Between 1985 and 1994, I became familiar with the editorial processes of
Indian Pediatrics in various capacities as a Member, Assistant
Editor and Publication Secretary of the Journal Committee. Then in late
1994, an unexpected telephonic call informed me of the Executive
Committee’s decision to immediately elevate me to the helm of affairs. I
assumed charge of the editorial process with mixed feelings of
disbelief, deep gratitude and anxiety at the onerous responsibility
entrusted upon me at a relatively young age. The challenge for me was to
not only continue the journal’s rapid growth trajectory with the
available meager resources but also to make it more influential for
clinical practice and public health policy.
The newly constituted think-tank was in substantial
agreement with the following envisaged role of journals and editors,
particularly in our setting: "the prime task of an editor is to
produce a journal that people will want to read. If the end product is
mere units of research, these could just as well be placed directly into
databases. Journals must explain, stimulate, provide a forum for
discussion, and at times, make readers angry!" [1]. Being a
researcher at the core, I instinctively sought robust evidence to guide
our future efforts. After substantial introspection, discussion with
close friends and some literature search, we concluded that our art of
editing has had minimal, if any, formal research input, particularly
from the target audience. It therefore seemed logical to continue
editing with skills imbibed as an "apprentice" while accumulating
evidence on a priority basis to guide further action.
Translating Evidence into Action
The National Conference of Indian Academy of
Pediatrics provided a golden opportunity for conducting qualitative
research through in-depth interviews and focused group discussions. This
was supplemented with a quantitative "Opinion poll for the desirable
content of Indian Pediatrics" in the January 1995 issue [2].
A particularly disconcerting observation was the
candid admission by some practitioners that they did not even open the
issue because the "contents were not useful, attractive, interesting,
stimulating or understandable". We then realized that a delicate balance
will have to be struck between the aspirations of academicians and
active researchers on one hand and the practitioners, particularly in
remote areas, on the other hand. The following specific suggestions
helped us to fine tune the internal processes and shape the future
content of Indian Pediatrics: (i) The journal should have
"something of interest for everybody in the target audience"; (ii)
"Original Articles" should be subjected to more rigorous epidemiological
cum statistical review and their Abstracts should be presented in a
structured format; (iii) Content of interest to practitioners
must be increased by including features relevant to everyday practice,
selected summaries of latest relevant research conducted abroad, and
dialogues with authorities on important topics; and (iv)
Publication of rare well defined syndromes must be drastically reduced
or stopped [2].
The journal committee endorsed the decision to
immediately act according to the gathered evidence. Some of the proposed
modifications were rapidly acted upon while others had a relatively long
gestation period as the contents till August 1995 had already been
finalized.
Our actions were in consonance with the prevalent
global trend of evidence based editing. Medical journals were
increasingly being transformed on the basis of collected scientific
information on various aspects of the editorial process including
content design, style and format, authorship, peer review, publication
ethics, editing, and relationship with the industry. Realizing the
importance of this issue, the World Association of Medical Editors was
launched in Bellagio, Italy on 6 March, 1995 to foster international
cooperation among editors of peer-reviewed medical journals. We kept
ourselves abreast of these international developments and repeatedly
accumulated relevant evidence applicable to our scenario to continually
shape the journal. The latter was achieved through perpetual interaction
with readers by the members of the journal committee and the national
advisory board.
Medical journals at that time were differentiated
into two main categories, namely, "recorder journals" and "newspaper
journals" [3,4]. Recorder journals came close to the desired function of
a journal from the point of view of the author; they were not really
meant to be read, but only to deposit science for future reference which
is undoubtedly important since science does not exist until published
[4]. General journals -newspaper journals - by contrast, had other aims:
they were active shapers of knowledge and of opinions [4]. They were
expected to "inform, interpret, criticize, and stimulate" [3] and also
retain some recorder function, at least for important facts [4].
On the basis of collected evidence and global trends,
Indian Pediatrics gradually shifted its focus from a predominantly
recorder journal towards a newspaper journal [5]. To make the journal
more educative, interactive, entertaining, and "reader friendly", a
variety of sections were introduced including Immunization Dialogue,
Readers’ Forum, Viewpoint, News in Brief, Clippings, Selected Summaries,
Personal Practice, Recommendations, Reports, Clinicopathological
Conferences and Images in Clinical Practice. The reporting format was
also molded according to the prevalent international recommendations
including recording of key messages for rapid browsing, specific
contribution by individual authors like film credits, competing
interests, and sources of funding.
We also yielded to the consumer demand of enhancing
production quality within our available resources; the journal cover was
changed to laminated art card instead of art paper and better quality
print paper was utilized inside.
