INSTITUTE FOn SCIENTl FICl NF0F4MAT10N8 3501 MARKET ST PHILADELPHIA PA 19104

Stephen P. Lock on “”

Number 3 January 15, 1990

I don’t remember exactly how long I have Lock: Editor and Scholar known Stephen P. Lock. Our first encounter was probably at a meeting of the Council of Biology Editors (CBE) some 20 years Stephen P. Lock was born in 1929 and re- ago. It is somewhat unsettling to realize that ceived his education at Queen’s College, so much time has gone by. Equally disquiet- Cambridge University, UK, and the Medical ing is the notion that Steve will soon retire College of St. Bartholomew’s Hospital. as editor of the venerable British Medical Trained as a hematologist, he served on the Journal (BMJ). But in the near future Steve staffs of various London teaching hospitals, will indeed step down, having helped train including St. Bartholomew’s and the Hos- his successor, due to be appointed in the fall pital for Sick Children, before being ap- of 1990. pointed assistant editor of BMJ in 1964. It seems odd to refer to Lock as an elder After serving as senior assistant editor and statesman of biomedical editing-however deputy editor, Lock became editor in 1975. accurate that description might be. The word I am amused that Steve opened his talk that comes to mind when I think of Steve with the traditional, mythical reminder about is youth. This youthfidness is reflected in the estimates of the number of extant jour- his writing and in his approach to problems. nals. I‘ve commented on this many times be- Last spring Lock addressed the CBE’S 33d fore. If there are 15,000 “serious” publica- annual meeting in Rochester, Mimesota. tions, as he puts it, he is quick to correct His talk on “Joumrdology,” published orig- the frdse impression this number creates. inally in the newsletter CBE Views, 1 is re- The so-called information’ ‘explosion” is printed here. In it, he demonstrates why he an illusion. There has actually been a con- has gained the respect of his peers. stant growth of 5 to 7 percent per year since While Lock has published scores of edi- 1665. Although there is good reason to be- torials and articles, his most visible work lieve that this growth pattern no longer is the 1985 book A Diflcult Bakmce,2 holds, it is a useful rule of thumb to estimate which I discussed in Current Contents@ that the number of journals is consistently (CP] several years ago as part of an essay related to the number of research scientists, on refereeing.3 At that time 1S1Press@ held or even to the number of physicians. Lock the publishing rights to this now-classic mentions unpublished work by Annals ofln- commentary on . The book orig- temal Medicine editor Edward J. Huth, an- inally had a limited distribution under the other elder statesman of medical editing who sponsorship of the Rock Carlirtg Fellowship is also approaching retirement. Huth deter- and the Nuffield Provincial Hospitals Trust. mined that for the last 30 years or so there A D@cult Balance is still available through have been about 17 journals for every 1,000 Waverly Press, Baltimore, Maryland. registered physicians.

