachers are a recent requirement. It follows that with a few exceptions the actual publication experience of faculty is inversely related to their seniority if we exclude gift authorships.  Gift authorship is assumed as a "privilege" of seniority. It is these senior beneficiaries who usually pose this uncomfortable question. The aim of this editorial is to explain the efforts which go in ensuring that published papers are of high quality and the common reasons for rejection of a paper.
When a manuscript gets rejected, the editorial board shares the disappointment of the author. Working up a manuscript for publication involves a lot of effort by editorial staff, reviewers, and technical editors in close collaboration with the authors. The editorial board members toil to ensure that all papers reach a quality acceptable for publication. Same message is passed on to the reviewers. They are conveyed that even if they think a particular paper is unfit for publication they should give constructive inputs to enable a revised version for reassessment. Only if the paper is beyond any scope for improvement we take a decision, reluctantly, to reject it. The decision to reject such papers is to ensure that all papers published by us are of assured quality. Misleading facts and inferences based on poor study designs do not benefit the research community or society and have the potential to mislead the scientific and lay community causing harm to patients and people. This is violation of the ethical principles of beneficence and nonmaleficence. Besides ethics, publication of good research and ideas will improve the standing of the journal. This enhanced reputation would be in the best interest of all stakeholders including the authors who publish with us. Online accessibility of the published papers makes them immediately accessible to readers and researchers globally. Papers with serious flaws besides adversely affecting the reputation of the journal would not be in the best career interest of the authors of such papers.
Of course in the present academic scenario in the country, the disappointment and desperation of authors following rejection of a paper is understandable. Emphasis presently is on quantity not quality. If the academic environment in our country improves (an optimistic thought), quality of papers will take precedence over quantity. Shoddy papers even published years ago will catch up with the authors and harm their reputation. For young faculty aspiring to go abroad, quality of papers will improve their prospects. It should come as a surprise to our academics that in the US, where quality takes precedence, no more than 20% of scientists have a peer-reviewed paper to their credit. 
A senior faculty once complained that after his paper got rejected by our journal, he submitted the same paper to an "International" journal in which the paper got accepted within 2 weeks. In a rather hostile tone he demanded, "What does this mean, editor?" the editor, tongue in cheek, retorted, "This means that our journal has higher standards than the so called 'International' journal!!" On a more serious note, the editor explained to this senior faculty that most of these so-called "International" journals are predatory which will publish any paper after charging the authors. This racket of predatory publishing has been well exposed by the Indian as well as the world media. Some time back The Hindu reported that most of these predatory journal publishers are operating from countries such as India, Pakistan, Nigeria, and China.  More recently, the Time magazine reported that one can be first author on a new research paper for cancer by paying $14,800.  These predatory journals have a profit motive and quality of the papers is the last priority for them. They exist in a supply demand environment in countries where academics require publications to promote their careers. Most authors are not necessarily victims of predatory journals; they submit papers to these dubious journals well aware of their status chancing that experts who evaluate their curriculum vitae will not check the journal credentials.  We feel this practice is highly unethical. Strict action by our academic community is needed to stem the rot.
In contrast to such predatory journals, bona fide journals follow strict protocol to ensure quality of published papers. To maintain complete objectivity, without fear or favor, the decision on a particular paper is not taken by a single person arbitrarily. Decisions on the manuscripts are mainly influenced by the inputs received from the reviewers who are the subject experts. Most journals, including us, follow a double-blind peer review. We give an overview below of common reasons for rejection of papers based on our experience, inputs received by our reviewers and some published literature. ,
The most common problem encountered at the editor's level is manuscripts not submitted according to the journal instructions. Detailed instructions for different types of articles are available at the journal website. In spite of this we keep on getting manuscripts not conforming to these guidelines. Usually, we do not reject the manuscript initially for this reason alone. We send back the manuscript to the authors with remarks to resubmit the manuscript, usually within a week, according to the journal's instructions.
At this stage, we come across different author responses. Some (about 10%) do not bother to respond even after repeated reminders. Others (another 10%) do resubmit but with hardly any modification. The majority of authors (about remaining 80%) do resubmit the revised manuscript according to the journal requirements. We have no hesitation in rejecting the manuscripts of those who do not respond or do so without revising the manuscript. After submission, the author is involved in all the subsequent stages, i.e., repeated revisions after inputs from reviewers, answering queries by the technical editors after provisional acceptance, and repeatedly checking and approving the proofs before publication. We expect that authors who have toiled to carry out genuine research will be prompt to respond to queries and requests from the editorial team. If they fail to do so, the genuineness of their work also comes under a cloud. In the absence of reliable methods to ascertain research integrity, we have to rely on such screening methods.
After the initial screening by the editorial team, the paper is sent for peer review to external referees. Common reasons for rejection by reviewers are as follows: the research question or the problem addressed in the paper is not clear, dull topic with plenty of previous research, background and justification of the paper not projected, small sample size, poor readability, sloppiness with spelling and grammatical mistakes, and conclusions are not based on the results of the paper.
If we consider the different sections of the paper separately, the following trend is noted. The introduction section which should build up the need for the study sometimes lacks the required punch. It has been recommended that the introduction should contain four themes.  The first paragraph should lay the background of the present research, i.e., the clinical or public health problem with relevant references; the second paragraph should give a brief synthetic literature review describing studies done to address the same research question as the present paper; the third paragraph should bring out the limitations of these studies or controversies if any raised by these studies; finally, the fourth paragraph should mention the improvement or additional features in the present paper. Any information which does not fit into any of these themes is redundant and should be removed.
