Journal of Thrombosis and Haemostasis, 12: 429

DOI: 10.1111/jth.12556

EDITORIAL

Publication stratification F . R . R O S E N D A A L * † and P . H . R E I T S M A * ‡ *Department of Thrombosis and Hemostasis, Leiden University Medical Center; †Department of Clinical Epidemiology, Leiden University Medical Center; and ‡Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands

To cite this article: Rosendaal FR, Reitsma PH. Publication stratification. J Thromb Haemost 2014; 12: 429.

‘Our progress as a nation can be no swifter than our progress in education’ (Attr. John F. Kennedy) The April issue of the Journal of Thrombosis and Haemostasis (JTH) features authors from all over the world: France, The Netherlands, United Kingdom, China, Italy, Taiwan, USA, Japan, Canada, Sweden, Estonia, Russia, Germany, Spain, Norway, and Spain. A wide geographic distribution of authorship is the norm for any international scientific journal nowadays, and in that respect this journal is no exception. Does the geographic origin of the papers that are published in JTH also reflect the origin of the papers that are submitted? The answer to this question is no: papers from some countries are more likely to be published in JTH than those originating in other countries. There are multiple reasons for this discrepancy. The first reason is that JTH is an English language journal. Although English, at this time in history, is the ‘lingua franca’ of science, most scientists have another mother tongue, and thus have more difficulty in writing clearly and convincingly than native English speakers. This puts native English speakers at an advantage over their nonnative counterparts when their work is peer-reviewed. At JTH, we try to see beyond idiosyncrasies when we judge papers, and there is a devoted scientific editor available (Dr Jim Crawley) to improve poor use of English at the stage of publication. However, at that stage, harm may already have been done by reviewers who take the use of English as a criterion for the evaluation of the quality of a manuscript, either consciously or, more likely, unwittingly. A second reason is that, in many less affluent countries, the research infrastructure is far from perfect. For researchers in those countries, this makes it difficult, if not impossible, to produce results that are advanced enough to qualify for publication in JTH. This will particularly affect research that requires major investments in machines and laboratory infrastructure, and therefore not many biochemical papers are submitted to JTH from

© 2014 International Society on Thrombosis and Haemostasis

developing countries, and when they are, they are almost always rejected. There is little that JTH or the ISTH can do to remedy this inequality, as it is primarily attributable to economic disparity. The situation is a bit different for papers with a strong clinical component. Quite a few of these are submitted from developing countries, but again they are often rejected. The reasons for rejection vary. One is that the submissions are often case reports, and the official policy of JTH is not, other than in exceptional circumstances, to publish such reports. As we have noted in an earlier editorial, we are currently reconsidering this, and it is quite possible that later this year we will allow a monthly case report. Another problem with clinical studies from developing countries is that they are often not very original or they describe a local situation that does not have validity elsewhere. An example of lack of originality is a report describing the incidence or prevalence of a certain thrombotic or bleeding condition in a particular country. More often than not, such information brings little in terms of clinical importance or mechanistic insights. Again, to a large extent, this will be related to financial circumstances; clinical studies are tending to become larger and larger, and require well-characterized patient and control groups. This makes epidemiologic studies the most expensive of all, and, in particular, the need to include healthy controls requires large research budgets; uncontrolled studies will rarely survive our review process. Frequently, clinical studies are severely underpowered or suffer from fatal flaws in study methodology. Methodological rigidity is a sine qua non for papers to become published in JTH. The ISTH tries to remedy this lack of methodological rigidity by offering educational courses all over the world that not only teach participants the intricate details of the hemostatic system and how to treat patients with bleeding or thrombotic disorders, but also devote a large proportion of the program to teaching the basics of methodologically sound clinical research. We are hopeful that, in the long term, this will help researchers from less affluent countries to publish their research findings more often in JTH.

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