19 But, in spite of all this, it is now clearly established that there is a much smaller nttm- ,,...,. ber of significant journals in the world. And /- as the literature grows, the role of these sig- nificant journals becomes even more cen- tral. Less than a few hundred journals ac- count for the vast majority of significant re- search. Nevertheless, each edition of CC covers approximately 1,000 journals. The combined editions, covering about 5,000 scientific titles in all, give a fairly compre- hensive view of worldwide science. What is more important is that this enor- mous output demands even higher standards in regard to publication, peer review, and professional performance by editors. Fur- ther complexity is added by the huge public interest in the results of research, intensified by a large corps of science journalists eager to report the latest discoveries. I find particularly interesting Steve’s pre- diction that in the near future editors will be held accountable for their conduct. He Stephen P. Lock forecasts that anonymity in journal opera- tions will disappear and that all authors will receive justice in the form of’ ‘much fuller is matched by the dearth of curricula on pub- explanations and instructions to au- lishing. I’ve urged my colleagues at sever- thors.. and peer reviewers’ reports. ” I al universities to consider the need and op- He also subscribes to the suggestion of portunities for establishing such a program. yearly self-audits by editors first suggested Steve Lock, of course, would make an ex- in THE SCIENTISP by Andrew Herx- cellent professor of joumalology. Fortunate- heimer, the editor of the Drug and thera- ly, his plans tier leaving BIUI include teach- peutic Bulletin.4 ing on this topic. He will be working part- Steve’s talk also refers to meta-analysis, time on the newly established Faculty of the a concept which not all CC readers will be History of Modem Clinical Science at the familiar with. It is a topic I intend to cover Wellcome Institute for the History of Med- in greater detail in the future because it is icine, London,s to be established under the so closely related to the notion of the library directorship of Sir Christopher Booth, cur- as a laboratory. The literature becomes a rently Harveian Librarian of the Royal Col- powerful tool when previously unrelated lege of Physicians of London. Lock hopes studies are pulled together by an informed ;Ocontinue teaching about joumalology— reviewer with adequate expertise in proba- wrticularly about fraud and peer review—as bility statistics. well as holding courses in medical writing, ‘‘Joumalology” is an appropriate neolo- >f which he has now conducted over 100 gism for what has become a widespread hu- hroughout the world in the past 20 years. man activity. Where it fits on the complex map of information science is of some aca- *$*** demic interest but more important is the fact that to my knowledge there exists no course My thinks to Christopher King for his help in joumrdology anywhere. This inadequacy n the preparation of this essay. ~,,,,~,

20 REFERENCES

1. Leek S P. ‘‘Joumalology”: are the quotes needed? ClJ,? Views 12:57-9, 1989. 2. ------=---- A dificu!t balance: editorial peer review in medicine. London: Nuffield Provincial Hospitals Trust, 1985. 172 p, 3. Gat-tleld E. Refereeing and peer review. Part 2, The research on refereeing and alternatives to the present system. Essays of an information scientist: the awards of science and other essays. Philadelphia: 1S1Press, 1988. Vol. 9. p. 239-48. 4. Herxheimer A. Make scientific journals more responsive-and responsible. i’HE SCZEN77ST 3(6):9; 11, 20 March 1989. (Reprinted in: Current Confenfs (31):3-6, 31 July 1989.) 5. Garfield E. The enduring legacy of Sir Hettry Welleome-pharmaceutical entrepreneur, philanthropist, and collector extraordinaire. Current Contenfs (3):3-8, 18 January 1988.

Reprinted with pcmdssmn from CBE Views 12(4):57-9, 1989.

“JolmmMogy”: Are the Quotes Needed?

Stephen P. Lock

British Medical Journal, Tavistock Square, London WDIH 9JR,

In ttrk tafk, Stepherr P. bck considers the continuing evolution in the population and forms of scientific joumats and in editorial prsctices. Asdisciplines split and gmw increasingly specialized, new journals arise to fdl the needs of the various subdkciplines. The implications of W, for specialist joumsfs and general joumsts alike, are exam- ined. Alsodiscussed is the prospect that, in the future, editors will be held increasingly responsible and accountable for articlecontent,

Some current estimates put the totaf number of rule of thumb is that a scientistwho publishesone scientificjournals at lCWOO, some 20-25,000 of article every year can fake in the contentsof more them biomedical-of which 15,000 or more are than one other paper a month, but less than one “serious” publications (that is, giving data and article a day. This leads to a few hundred indL referwtces, using peer review, and so on). And vidrsalskeepingeachother in business.Now a few yet tfis so-erdled “explosion” is an illusion; the hundred is the same size as the membership of rate of expansion since the beginning of serious the early scientific societies, and of today’s in- publication in 1665 has been a constant 5 to 7% visible colleges.z a year. ] There are, of course, many more scien- Disciplines tend to split every 10 years or so, tists arounddtan drere ever have been, ad there’s and the new strbdiseipfinesdo not nec-eswrifymr- a cogentsuggestionthat dieproportionof the num- responcfwith the organizational and professional ber ofjournals to the number of scientists is con- structures. These are much more rigid and slower stant. This was home out by some unpublished to change than the way in which the pattern of research by Dr. Edward J. Htrth, the editor of the new knowledgechanges. These struetttres wilJin- Annals of Internal Medicine, who took two un- clude journals, and thus there is constantly a real doubtedlyaccurate figures over the past 30 years: need for newjoumrds which wifl reflect the needs the number of journals received by the Natiortaf of the new subdiscipline. In this way a specialist Library of Me&cine in Bethesda. Maryland, and journal will be formed to take some of the work the number of registered physicians in the United which has become too complex for the genersd States. He found that there was a constant ratio joumrd-and the general journal may truly have of 17journals per 1000 physicians and that this been under tremendouspressure for spaceand un- hadn’t changed over the past 30 years. able to pubfisheven all the first-rate materitd strb- If this pattern is tree, what is the reason? The rnittcd to it. But in time even the specialist jour- answer can be found, I think, in the way that sci- nal is seen as too rigid or unable to cope with all entificdiseiplirresevolve. DerekJ. de SoUaPrice’s the articles, and so the need for another, super-

