E DI TO R IA L

BJD

British Journal of Dermatology

Letters to the editor: time for more scholarly debate

DOI: 10.1111/bjd.13134 ‘Editors like correspondence; it livens up the journal, shows that people are reading it, and allows “ordinary” doctors outside academic units to have their say.1 This statement still holds true more than 40 years later. However, it also begs the question, what purpose does publishing letters to the editor serve in a contemporary journal? Firstly, and most importantly, the correspondence section of a journal provides a forum for scholarly debate that facilitates postpublication peer review and allows exchange of ideas and information. By publishing these letters, the journal ensures that they become part of the published record. As with original articles, letters are indexed and can be accessed via bibliographical databases. Furthermore, the publication of scholarly correspondence is a duty for journals, as clearly articulated by the International Committee of Medical Journal Editors (ICMJE): ‘Medical journals should provide readers with a mechanism for submitting comments, questions, or criticisms about published articles, usually but not necessarily always through a correspondence section or online forum. The authors of articles discussed in correspondence or an online forum have a responsibility to respond to substantial criticisms of their work using those same mechanisms and should be asked by editors to respond.2 However, the term ‘letters to the editor’ is perhaps misleading, as the audience for published letters is, in most instances, the readership of the journal, not the editor. How do letters to the editor subdivide into different types? For the British Journal of Dermatology (BJD), there are four main categories of correspondence: letters relating to previously published articles (comments, questions, criticisms and replies); short reports (the presentation of novel data or findings in brief); opinion pieces unrelated to previously published content; and case reports. Of these, the category that most clearly matches the ICMJE statement above is the first one. However, analysis of the correspondence section of the BJD in recent years reveals that letters in response to previously published content are a rare and endangered species. How so? Perhaps the BJD peer review is so good that there are few loose ends for others to catch on to? An appealing concept, but unlikely given the vagaries of peer review.3 Perhaps clinicians are too busy to read the BJD in a timely fashion, only chancing upon papers a few months after publication when the moment has gone?4 This may be true for some dermatologists with their pile of unopened journals; like fresh food, published journal content rapidly passes an optimal date (for the aspiring correspondent).4 For some journals, this correspondence deadline is clearly defined, and accepted letters are © 2014 British Association of Dermatologists

published rapidly, reflecting a commitment to encourage and support comments, questions or criticisms about articles they have published. How are letters to the editor processed by the BJD? The answer is, much like any other submitted article. Most accepted letters undergo peer review. This typically involves one or perhaps two peer reviewers.3 Letters that refer to a recently published paper are sent to the authors with an offer to publish their response. Most case reports submitted as items of correspondence are rejected (the BJD has moved away from publishing this type of content). The only exception is case reports that are clearly novel, or shed important light on some aspect of a particular condition. However, the attrition rate is high, as few case reports satisfy these criteria. Why would a dermatologist or skin researcher write a letter to the editor?5 In most cases a letter to the editor is an opportunity to be published; they allow novice authors to cut their teeth and to participate in the scholarly debate. Thus, the best way to join the debate is to read the BJD and know enough about dermatology to be able to extend the understanding of recently published content by submitting a well-crafted letter. Fulsome praise of a paper or damning criticism is not enough (and is speedily rejected). Success requires a thorough knowledge of the literature and a keen, enquiring mind so that added value can be offered for recently published material. Sometimes a letter is needed to correct the published record (after all, the peer-review system is not perfect).3 On other occasions, a letter provides an opportunity to raise questions or make comments that help to provide new insights into the original article. Some letters are short reports; these tend to raise an idea before robust data have been generated to support or refute it. Authors of such letters want and need feedback from the dermatology community (so called ‘kicking the can’). Although regarded as lightweight by some, this type of letter may lead to an idea that stimulates others to research or to practise differently. Additionally, correspondence provides authors with an opportunity to share interesting ideas. What tips does this editor have for aspiring letter writers? Start by reading the BJD regularly and presenting the best and most interesting papers in your local journal club. To do this well, the aspiring letter writer must first acquire and develop expertise in critically reading primary research papers.6 The excellent critical appraisal skills of the presenter combined with top-quality discussion from colleagues creates fertile ground for the germination of ideas. Within this forum, clinicians and scientists can develop ideas for letters from their local academic community. Authors of letters must avoid emotive language; indeed, they should use the same writing style as they would for an original scientific article. Such letters British Journal of Dermatology (2014) 171, pp1–2

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should be concise, focused on making just one or two points, rather than offering a comprehensive critique of the whole paper. Authors should recognize the correspondence section for what it is and feel free to have some fun, while respecting their colleagues; carefully executed humour can augment a letter. Having written a scholarly letter in response to a recent original article, the author should then ask other members of their team to peer review it. Internal peer review is an essential step that helps young authors to hone their writing skills. If the letter is rated highly, the author should submit it. If not, they shouldn’t bother (there is always the opportunity for another go the following month). What is the BJD doing to support aspiring letter writers? We are making it known through this editorial and our instructions to authors that we would like to publish more correspondence relating to recently published original articles (and fewer case reports). These letters should be submitted within 1 month of the publication to which they refer. The peerreview process will be accelerated for such letters to ensure timely publication. Once accepted, letters relating to recent original articles will be fast tracked through the journal production process. A few weeks later, the letter that has been lovingly crafted, redrafted and submitted might then appear in print. What joy for the author to be part of the debate rather than a passive spectator! Come on, join in.

British Journal of Dermatology (2014) 171, pp1–2

Acknowledgments Thanks to John Ingram. Aneurin Bevan University Health Board, Royal Gwent Hospital, Cardiff Road, Newport, Gwent NP20 2UB, U.K. E-mail: [email protected]

A. ANSTEY

References 1 Thorne C. Letters to the editor. In: Better Medical Writing. New York, NY: Grune & Stratton, 1971; Chapter 10. 2 International Committee of Medical Journal Editors. Recommendations for the conduct, reporting, editing, and publication of scholarly work in medical journals. Available at: http://www.icmje.org/ icmje-recommendations.pdf (last accessed 19 May 2014). 3 Anstey A. Peer reviewing and publishing: the yin and yang of academia. Br J Dermatol 2013; 169:489–90. 4 Anstey A. Reading the British Journal of Dermatology. Br J Dermatol 2013; 169:729–30. 5 Anstey A. Why write? Br J Dermatol 2013; 169:1173–4. 6 Greenhalgh T. How to Read a Paper: The Basics of Evidence-Based Medicine, 4th edn. Oxford: Wiley-Blackwell, 2010.

© 2014 British Association of Dermatologists

Letters to the editor: time for more scholarly debate.

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