Forewarned Is Forearmed: What Do Editors Look for During Initial Manuscript Assessment?

Medical writing plays a key role in promoting science. ¹ It should obey general principles of methodology and publication ethics.^1,2 Specific advice may be offered for all types of articles.^3–7 This journal has published several helpful articles providing such guidance.^2–11 The present editorial will candidly share some thoughts on editors’ priorities and choices during the initial triage stage.

First, submitted articles must be within the journal's scope.^1,2 It should be a surprise, but it is not any more, that some authors submit entirely irrelevant articles. For example, regarding the present journal, this may include material focused on chest pain, appendicitis etc.

Secondly, submitted articles are evaluated in terms of novelty.^1,2 The latter is in the interest of science, but it also helps with the journal's reputation.

Will it be cited? This is the next issue to consider. An example may be an article of particular topical interest, especially from a centre of excellence, which is likely to be highly cited. Citations are important, because they determine the journal's impact factor and its ranking within a specific field.

In addition, manuscript preparation is of the utmost importance.^1,2 Manuscripts should be prepared in accordance with journals’ guidelines and with meticulous attention to details. Poor structure, typographical errors and stylistic inconsistencies are to be avoided.^1,2 Omission of structural parts (eg, key words, search criteria, limitations, conflicts of interest, author contribution) also depreciates the submission and its authors. For example, what opinion will an editor form, if the reference list consists of references written in different styles?

At an early stage, plagiarism and duplication must be promptly detected. ¹² Authors should ensure no duplication and provide appropriate credit for any evidence they cite.

Poor language is another issue to consider.^1,2 Some journals may ignore poor language and offer professional editing services. However, this may confer additional cost to the authors and it may delay publication. In addition, distortion of meaning is a real risk, if the text is edited by professional editors who are not familiar with the topic. As a general rule, poor language and style are not helpful.

Relevant to meticulous manuscript preparation is an appropriate abstract.^13,14 It must comply with the journal's guidelines (eg, word count, structured vs unstructured format etc).^13,14 It should also provide a logical, fair and balanced account of the manuscript. ¹³ Conversely, a poorly written or incoherent abstract increases the risk of rejection. ¹⁴ The abstract should be considered as the “shop window” of the article. It will also be an item that will receive considerable attention by editors during initial evaluation of a submission.^13,14

All authors and all submissions are equal and should be dealt with fairly, consistently and with respect. Nevertheless, a few aspects may inevitably tend to provide some minor advantages, at least for some editors. These may include the authors’ prior work with the journal, publication of previous high-quality manuscripts, or services rendered in the capacity of a reliable reviewer. The latter is related to the reliance of all journals on voluntary work by reviewers and the increasing difficulty in obtaining rigorous, timely and reliable reviews.^15–17 Unfortunately, the authors’ publication record and/or centre of excellence are not irrelevant. Perhaps one way around this problem might be for authors to seek collaboration with more established centres until they develop a good reputation of their own. This step may also provide useful guidance on how to write a paper. However, by no means does a submission from a reputable centre offer a green light or carte blanche! Manuscripts will still be thoroughly reviewed; regrettably, sometimes, manuscripts bearing the names of very senior authors represent work by very junior associates that has not been edited or even approved by the group leaders. Furthermore, a history of very poor quality work or experience consistent with inadequate co-operation, disrespect to reviewers’ comments and unreliability regarding meeting deadlines, occasionally, tend to slightly speak against a new submission.

A special situation is when a manuscript has been invited. This increases the likelihood of publication. Certainly, kind invitations should not be abused by producing inferior work, audaciously taking acceptance for granted. Such behaviour undermines the authors’ reputation.

Editorials represent another special situation. ¹⁸ In general, these are written by the journal's editors/editorial board members or other senior colleagues, who have been invited. Accompanying editorials may also be commissioned to highlight the importance of new data. Many journals ask reviewers whether they believe that an accompanying editorial may be worth considering and whether they would like to contribute; this is a form of reward for their efforts.^16,17 Editorials also improve journal performance by providing an expert opinion on published findings. In some journals, editorials are in open access format.

Similarly, letters to the editor should be encouraged.^19,20 Again, these highlight the importance of new data and offer an opportunity for scientific interaction, improving a journal's performance. Letters should be brief and focused on key issues. They are another form of peer review where opinions can come from any part of the world. Like editorials, some journals publish correspondence in open access format.

Conversely, many journals are reluctant to publish case reports, considering that their level of evidence is low and that they usually do not get cited. ³ There are journals dedicated to case reports. ³ Consequently, authors should carefully check if a journal accepts case reports. Ideally, the latter should be brief. Some types of case reports offering new insights ³ are more valuable than others merely describing didactic cases.

A final issue is the timing of a submission. Indeed, a submission may be generally satisfactory, but the journal may have just accepted or published similar work. This cannot be prevented by authors. Certainly, they can check journal websites for similar recent publications (including published online ahead of print lists) and they should not delay publishing, provided that they do not sacrifice quality in the interest of speed. ¹²

How can inexperienced authors be helped? First, by manuscript scrutiny and writing practice, ideally guided by experienced colleagues. Secondly, journals may publish helpful articles, like the present one. Furthermore, scientific medical meetings may include lectures and workshops on medical writing. Finally, editors should be willing to offer personal advice to the extent that this may, occasionally, be possible. An example is willingness “to take a look” at a manuscript sent to them before formal submission, so as to advise the authors if it is within the scope of the journal.

In conclusion, it is the editors’ duty to provide a rapid, thorough and fair selection of manuscripts for further processing or rejection at triage stage. This procedure is an important responsibility and follows some general principles herein outlined. Forewarned is forearmed!