Journal rejects article after objections from marketing department
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7434.244-b (Published 29 January 2004) Cite this as: BMJ 2004;328:244
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To the Editor:
While the subject of a marketing decision influencing editorial
policy (1) is likely to elicit justifiable outrage, we should realise that
at least the process was transparent in this case.
What we should be far more concerned about is the possibility that
this phenomenon may be widespread and much more subtly nuanced.
One can only hope that this sentinel event will act as a call to
action by bodies such as the World Association of Medical Editors (WAME),
the Committee on Publication Ethics (COPE)(2) and the International
Committee of Medical Journal Editors (IJME)(3).
1 Dyer O, Journal rejects article after objections from marketing
department. BMJ 2004;328:244.
2 http://www.publicationethics.org.uk/
Competing interests:
None declared
Competing interests: No competing interests
For anyone interested in topics such as authorship and editorial
issues, this is a situation that can clearly be used as a "teaching
case", when speaking about editorial misconduct.
Reviewers are trusted with original and unpublished information, and they
should not to use that information in any possible manner. A reviewer has
the privilege of being exposed firsthand to information that could be
potentially beneficial, such as new findings or discoveries that could be
so important as to initiate changes in clinical guidelines or in
therapeutic actions.
This is a position of utmost responsability; violation of the trust
presented to reviewers should be severely sanctioned, at the very least at
an academic level. The names of the reviewers that revealed confidential
information that lead to stop the publication of such an editorial should
be exposed, and from my point of view, these persons should be banned from
reviewing activities. I cannot think of a serious editor of a serious
journal that would even want to be near reviewers who are willing to
reveal the information presented to them, let alone incur in unethical
positions that could lead to impede a publication, based on marketing
implications, and flagrantly violating the most basic principles of
editorial independence.
It is clear for me that the Executive Editor of Transplantation and
Dialysis is absolutely wrong when he states that the case has been "blown
out of proportion": once the reviewer's misconduct was apparent, Mr.
Herman was not strong or serious enough to make up for this unethical
misconduct, and followed the easy path: ignore the issue and reject the
publication, not without first presenting lame excuses in a letter that
only reveals his editorial incompetence. Is there a journal out there at
all interested in keeping -or opening- a position for executive editor
for anybody capable of this kind of misconduct? Hopefully, not.
Competing interests:
None declared
Competing interests: No competing interests
I would like to point out that I made an error in this story. The
journal in question is called Dialysis and Transplantation, not
Transplantation and Dialysis. A print correction will appear in next
week's journal. My apologies.
Also, while the editor of Dialysis and Transplantation initially
refused comment, that position has changed since we went to press, and I
have received the following comment:
January 27, 2004
A Reply by Dialysis & Transplantation
(This response is being forwarded at the request of Tom S. Blackstone,
Associate Publisher and Director of Marketing, Dialysis &
Transplantation.)
As the associate publisher and director of marketing of the journal
Dialysis & Transplantation, I did, in fact, overrule the executive
editor's desire to publish the editorial, "Formulation of a Medicare
Epoetin Coverage and Reimbursement Policy: Need for Valid Patient Survival
Information," which was written and submitted by Dennis J. Cotter,
president, Medical Technology and Practice Patterns Institute, Inc.,
Bethesda, Maryland. Further, that decision was, in fact, based on the
controversial nature of the editorial.
At the core of that decision was an in-depth understanding of the
audience served by this journal (having worked on this journal for more
than 25 years), as well as an appreciation of the journal's highly
directed focus on clinical application. With rare exception, every article
that has been published in this journal during its entire 31 years of
existence has been authored by a healthcare practitioner and/or by someone
working in a clinical nephrology, renal transplantation, or academic
medicine setting - whether a nephrologist, surgeon, nurse, dietitian,
social worker, technician, or renal administrator.
From the perspective of meeting the needs of the readership that we
serve, I had difficulty in weighing the controversial nature of the
editorial against the source of the editorial. It was my decision that it
would not have been in the best interest of the nephrology community for
someone who is not part of that community to lambaste within this journal
deeply entrenched, widely accepted clinical practices.
Publication of such an article could have a negative effect on the
journal's credibility within the nephrology community. In addition, the
very strong possibility exists that such an article would alienate a
significant portion of the journal's readership who would, in fact, not
agree with many of the premises raised within the editorial.
The highly probable end result would be that Dialysis &
Transplantation would lose readership and circulation. This is a serious
marketing concern, as it would be for any publisher.
Publishers reject countless articles every day, and it is their
prerogative to do so. It is, of course, any author's prerogative to submit
the article to another publisher.
Tom S. Blackstone
Associate Publisher & Director of Marketing
Dialysis & Transplantation
Competing interests:
I wrote this news article
Competing interests: No competing interests
If the facts mentioned in the article by Dyer can be wholly
substantiated, this raises important issues about the scientific integrity
and business ethics of the journal. I edit a smaller circulation journal,
but if I were in this position this would raise questions for me as to my
role in that journal.I would also be discussing this issue with editorial
board colleagues and other editorial colleagues in organisations such as
WAME (World Association of Medical Editors).
If a journal's publishers were to take such a stance on article
acceptance i.e. suppression of scientific papers due to commercial
pressures, then this must have an impact on the amount of trust that
readers will place in the peer review process and quality of the journal.
I feel this would also inevitably have an impact on how much the journal
will be cited and its impact factor. I believe that the authorities
responsible for citation and indexation should be made aware of any such
ethical concerns by the scientific community.
If the facts in this case are certain then what a tremendous own goal
by the marketing department - exactly the wrong type of publicity, at the
wrong time and wrong place i.e. in a very high profile place!
