Publish and be damned

I published my first peer-reviewed scientific paper 44 years ago, in 1975, on ‘The damaged digital nerve’.¹ There were no charges made by the journal, and I was well supported by the editor at that time, Graham Stack, who ran the journal and published it single-handedly. I have subsequently published over 350 peer reviewed articles with a few, particularly over the past five years, requiring substantial financial support to be registered as open access articles. The development of the journal industry has changed dramatically as a result of open access. My perception is that many of the established journals that have converted to open access have demonstrated a significant financial benefit in moving in this direction, but some have charged authors excessively for this ‘benefit’. These established journals provide a robust peer review and publishing service and many of us have benefited from easy access to the published research that has resulted. However, the big challenge facing the publishing world is that other organizations have become aware of the financial benefits of this form of publishing and many companies, claiming to be publishers, are now getting in on the act.

The problem

In 2015, the British Medical Journal published an editorial, entitled ‘Firm action needed on predatory journals’,² which was an important warning to academics in the general areas of medicine and healthcare, doctors, and nurses that their work was likely to be affected in the future. Their definition of ‘predatory open access journals’ was those whose publications require large fees without providing robust editorial or publishing services. Other authors have drawn attention to their concerns with, for instance, articles entitled ‘Stop Predatory Journals’³ and ‘Beall’s List of Predatory Journals and Publishers’.⁴ Following my retirement, I decided, like many others, to continue supporting and contributing to academic journals – reading and submitting papers, reviewing articles, and generally maintaining my academic interests.

Over the past five years, I have written some high-profile articles and, as a result, during the past 16 months I have received over 120 email requests from (mostly) predatory journals inviting me to submit articles at a reduced rate (or free), to become a reviewer, or to join their editorial boards. I have even received offers to become an editor or sub-editor. It is often difficult to trace the publishers of these journals and where they are based. There is evidence that a number of the USA addresses, used by some of these journals, are ‘post boxes’ used by companies based either in India or in the Far East.

It is now clear to me that some new publishers are producing open access journals as a ‘cash cow’. Unfortunately, these journals are in danger of killing the goose that lays the golden egg. Many of these publishers are lowering standards because the papers that are submitted and accepted generate an income for their journal. However, there is a more serious effect that is beginning to undermine the whole structure of academic publications – those currently involved in reviewing papers are being invited to join the editorial boards of these new journals, which they perceive as raising their own profile and kudos. As a consequence, academically gifted individuals are unable to support established journals. In addition, reviewers are being pursued to support the peer review process, as reviewers for these new journals, to the disadvantage of the established high-quality journals.

The solution: advice to universities and other academic Institutions

The United Kingdom Universities and Research Excellence Framework (REF) are protecting the established publishers by placing a much greater emphasis on articles published in journals with a high impact factor,⁵ and this is commendable. However, overseas universities are not as selective, and I would encourage them to consider ways of ensuring that there is appropriate screening of academic publications to guarantee that the papers quoted by their academics and by their universities exclude those published in inappropriate predatory journals.

One way of tackling the problem of rogue journals is to stop recognizing the articles that they publish. This can be done by only considering genuine research papers that carry a PubMed ID number (PMID or PMCID). In the United Kingdom, the Orthopaedic Training Programme Selection Committee have already taken this step and, when assessing trainees for progressing through training, only publications with a PMID or PMCID number are now being considered as significant publications.

Unfortunately, many patients and doctors who are carrying out web searches for medical treatments, operations, and outcomes are not selective when choosing the journals from which they obtain information. As a result, we are in danger of allowing poorly refereed research papers to influence future medical practice and, as a consequence, patients will suffer.

I suspect that we are now in a position where our surgeons are so pressurized into publishing papers that they may well see these new, poorly refereed journals as a way of publishing more easily. However, I fear they may be damned for doing so because these articles may not be recognized in future as having value because of deficiencies in the reviewing process. Moreover, their papers might become inaccessible with the disappearance of the journal titles as these journals fail to survive.

The solution: advice to those submitting articles, considering being reviewers, and considering becoming Editorial Board Members

I recommend that those who wish to have their research published should think long and hard about the journals to which they submit their papers. We all know that journals such as The Bone & Joint Journal, Clinical Orthopaedics and Related Research, or the Journal of Bone and Joint Surgery have a high rate of rejection. However, if a paper is accepted, its authors can be rightly proud of their contribution to the medical and scientific literature and will know that their paper has been peer reviewed to a high standard. Choose a journal with a good reputation, which both you and your colleagues access regularly, and which is recognized by PubMed and has PMID or PMCID numbers.⁵

A recent editorial in the Journal of the American Board of Family Medicine reported two unfortunate cases in which predatory journals published articles without adequate peer review.⁶ In these cases, when the authors realized that the journals were not appropriate, they requested that their articles should be withdrawn and submitted to more appropriate journals. These journals accepted their papers, only to find that the original journal also published the paper. This led to the authors and the publisher committing ‘academic misconduct’ by inadvertently creating dual publications. Christopher Bono, a Professor of Orthopaedic Surgery at Harvard Medical School, Boston, Massachusetts has also drawn attention to the problems and damage being inflicted by predatory journals.⁷

Wise authors should check the footprint of the journal to which they are considering submitting. How long has it been publishing? If less than five years, it may not be around in five years’ time. If the publisher is not one that they recognize, they should make further enquiries to ensure that the journal and publisher adhere to rigorous publishing processes. The credibility of the editorial board is very important. Be wary of cut-price charges for open access publishing – this usually means the journal is desperate for papers and may have a poor peer review process and publish poor science.

I encourage all parties to bear their responsibility of addressing today’s problems with predatory open access journals by understanding what has been happening in our medical publishing world. Those submitting articles should choose their journals carefully; those supervising young surgeons should guide them away from predatory journals and towards high-quality established journals; and our established journals, who have been partly responsible for this epidemic by charging high open access fees, should endeavour to keep these charges as low as possible.

Take home message

- Beware of scientific articles published in journals you do not recognize. These articles may not have been properly refereed.

- Advise trainees under your care to submit their articles only to journals in which research papers carry a PubMed ID number (PMID or PMCID).

- When writing academic papers, be careful to reference only papers published in journals that are known to be respected by the orthopaedic community.