Ten years of Interactive CardioVascular and Thoracic Surgery

Exactly 10 years ago, the first issue of Interactive CardioVascular and Thoracic Surgery (ICVTS) appeared in print [1], just in time for the 16th Annual Meeting of the European Association for Cardio-Thoracic Surgery (EACTS) in Monte Carlo, Monaco, 22–25 September 2002. However, its electronic version had already appeared in June 2002, to enable online discussion of papers from the first issue. In fact, the virtual conference concept where the accepted manuscript along with its online discussion is published in the print issue was implemented from the outset. The creation of an additional journal had been in the mind of the founding editor for some time prior to his nomination [2], although translating the thought into reality was not easy. First of all, there was no budget for the project; secondly, the publisher of the European Journal of Cardio-Thoracic Surgery (EJCTS) was not enthusiastic about a competing product; thirdly, some experts in the field felt that the task of getting a second journal off the ground might be too ambitious. Undeterred, we forged ahead. The project was financed initially by extracting a slice from the EJCTS page budget. Publication was web-driven (Fig. 1), with a scope and content categories unlike those used traditionally, and specifically different from EJCTS. Thus, ICVTS was looking for ‘State of the Art’, papers not Reviews; ‘New Ideas’, ‘Work in Progress’, ‘Follow-up papers’ ‘Negative Results’ not original articles, and so forth. As for the sceptics, they were proven wrong.

Figure 1:

Cover of the first issue of ICVTS 2002 with a web-inspired design.

Since then, ICVTS has made big strides. On top of being freely available and the implementation of the virtual conference concept outlined above, a number of improvements have been introduced, including videos as supplemental files [3]. An extremely popular feature initiated by Dunning et al. was ‘Best BETs’ [4], short structured reviews of the literature on very specific questions [5]. From the beginning, ICVTS attracted a fairly significant amount of interest on the world wide web, of an order of magnitude similar to EJCTS, despite the latter having more content [6]. Several factors have contributed to this phenomenon, including the most obvious ones:

1. a global scope with an international editorial board;

2. the free access concept early-on, at a time when this was somewhat unusual;

3. the virtual conference concept with online discussion, also published in the printed issue;

4. the inclusion of meeting abstracts in ICVTS supplements [7, 8];

5. the promotion of ICVTS as the official journal of the European Board of Cardiovascular Perfusion (www.ebcp.org) with the help of the chairman of the Board, Alexander Wahba, the secretary Frank Merkle and others [9, 10].

However, one of the less obvious reasons driving web traffic was the placing of ICVTS in a very prominent position on CTSNet (www.ctsnet.org) by its then Editor, Tom Ferguson, who deserves thanks for his foresight.

Yet, the increasing volume of web traffic rapidly brought about some problems with a publisher, who was unable and/or unwilling to support the required development of the ICVTS website, which obviously went beyond simple maintenance [11]. Consequently, it was decided that EACTS would self-publish ICVTS, backed by the experienced editorial team of Ian Beecroft, Rita Brightwell and Judy Gaillard, with the collaboration of Morgan Lyons (Compuscript), not forgetting Margaret Tolland's invaluable help in the compilation and editing of the conference abstract supplements. The self-publishing venture was successful. L. Henry Edmunds, Editor-in-Chief of the Annals of Thoracic Surgery has dubbed ICVTS a ‘stalking horse’, considering the fact that EACTS was tied to a publisher for EJCTS, but ICVTS ran ‘without strings’. The resulting know-how acquired in-house facilitated a smoother acquisition of the rights to EJCTS by the EACTS Council, as well as the subsequent competition to publish the EACTS journal portfolio, by then augmented by the Multimedia Manual of Cardio-Thoracic Surgery (MMCTS), edited by Marko Turina (www.mmcts.org).