21 specialist journaf arises. A typical pattern might editor has introduced peer review if this did not be: Philosophical Transactions of the Royal So- exist before-or made it more stringent with cieq, Bn”tish Medical Journal (BMJ), , Jour- guidelines and soon if peer review did exist. He nal of Gastrointestinal Errdoscopy, Pancreas. has started paying attention to the important as- [n this way you get a hierarchy of journals. Nev- pects of statistics-say, the design or the analysis ertheless, these are not static and their content of a . And tinafly he has started sub- changes with the needs of the readership and the editing the manuscript to be published-not just philosophies of the times. Take my own journal, bousestyling but cutting and reshaping the ac- for example, the BMJ. At one time this covered count, so that it can he read with ease by both all fields, principally with original articles and a native readers of that language and others whose few editorials, Then increasing specialization language is different. And the result has of course meant that a number of separate disciplines set been shorter and more lucid articles. up their own journals. Now the load of specialist Afl this can come about because obviously jour- articles with very little general appeal could be nals are big business and the revenue from sub- diverted away from the general journal. But then scriptions and advertisements can pay for this kind the readers of the generaI journal wanted to be of professionalization. But it has afso come about kept in touch with important developments in all for a philosophical reason. Let’s go back to the the specialties and to have them explained and put invisible college, which forms a new discipline, into the context of accepted practice. So general which then needs its own joumaf, At this stage journals started to publish many more review ar- the readership of the journaf is the same as the ticles, editorials, and other forms of comment in authorship—small groups of workers are writing an attempt to keep this fragmented corpus of gen- for each other. Later on, when the discipline has eral medicine together. Today, for example, the expanded, the situation is different: readers are BMJ may have 8 pages of leading articles and a now in the majority; they don’ t necessarily un- regular review; 6 pages of a new style of News derstand every article any more, and so they need presentation, with informed expert comment on articles to be clear, relevant, and accurate. Hence developments; a Medical Practice section of 16 the editor now has to change his emphasis to the pages including an ABC of child abuse and,an ar- needs of the reader, and this means the new struc- ticle on new drugs; a large correspondence sec- ture of the journal and the new process of edhing tion almost entirely devoted to comment on pre- which I‘ve described. viously published articles; and so on, Although he’s usually a pan-time worker, the This process of generalization is now also hap- editor also becomes professionalized, and soon pening to speciaf journals in the first tier: these he forms clubs and groups, which then discuss are now becoming general jourrrafs of their dis- problems and produce guidelines and codes. Many cipline. For example, pediatrics is now not only such groups have been formed in the past few a large specialty but also a very wide one. The years, and they have discussed matters such as pediatric geneticist needs to keep up with pxfiatric ethics, statistics, authorship, and what to do about orthopedics and pediatric endocrinology-other- publications based on fraudulent work, to such wise he is lost, and so may be his patients. For an extent that they now talk about ‘‘journalology” this reason we get the first tier pediatric journal in on]y the faintest of ironic terms. displacing some of the articles submitted to it to Once you become an organization you develop the second tier and filling the space with editori- responsibilities. From within there are factions als, review articles, personal practice, and so on. that want a bigger say in the outside world, If you look at, say, the Archives of Disease in whether it’s responsibility or money, or both, Chifdhoad 30 years ago, you will see nothing but From without there are calls from national and hard science—no editorials, personal practice ar- international bodies for advice on all sorts of top- ticles, reviews, opinion pieces, correspondence, ics, as well as demands that the organization and so on. Today the make-up of the journal is should do something. The whole process has be- quite different. Nevertheless, if you compare the come less fun, and more of a job, but that is the BMJ or the Archives 30 or 40 years apart, what way it should be. It’s inevitable, for, much as re- is also obvious is the consistency of the number search started with the amateur aristocrat, the of original papers published. This apparent par- Honorable Robert Boyle, paying for it hmself, adox has come abut by the professionalization it has ended up as a billion dollar enterprise em- of the editor and his activities, with, of course, ploying thousands of professionals and supervised the approval of the author and the readers. The by NIH committees and so on.

