“Twelve significant photographs in any one year is a good crop.”
- Ansel Adams
This year, CASE will release an issue each month, expanding from six annual issues since its inaugural issue in 2017, to 10 issues this past year, to an even dozen issues starting in 2023. I thought this would be an ideal time to provide you an annual State-of-the-Journal update.
To start, I remain humbly committed to serve in the role as your Editor-in-Chief for CASE, and I am proud to tell you the Journal is in good health. At the time of my writing (late November 2022), our journal submissions are trending higher than any prior year (except the ‘pandemic exception’ year 2020 when submissions exceeded all projections for all journals). Furthermore, we have rebounded nicely from the post-pandemic return-to-work slowdown period and have regained earlier momentum, increasing submissions by ∼20% in 2022. Our acceptance rate is ∼50% and reflects the high-quality submissions and active engagement of our expert content peer reviewers and subsection editors. Each issue contains eight to ten unique reports.
We continue to receive many excellent CASE reports and CASE series. In addition to these, the website continues to gain relevance as a unique educational tool that offers alternative avenues for communication and education to our community. We would like to receive more “Unlock the CASE” submissions which serve as quick, fun sources of educational material. We have received many “Sonographer Sound-Off (SSO)” submissions, and we have been pleased by your active engagement with these sonographer-led pearls of wisdom. Keep sending those to us! We published six Letters to the Editor and continue to ask that you use these as a tool to directly communicate with the authors on CASEs you have read.
The CASE editorial board is exceptional in their dedication to helping authors present their best work. In particular, the talented group of Subsection Editors are the fuel without which the CASE engine could not run: Bonita Anderson, MAppSc, DMU, AMS, ACS, FASE; Gerard P. Aurigemma, MD, FASE; Majd Makhoul, MD, FAAP, FACC; Carol C. Mitchell, PhD, ACS, RDMS, RDCS, RVT, RT(R), FASE; Denisa Muraru, MD, PhD, FESC, FACC, FASE; Akhil Narang, MD, FASE; Rebecca L. Stepien, DVM, MS, DACVIM; and Lissa Sugeng, MD, MPH, FACC, FASE. With carefully prepared editorial feedback, authors are able to demonstrate their expertise and help us learn from their patient case experiences. In 2022, there were nearly 80 different peer-reviewers that volunteered their time for CASE. In addition to physician experts, there were basic scientists, veterinarians, and nearly 10 sonographer-experts providing editorial peer review. 20% of these expert reviews were from outside the United States. CASE also benefitted from having three cardiovascular imaging experts serve as guest editors this past year, including Allan L. Klein, MD, FASE, Steve W. Leung, MD, FASE, and Chittur A. Sivaram, MD, FASE, as well as the educational efforts of our CME Editor, Andy Pellett, PhD, RCS, RDCS, FASE.
One of my important missions as Editor-in-Chief was to engage Sonographers in CASE. Although pleased with the recent sonographer excitement, I remain committed to your views, your expert input, and look forward to your continued engagement. The SSO option remains for 2023, and we are preparing for another “MACH-1” event at our Annual Scientific Session (watch for details and submit your case report abstract to ASE so you will qualify for this fun, rapid-fire presentation to your peers). We are grateful for the support of the ASE Sonographer Council who offered fee waivers to CASE sonographer authors, and we were able to publish many reports led by sonographer-authors. We have also seen an increased number of publications including sonographers in their acknowledgements which is another wonderful method to recognize the incumbent teamwork necessary for quality echocardiographic practices.
We published our initial CASE Special Issue in 2022 and had incredible feedback related to the topic of point of care ultrasound (POCUS). Our Focus Issue in 2023 is intentionally linked with the JASE Special Issue on Valvular Heart Disease, and we know you will enjoy this complementary image-based companion. Looking forward, these Special Issue Editions will only mature and grow into an even more attractive educational resource as authors become familiar with their value and submission timelines.
Another component of the growth of the Journal has been the editorial effort to enhance the universal nomenclature and standardization toward CASE reporting. Some of this has been addressed in previous Editorials (What Does AI Mean to You? and Interpreting the Interpretation), but through a strategic effort on behalf of the Editorial Board, we have worked toward increasing the consistency of the final product you read. We regularly ask authors to provide society-based references and guideline-based parameters for all reported imaging findings. We insist upon un-biased image interpretations that include the expert reviewers' feedback into the demonstrated findings. This often requires the submission of additional images and materials, and we are very grateful for the authors’ incredible efforts aimed at maximizing the educational value of the final product. We are extremely proud of the vast number of multimodal imaging correlations, many of which also include histopathology as the final rewarding correlate.
Recently, in keeping with the global trend toward scientific communication, we have been requesting patient consent statements while highlighting any perceived conflicts of interest. We strongly encourage an emphasis on diversity, equity, and inclusion which comes with recommendations for gender-neutral language. We have specifically requested that authors avoid over-stated claims such as the first and only reported finding given that this claim is impossible to support and rarely scientifically meaningful. Did you know there are nearly 30,000 medical journals publishing more than 1 million papers yearly (i.e. two publications/minute). Although some of these requested edits may not initially feel natural, in time, we believe this approach will be standard with all scientific journals.
Another development of the Journal over this past year has been the creation and fostering of subsections within the general imaging framework. These are aimed at providing a collection of categories where we can generate a network of experts who consistently provide you with advanced editorial feedback while incorporating strategic comparative analysis to keep the Journal fresh, innovative, and comprehensive (Figure 1). Knowing these sections may help guide you as you prepare your report for CASE.
Figure 1.
List of CASE subsection headings.
CASE was also the star of a recent #ASEchoJC event where two CASE report authors participated in a Twitter journal club as an educational tool to teach about cor triatriatum dexter (Sunthankar et al.) and sinus of Valsalva rupture (Armenta-Moreno et al.). This latter CASE was our first ever bilingual discussion making it even more relevant to our global community. Impressively, the early (four-hour) statistics for this one-hour event demonstrated >225 tweets/hour leading to nearly eight million impressions.
This month’s special focus issue, Echo in Valvular Heart Disease and Interventional Echo, includes two reports on the various clinical presentations of quadricuspid aortic valve disease, from Vucic et al. and Tedga et al. To further emphasize the bizarre nature of congenital valve diseases that result in four AV leaflets instead of three, Grandez et al. demonstrate a phenomenally rare situation that resulted in one MV leaflet instead of two. Datta et al. present two CASE examples as a means to offer a standardized terminology and definition for PFO dimensions with exceptional images and an educational table. This is followed by a TEE-guided percutaneous closure of an ascending aortic pseudoaneurysm (Gonzalez et al.) and a possibly unreported, but avoidable, left atrial appendage occlusion device complication recognized and corrected with TEE-guidance (Pruitt et al.). Finally, there is a transcatheter edge-to-edge repair for a left AV valve cleft (Mital et al.) and a novel transcatheter tricuspid valve replacement for severe tricuspid regurgitation in a patient found to have Anderson Fabry disease (Zhou et al.).
I enjoyed reviewing each of these reports and found that my diagnostic acumen rose through this process. I am delighted that these are available together in this special issue for you and anticipate that you will also learn from these outstanding reports which include phenomenal images. As always, I enjoy hearing from you at Case4ase@gmail.com with your insightful questions, ideas, or feedback aimed at improving your Journal.
And remember, every echo you see today has a teaching point; and every teaching point is a potential new CASE report.