All these modifications proved vital for making
Indian Pediatrics more vibrant and improving it’s "readability and
utility index".
Supporting Editorial Processes
Simultaneous vigilance over crucial editorial
components made editing more efficient and transparent. This was
achieved through regular input from journal committee meetings.
Important aspects included anonymous reviews, transparency in decision
making irrespective of the reputation or clout of the authors,
communicating the reasons for rejection to authors, taking decisions in
a strict time bound manner with constant monitoring of pending
manuscripts, and hunting for new reviewers who were willing to provide
requisite quality input within the stipulated time limit. The quality
bar for acceptance of manuscripts was raised. I had no hesitation in
rejecting a research manuscript co-authored by me on the basis of peer
review. The acceptance rate of the manuscripts gradually reduced from
around 55-60% to 16-20%. This undoubtedly ruffled several feathers but
ultimately enhanced the quality of publications substantially, which was
appreciated by the mainstream audience. These changes also motivated
some reputed Indian researchers to submit their work to Indian
Pediatrics in preference to international journals.
We proactively solicited editorial and research
contributions on topical issues and peer review from international
authorities, particularly non resident Indians; sometimes personal
contacts proved very useful for this purpose. This provided some
international lustre to the journal.
Publication ethics were monitored more stringently.
This was necessitated by instances of duplicate publication, gift
authorship and questionable data integrity that were brought to our
notice by vigilant readers and referees [6]. The Journal Committee did
not push these issues under the carpet but took appropriate action on
the basis of the International Committee on Publication Ethics
guidelines.
A close liaison was maintained with the Cambridge
press and the postal authorities to ensure strict timeliness of posting.
The contents were kept finalized for the next three months to preempt
any unforeseen circumstances. With these measures, all the 85 issues
during my tenure were ready and posted on time.
Launching the Electronic Version
Traditional paper periodicals were facing
annihilation or being relegated to a poor second place. Moving with the
times, we also introduced a modest "electronic version" of Indian
Pediatrics with an envisaged complementary role, in April 1998.
Subsequently, in late 1999, Indian Pediatrics too launched the
full text dynamic web site. This development represented a pioneering
effort amongst Asian medical journals. Despite potential loss of
international subscription revenue, we deliberately kept the access to
our electronic version free of cost. These measures enhanced the global
visibility, stature and scientific quality of Indian Pediatrics.
The average access rate of 4500 per week in December 1999 bears ample
testimony to the overwhelming importance of the launched "electronic
version". Further, with this development, international indexing of
published articles was achieved within one week.
Fiscal Health
There was an urgent need to transform the fiscal
balance from negative to positive to ensure effective operationalization
of the envisaged modifications. The IAP constitutional mandate of
sending the monthly issue to all members free of charge was a steadily
growing drain on the journal’s fiscal health because the central
contribution was barely sufficient to meet one-third of the production
costs. We adopted a dual strategy to improve fiscal health. Expenses
were curtailed by resorting to hard negotiations with the publication
house, saving on editing and proof reading expenses by in-house efforts,
procuring paper directly from the market, multi-tasking by the skeletal
staff and so forth. Finances were also raised by tapping all possible
"ethical" resources including proactive colored advertisement support
from industry other than Infant Milk Substitute Manufacturers, royalty
from Indian Pediatrics produced books, tapping international
agencies, charging for excessive reprints or pages, and putting unused
money in short term fixed deposits. These measures proved successful in
substantially improving the fiscal health so that we could initiate the
desired changes.
Boosting the Infrastructure
Indian Pediatrics was operating from a small (100
square feet) rented room with a skeleton staff of two secretaries and
two class IV workers. Contrast this with the Lancet Editor’s
statement at that time that "he finds 12 full-time editors and a total
staff of 50 inadequate" [1]. The augmented financial resources helped us
to boost the infrastructure and staff support. Notable milestones
included augmentation of secretarial assistance, procurement of a small
office space in a commercial complex along with rented space, shifting
from typewriters to computers, buying printers and photocopier, and
getting internet access. The staff gladly provided dedicated input as
they received salary commensurate with the corresponding government
scales and promotion. All these factors contributed in substantial
measure to the journal production and its quality.
Concluding Comments
I consider myself to be blessed at being provided
this opportunity of contributing to the growth of Indian Pediatrics.
It was possible to achieve something only because of God’s grace, the
strong foundation laid by my predecessors, the endorsement of the target
audience, the contributors’ input, continued selfless devotion of the
Journal Committee members, National Advisory Board and peer reviewers,
support of IAP Executive Board and Office Bearers, Cambridge Press and
last but not the least, the dedicated journal staff.
References