-. Accountability for Editors meant (and some of them still haven’t). All too often the design of the trial, the analysis, and the What afl this may mean for edhors, I believe, interpretation were all inadequate. It needed sim- is that there will be a right way of doing tMngs ilar demonstrations for another 10 to 15 years be- and a wrong way, and eventrrdy I believe that fore anybody did much about it.7$ And then ed- society may even come to condemn tbe wrong itors began to use statistical referees, and imme- way in the terms that everybody understanda: legal diately both groups developed new preoccupa- and financial, At the extreme, for example, let’s tions, What papers deserved particular statistical suppose that there is a scare story published in attention? How could what the statisticians were a prestigious journal, merely as a debating point. talking about be translated for both editors and This arouses a lot of public interest; there is iden- authors? And where did we get aff those necessary tifiable gross distress of individuals or families statisticians from? And what on earth do e&tors or a catastrophic loss of earnings to the firm that do when statisticians don ‘t agree? is concerned in making a product, But the editor of that journal has not submitted that particular article to external peer review, and/or has not Is Mets-Analysis Enough? checked the circumstances, and/or he or she has not accompanied it with an editorial to put the is- The next stage in this evolution was to put mat- sue into perspective or Iabelled it with a‘’ for de- ters on a more formal basis with indicative rules bate” byline to indicate that the whole concept for which papers needed statistical refereeing and is speculative. (I emphasize that I’m thinking of checfdists for the referees.9 And then, of course, hyfmthetical British examples rather than anything there came another stage, when things got yet from this side of the Atlantic.) I believe that some- more complicated. We began to realize that with time in the future this txtitor might be held respon- a report of a single cfiicaf trial a so-cafled norrsig- sible in law for darnages, on the grounds that he nificant result was not an end in itselfi we need- was in dereliction of his duty, and that he had be- ed power estimation and confidence intervals. haved irres+xmsibly by not taking a number of im- This led to a consideration of what you do about portant precautions. trials that are inevitably small scafe, or produce We are in the middle of the evolution of rdfthis, negative results, or are not published, and, hey so let me illustrate what I mean by looking at sta- presto, you remember the existence of meta-anrd- tistics in medicine, rather than the more obvious ysis. Is simple meta-analysis enough? Answer: topic of peer review, the subject of a splendid con- “no,” because not atl trials are equally vatid, And ference in Chicago [First International Congress so you develop a chcddist for which trirds should on Peer Review in Biomedical publication, 10-12 go into the meta-analysis, and how you get at May 19891. In other disciplines statistics go back unpublished work, and work that has produced a long way. In agricrdture, for example, they were negative results, and so on. 10 being used routinely in the 1920s. The first men- I’ve chosen statistics as a convenient example, tion of probability, I think, was in the Canadian I suppose, because I am still in awe of it and its Medical Association Journal, in 19343 and then practitioners. But it is a convenient example, and in the BM.1 in 1936;4 A, Bradford Hill published we could apply this pattern of evolution to several a series of articles in the Lamer in 1937, still other aspects of the evolving jorrrnalology: to def- updated every couple of years as a book,s and initions of authorship, , peer then the great Ronafd Fisher piled in the follow- review, and duplicate publication, to name onty ing year. a few. I would like to end with a few personal But statistics didn’t really come into their own prejudices, I believe, for example, that the most until after the second world war, any more than important development in the last 10 years has peer review did. Then we had massive controlkd been the introduction of the structured abstract, trials of expensive drugs in short supply, such as which enables the editor, the referee, the reader cortisone and the antibiotics, and everybody felt (and, increasingly, the author) to see whether a that in using statistics they would really come in- paper is any good. 11And increasingly it will en- to the scientific era. Nevertheless, 10 years later able a marriage between conventiotsaJ publication the first analysis showed that, however impressive on the one hand and the electronic data base on they were on the surface,s the actual statistical the other, particularly once this type of abstract details were awful, for, let’s face it, most of the has been applied to review articles and to case physicians had no idea what P values, SD, or SE reports and the like, as 1 believe it can be.

