Editorial-Politis
www.stomaeduj.com
COVID-19 and academic
Editorial
publishing ranking
Constantinus Politis
MD, DDS, MM, MHA, PhD
Professor & Chairperson
Editor-in-Chief
Dear Readers,
In a section of Foreign Affairs (Volume 100, Number 5, 2021), Dr. Chonira Aturupane of Stanford University
points out that during the COVID-19 pandemic a number of challenges stood in the way of effective
policymaking: the prevalence of unreliable information; the degree to which uncertainty and unpredictable
factors can derail the best-laid plans; the importance of comprehensive and feasible implementation plans.
We will concentrate on the first issue, the importance of credible data.
Credible data, reliable information in science does not equal the absence of fake news. Credibility in scientific
reporting requires at least the following dimensions to be assessed: method and data transparency; adequate
sample size and power; validity of the data; adequate use of secondary data; analytic reproducibility and
robustness; effect replicability; independent study sponsoring. Respecting all these requirements should
lead to evidence-based data and evidence-based medicine (EBM).
Yet, on the reporting site in journals, the cornerstone of EBM has shifted far too much from original research
towards the higher positioned systematic reviews and meta-analysis. Many thousands of pages have been
filled with answering questions nobody was waiting for. Further on, unexperienced readers should not
assume that level 1 evidence is always the best choice or appropriate for the research question. An item
often overlooked is the natural history of a condition. For reviewers of most journals it is nearly impossible to
adequately assess all items which define the quality of a study: randomization, blinding, a description of the
randomization and blinding process, description of the number of subjects who withdrew or dropped out of
the study; the confidence intervals around study estimates, and a description of the power analysis and the
statistical methods used. Most reviewers are no statisticians.
This only can be solved if the number of journals is sufficiently reduced to allow for a thorough change of
the review process. Before getting to the clinical reviewers, language experts should filter out inadequate
manuscripts and trained statisticians should filter out studies which are underpowered, unvalidated or ill-
designed. Only then should clinical reviewers assess the manuscript. This requires journals to be digital only
with a well-developed staffing connected in the cloud and funded by independent academic consortia. The
digital only version, and of course open access, allows for post-hoc comments or corrections to be added as
a section to published papers.
As for systematic reviews and meta-analysis, these are very often conducted by PhD students or Master
students in the fullfillment of a PhD or a Masters Program. It is cheap, fills pages, whether the question is
relevant or not. It is very often easily accepted in high ranked journals, creating easily gained impact factors,
citations and h-index points, and all of this usually at a young research age.
It is time to attach less importance to systematic reviews if the question they try to answer is not relevant.
More is to be gained in well-conducted clinical research, but this is tedious work requiring resources and
an experienced research team. In the clinical reality of surgical departments this is a rare phenomenon. The
consequence of this surgical reality is that younger surgeons write manuscripts and publish articles and
seasoned surgeons write book chapters or books or invited sessions in journals.
There is yet another way skilled surgeons can contribute to journals and science. Through their scientific
societies, often in joined efforts with representatives of sister organisations, they can aim for concensus
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statements and guidelines. Professor Hendrik Terheyden, editor-in-chief of the International Journal of
Editorials Implant Dentistry has guided the International Academy for Oral and Facial Rehabilitation (IAOFR) to work
along these lines. The IAOFR, presided by Prof. Dr. Piet Haers, is an international group with more than 30
years of continuous history in the field of oral and facial rehabilitation of patients with innate or acquired
tooth loss or defects of the jaws and the craniofacial region. This group has an international composition,
high scientific expertise and independence. Consensus Statements and Guidelines can target a worldwide
audience of practitioners, clinicians and patients. The methodology used is in accordance with the
GIN-McMaster Guideline Development Checklist, the AWMF Guidance Manual and Rules for Guideline
Development, and the policies of the Guidelines International Network. All this information is freely accessible
on the internet. Consensus Statements and Guidelines allow for a corridor of accepted clinical treatment or
pathways, excluding under-therapy, over-therapy, false therapy, obsolete therapy. Consensus Statements
and Guidelines try to identify a standard of care and have the character of a recommendation to clinicians
in standard clinical situations and a standard clinical environment without any legal force. Consequently,
clinicians can deviate from recommendations in specific cases and situations. Consensus Statements and
Guidelines can also be of help for informed patients for participative therapeutic decisions. Guidelines also
provide tools for policymakers.
Conflicts of interest need to be addressed in a transparent way. The policy of an independent guideline
group requires a declaration, evaluation and management of conflicts of interest of every participant of
the guideline group because the guideline should not be vulnerable to competing interests of industry
companies or competing societies afterwards. A listing of possible conflicts of interest of the participants
should be forwarded to all participants in advance of the consensus meeting.
Since medicine is a quickly evolving field each statement and guideline expires 3 years after publication. The
‘Terheyden-Haers doctrine’ not only allows seasoned and skilled surgeons to combine surgical experience
with common sense and scientific rigor but to translate the surgeon’s group-knowledge into answers to
questions which are relevant to patients and society at large.
Journals will remain necessary for those who pursue academic careers and are in need of citations, h-index
scores to advance in the academic ranking. The perverse side-effect however is that Universities and
Academic Institutions in so-doing make publishers of scientific journals with paid 'open access' filthy rich,
while at the same time depriving a mass of interested parties of scientific information. It is high time that
universities embrace unpaid open access and look for alternatives beyond the h-indexes and citation indices
to appreciate the scientific value of young academics.
Sincerely yours,
Constantinus Politis
MD, DDS, MM, MHA, PhD
Professor & Chairperson
Editor-in-Chief
https://doi.org/10.25241/stomaeduj.2021.8(3).edit.1
152 Stoma Edu J. 2021;8(3):151-152 pISSN 2360-2406; eISSN 2502-0285