With Friedhelm Beyersdorf at the helm, supported by the new editorial team (Judy Gaillard, Franziska Lüder, Jia-Lin Müller and Melanie Künzie), as of 2012, EJCTS, ICVTS (Fig. 2) and MMCTS are now published by Oxford University Press [12]. Recent statistics on ICVTS web traffic show a monthly full-text download number between 47 000 and >50 000 for the first half of 2012 (with the exception of January, when the change of publisher may have affected the numbers; Fig. 3). More interesting than the sheer numbers is the type of articles downloaded. All categories contributed to the overall ICVTS web traffic, well-demonstrated by the most frequent downloads in the first half of 2012 extracted from the statistics summarized in Fig. 3. All papers with >200/month (arbitrary definition for practical reasons) full-text downloads are listed in Table 1 [13–25]. Interestingly enough, the papers most frequently downloaded in the first half of 2012 have been those published during the entire 10-year span of ICVTS; they cover all categories, not only Institutional Reports (now renamed Original Articles), but also Best BETs, Negative Results, Protocols and even Case Reports. This is somewhat contrary to conventional editorial wisdom that only original articles and reviews are ranked highly because they supposedly contribute most to the Impact Factor. Table 1 also demonstrates that interesting articles have a much longer citation life than that implied by the Impact Factor, which is derived from the most frequently cited articles in the previous 2 years.

Figure 2:

Refreshed cover of the first issue of ICVTS 2012 published by Oxford University Press.

Figure 3:

Full-text downloads from ICVTS during the first half of 2012 (data provided by Oxford University Press): numbers vary between 26 700 and >50 000 downloads per month.

Table 1:

List of most frequent full-text downloads from ICVTS (search criterion = n > 200): interestingly enough the papers most frequently downloaded in the first half of 2012 have been published during the entire 10 years of ICVTS activities and come from all categories including not only Institutional reviews, but also Best BETs, Negative results, Protocols and even Case reports

Reference no.	Full-text downloads >200/month	First author	Title	Category	Year
[13]	3740	Laisar	Life expectancy of patients with malignant pleural effusion treated with video-assisted thoracoscopic talc pleurodesis	Institutional report	2005
[14]	1265	Yamashiro	Ventricular tachycardia with congenital left ventricular aneurysm in an adult	Case report	2002
[15]	674	Agostini	Is incentive spirometry effective following thoracic surgery?	Best BET	2007
[16]	493	Pillai	Thoracic complications of nasogastric tube: review of safe practice	Negative results	2005
[17]	467	Schulz	Fatal complications of pacemaker and implantable cardioverter-defibrillator implantation: medical malpractice?	Negative results	2008
[18]	281	Walker	Does enteric-coated aspirin result in a lower incidence of gastrointestinal complications compared with normal aspirin?	Best BET	2007
[19]	249	Aydoğdu	Primary tumours of the ribs; experience with 78 patients	Institutional report	2008
[20]	277	Tiruvoipati	Surgical approach for pericardiectomy: a comparative study between median sternotomy and left anterolateral thoracotomy	Institutional report	2003
[21]	219	Garcia	Left ventricular mass index as a prognostic factor in patients with severe aortic stenosis and ventricular dysfunction	Institutional report	2004
[22]	215	Follis	Argatroban as a substitute of heparin during cardiopulmonary bypass: a safe alternative?	Negative results	2009
[23]	210	Nakamura	The use of Blake drains following general thoracic surgery: is it an acceptable option?	Institutional report	2008
[24]	208	Kouerinis	Heparin-induced thrombocytopenia diagnosis in cardiac surgery: is there a role for thromboelastography?	Protocol	2007
[25]	204	Marx	Stress Doppler echocardiography of the internal thoracic artery—a new non-invasive approach for functional assessment after minimally invasive coronary bypass grafting	Institutional report	2006

ICVTS was initially established as an experimental publication with a greater degree of freedom than the traditional, Impact Factor-driven journals. After 10 years of growth, this concept has demonstrated that further development is merited. Currently, the potential inclusion of, for example, social media, new article types, and educational commentaries, is being evaluated. In addition, an application is underway for an Impact Factor for the journal.

Check out more at www.icvts.org