Competing interests:
Dr. Lynch is Editor of Primary Care Psychiatry
Competing interests: No competing interests
Tampering with editorial independence = The DEATH SENTENCE for
scientific progress
Dear Editor,
The BMJ has to be congratulated for bringing this case of
interference in editorial independence to a wider audience (1). The
executive editor of the journal “Transplantation and Dialysis” was
overruled by the marketing department despite a favourable peer review
regarding the editorial by Dennis Cotter “Formulation of a Medicare
Epoetin Coverage and Reimbursement Policy: Need for Valid Patient Survival
Information” the abstract of which is in the public domain (2).
This is a clear violation of the World Association of Medical Editors
(WAME) policy statement on editorial independence. According to WAME (3),
“Editors-in-chief should have full authority over the editorial content of
the journal, generally referred to as “editorial independence.” Owners
should not interfere in the evaluation, selection, or editing of
individual articles, either directly or by creating an environment in
which editorial decisions are strongly influenced. Editorial decisions
should be based mainly on the validity of the work and its importance to
readers, not the commercial success of the journal”.
According to an editorial (4) from Canada “Many societies depend on
income from their journal to support other initiatives of interest to the
membership. Income is increasingly dependent on advertising revenue –
thus, there may be subtle but real pressures to please the industry
partners with content and editorial position”. However the editor of the
BMJ (5) has emphasised the need to establish trust between editors and the
owners of the journal, which means striking a balance between editorial
independence and accountability. Welch in his editorial (6), in the
“Effective Clinical Practice”, wondered whether medical journals are on
the wrong track and strongly advocated the independence of medical
journals and their editors to serve as a counterbalance to combat the
commercial interests in the publication arena.
Kassirer in his editorial (7) in the New England Journal of Medicine
declared “In my opinion, any requirement that a medical journal represent
the views of the journal's owner or a medical society's constituency is
inconsistent with the principle of editorial independence”. But a clash of
ideas and principles left many Editors bruised. In the past, three journal
editors had to leave (8); two American and one European. A recent survey
(9) of medical editors found that pressure over editorial content by the
journal leadership is not uncommon and according to the author of the
survey “Stronger safeguards are needed to give editors protection against
pressure over editorial content, including written guarantees of editorial
freedom and governance structures that support those guarantees”.
So where does the “Transplantation and Dialysis” decision to reject
the editorial on epoetin based on the marketing department’s veto leave
us? Bjork (10) in “The American psychologist” points out the lessons from
history. “When political or other pressures interfere with the autonomy of
science, the societal and scientific consequences are grim.
According to “Transplantation and Dialysis” web site (11) it is the
oldest renal care journal in the world and has the largest-circulation
(24,000-plus) and caters to a multidisciplinary audience of practitioners
(physicians, surgeons, nurses, nutritionists, technicians, technologists,
social workers, administrators, transplant/procurement coordinators. Hence
refusing to publish or open a debate on an issue such as epoetin will
ultimately affect patients getting the best possible care. We do not know
how this saga will unfold; but to establish editorial independence and to
restore the scientific credibility the journal should publish this
editorial but can invite another expert to present an alternate view on
the topic.
1 Dyer O, Journal rejects article after objections from marketing
department. BMJ 2004;328:244.
2 http://www.mtppi.org/reports.php?repid=062 accessed on 30th January
2004.
3 http://www.wame.org/wamestmt.htm#independence accessed on 30th
January 2004.
4 Smith ER. Editorial independence. Can J Cardiol. 2002;18(6):679-82.
5 Smith R. Another editor bites the dust. BMJ 1999;319:272-272
6 Welch HG. Should medical journals be a private business or a public
service? Eff Clin Pract. 2000;3(4):185-7.
7 Kassirer JP. Editorial independence. N Engl J Med1999;340(21):1671-
2.
8 Anonymous. [1999, the year of fired editors-in-chief] Ned Tijdschr
Geneeskd. 2000 ;144(1):3-4. Dutch.
9 Davis RM, Mullner M. Editorial independence at medical journals
owned by professional associations: a survey of editors. Sci Eng Ethics.
2002 ;8(4):513-28.
10 Bjork RA. Independence of scientific publishing. Reaffirming the
principle. Am Psychol. 2000 Sep;55(9):981-4.
11 http://www.eneph.com/about.htm accessed on 30th January 2004
Dr.P.Badrinath PhD, MFPHMI
SPR in Public Health & Recognised Clinical Teacher,
Southend PCT & University of Cambridge,
Harcourt Avenue, Southend on Sea, SS2 6HE.
Competing interests:
The author is a strong believer and advocate of editorial independence
Competing interests: No competing interests
Reasons for manuscript rejection
In a recent issue of BMJ Dr. Dryer reported about the decision of a
journal not to publish an editorial due to pressure from the marketing
department of the journal (BMJ 328: 244). It should be noted that this is
probably just the top of the iceberg. The influence of pharmaceutical
companies and the slavish attitude of editors against marketing strategies
represent a considerable publication bias, which might be of an
extraordinary importance in the field of biomedical research. However, in
my opinion and in my experience there are also some other factors that
affect the review process of submitted manuscripts and should not.
Belonging to these is the publication history of the authors and their
affiliation. At the beginning of a scientific career it is quite difficult
to convince editorial boards of the importance of a manuscript. Even more
if the author comes from a scientifically developing country in Eastern
Europe. I agree that our financial limitations (for example in Slovakia)
make it complicated to make an up-to-date science interesting for the
whole worldwide community, especially in molecular medicine. On the other
hand, lacking funds support the tricky inventiveness that has always been
associated with essential discoveries. Keeping the author’s names and
countries confidential during the review process would reduce at least a
part of the publication bias.
Competing interests:
None declared
Competing interests: No competing interests