Retiring Editor Says Its Time For Journals To Be Retired

Harlan Krumholz is not going gentle into the good night. Near the end of his tenure as the founding editor of Circulation:Cardiovascular Quality and Outcomes Krumholz has delivered a fiery editorial [PDF] arguing that the current model of printed peer-reviewed journals may not, and probably should not, survive in “a new world that is flat, digital, and transparent.” (To be clear: Krumholz is retiring only from this one editorial position; he will be kept busy by his many other responsibilities at Yale, PCORI, YODA, and elsewhere.)

Medical journals– “traditional,” “hierarchical,” and “in the hands of experts”–  will likely be swept away by “the impending revolution.” In his brief article Krumholz identifies 9 reasons why journals today are “outdated”:

Too Slow– even with recent improvements, and despite the occasional exceptions of expedited publication, “most articles take a year or more to be publicly available.” Krumholz points out that “if new knowledge in medicine is not time sensitive, perhaps it is not important enough to be published.” Perhaps it is time for medicine to follow other fields with “public posting of new publications and a public peer review process.”

Too Expensive– Page charges for authors, rising expenses for publishers, prohibitive costs for libraries and subscribers: “In the future, medical knowledge will likely be considered a social good and cost barriers will not play their current role.”

Too Limited– One size doesn’t fit all. “In the future, investigators will have the capacity to fit the structure of the presentation of new data to the needs of the project; constraints on format, beyond those that improve readability, will be unnecessary.” (But I would also remind everyone that brevity is also valuable: would Watson and Crick’s famous article have been improved by unlimited length?)

Too Unreliable– “Peer review and the journal decision-making process occur without much external scrutiny and transparency.” There is “little accountability for performance” or bias. Articles published in prestigious journals “may derive as much from the venue as from the quality of the science.” Krumholz calls for an “open process” that “can be subject to iterative improvement and public comment.”

Too Focused on the Wrong Metrics– “Journals vie for prestige, which brings them attention, authors, and revenue.” This prestige is increasingly based on impact factor, which “can distort decisions about what to publish and encourage a culture of pandering to the citation rather than seeking to advance scientific knowledge and improve clinical practice. The flaws of the impact factor are well characterized, but its pre-eminence is unquestioned.”

Too Powerful– Editors of top journals wield far too much power, writes Krumholz. “Publication… [in a top journal] can transform a career or influence millions of dollars or more in sales of a product.”

Too Parochial– “Journals tend to lack diversity in their editorial groups. This applies to sex and race/ethnicity, as well as national origin.”

Too Static– “Many scientific projects might be better presented as an interactive website…”

Too Dependent on a Flawed Business Model– Journals have been “cash cows” for organizations and corporations.” “The model from the author’s perspective has been likened to a restaurant in which the customers cook the meal and then pay the bill.”


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