Most mistakes are made in the methods sections - major ones being study designs not mentioned or wrongly described, predictors, outcomes, and confounders are not described explicitly and sometimes difficult to decipher, or if mentioned the methods of measurement of these variables are not described or are vague. Methods to reduce measurement errors (both due to instrument and observer) tend to be overlooked. Authors may fail to mention methods of selection of study participants including the controls. Case definition may be imprecise or not described at all. Sometimes the statistical tests are not appropriate. With increasing availability of statistical packages, there is tendency to indulge in data dredging and statistical overkill. Complex statistical outputs are incorporated in the paper, sometimes appropriately but often inappropriately. Just getting the statistician's approval may be necessary but not sufficient since statisticians lack the clinical insight necessary for proper interpretation of statistical results in context of the big clinical picture. Sometimes in response to queries raised regarding inappropriate statistical tests the authors give a one line reply that the statistics were checked by a biostatistician. For optimum application of statistical techniques, a healthy communication between the investigator and the statistician is essential.
The common mistakes in the results section include the following. The main results related to the research question are sometimes difficult to locate. The effect size, i.e., if two groups are being compared the difference in outcome in the two groups is not mentioned. This difference if mentioned is sometimes clinically not relevant. Without mentioning this difference or effect size, or sometimes with clinically irrelevant effect sizes, complicated statistical outputs with P values which have little practical application are mentioned at great length. More than the hallowed P value, confidence intervals convey more to the discerning reader. If the confidence intervals are presented (and increasingly journals are insisting on confidence intervals instead or in addition to the P values), a lot of information is conveyed. First, confidence interval indicates whether the sample size was adequate (a wide confidence interval indicates a small sample size). Second, the upper and lower limits of the confidence interval can help the reader make a judgment on the clinical or public health relevance given the best and worst estimates of the results. Third, depending on whether 1 (for relative risk, odds ratio for categorical data) or 0 (for mean difference for quantitative data) is included in the confidence interval, the statistical significance can be inferred making the hallowed P value redundant. In times to come, editors and reviewers will tend to reject papers which do not give confidence intervals in the statistical analysis wherever appropriate.
Judicious use of tables and figures with appropriate titles in the results section enhances comprehension. These should be self-explanatory and meaning of every item clear without referring to the text. All the tables and figures should be cited in the text and they should be in chronological order. Sloppy tables and figures with glaring errors can test the patience of editors and reviewers increasing the likelihood of rejection.
Mistakes in discussion section include repetition of results, not considering alternative explanation for the results, failing to put the findings in proper perspective against results from previous studies often due to inadequate review of literature, not properly discussing the implications and relevance of the results and the way forward. Sometimes new data crop up under the discussion section without them being first mentioned under results. This is unacceptable. The most important point is that discussion should focus on findings of the present study and not be an essay on the topic which could be written without having access to study results. If such content creeps in, they are redundant and should be removed.
One of the most common problems encountered in the references section is that often they are outdated. This is very common for papers based on postgraduate dissertations work which may have been carried out some time back. Authors may be too lazy to update the references. Other problems with references are not following the Vancouver system in citing and listing the references in spite of repeated requests, citing references from "predatory journals" and lifting references without reading the whole paper leading to misinterpretation of the message conveyed by the reference. Another point to note is while citing from the references authors should paraphrase the content in their own words to avoid plagiarism, a serious lapse described below.
The most serious misdemeanor which demands immediate rejection and perhaps some deterrence is plagiarism. We have zero tolerance policy for this. We have a moral duty to report such lapses to the institution of the authors after thorough investigation. If we detect plagiarism before publication, we reject the manuscript outright with a warning note to the authors explaining the highly unethical nature of such lapses. If detected after publication, we have no hesitation in retracting plagiarized papers.
Ethical issues arising out of acts of plagiarism are sometimes difficult to resolve. Ethics is never black and white, so is with publication ethics and misconduct. Lot depends on the social and academic environment in which such acts take place. Our present social environment in academics is limited to counting the publications and no further.
To deter and punish misconduct of plagiarism, we require a very robust academic environment which goes beyond the count and stresses on quality and integrity. In North American Universities, there are punitive systems in place to discredit plagiarists. This deterrence tends to be an integral part of university honor codes. These "honor codes" have a long history, and are taken very seriously by the authorities. In such an environment, chances of detection and punishment for plagiarism are uncomfortably high. Lying, cheating, and stealing (plagiarism amounts to stealing) are not tolerated, and anyone found guilty of such an offense is liable to be dismissed from the university. 
Regrettably, we are nowhere near their standards and therefore cases of plagiarism are rampant. Least we can do is reject such papers.
It has been our experience that once we explain the whole publication process and our intention to ensure high standards for our journal even the most hostile authors of rejected papers are convinced of our good intentions and become our allies in improving the quality and content of submitted papers. Since we cannot reach out to all authors personally, we hope this editorial serves the purpose of informing the authors of our mission and methods. We hope authors will judge their rejected manuscripts against the backdrop of common reasons for rejection brought out in this editorial. Our endeavor is to make them see our point of view and improve the quality of their manuscripts which in turn will raise the bar of our journal.
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