23 Anonymity Will Disappear by editors, Haff the contributions coming to my office don’t conform with simple and necessary Next, I believe that increasingly editors will requirements; for example, there are not enough have to remember their pofiticd role, with a small copies, or the manuscripts aren’t in double spac- “p,”’ and that justice and their explanations will ing. These problems take up a lot of time, which have to be seen to be fair. Within 30 years ano- is unfair to those who keep to the rwles. in future nymity, I’m sure, will disappear from all parts I believe we should shred these manuscripts and of the joumaf and its operations, and there will tell the authors to provide us with what we want. be much fuller explanations and instructions to F@y, 40 years later most predictions on jour- authors and particularly including peer reviewers’ nalology turnout to be wrong. We stilf don’t have, repotts. Another propoaaf, a yearly self-audit ptb for instance, the two types of journals, newspaper lished by editors, on the lines recentfy suggested and recorder, that were being postttfated in the by Andrew Herxheirner12 will help a lot. The 1950s by J.D. Bernal and Sir Theodore F, FOX.13 converse, I believe, must be increased harshness But predictions are fun, so why not indulge?

REFERENCES

1. Price D J D. .$cierrcesince Babylon, New Haven, CT: Yale University Press, 1961. 149 p. 2. ------The development and stmcture of the blomedhl literature. (Warren K S, cd.) Coping with the biomedical literature, New York: Praeger, 1981. p. 3-16. 3. MafrslandD. Cbsrwe and the blood count. Can. Med. Awn. J. 30:656-8, 1934. 4, ------Problems of chance in clinical trists, Brif. Med. J. 2:221-4, 1936. 5. Hifl A B. Principles of medical starisfics. New York: Oxford Urriversi~ Press, 1971.390 p, 6. Schor S & Karteo L Ststisticat evacuation of medicat joumat manuscripts. J. Arrw. Med. Assn. 195:1123-8, 1966. 7. 0-erSbnordass R, Cherette J, McPeek B & Mostetfer F. Repurting on methods in ctinicat trials. N, Engl. J, Med. 302:1332-6, 1982. 8. Gore S M, Jones I G & Rylter E C. Misuse of statistics methods: critical assessment of articles in BMJ from January to Msrcb 1976. Brit. Med. J. t :85-7, 1977. 9. Bsdfar J C & M@eI1er F, eds. 71e medical uses of slari$tics. Boston, MA: New Engtand Journal of Medicine Books, 1986.425 p. 10. L’Abbe K L, L3etskyA S & O’Rourke K. Meta arratysis in clinical research. Am. Inrem. Med. 107:224-33, 1987. II. Ad Hoc Working Group for Crkicaf Appraimd of the Medirat Literature. A proposal for more informative abstracts of clinical articles. Ann. /n/em. Med. 106:598-604, 1987. 12, Herxbeinser A. Make scientific joumafs more responsive-and responsible. THE SCIENTIST 3(6):9; 11, 20 March 1989. 13. Fox T F. Crisis in communication: the )irnctiorr.r and fiuure of medical jounra.k, London: Atfdone Press, 1965.59 p.

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