The impact and reach of the MJA in a year of living dangerously

One hundred years ago — after the Spanish influenza pandemic and just a few years after the founding of the Medical Journal of Australia — the roaring twenties saw a new period of prosperity, technological advances, and social change that only ended with the Wall Street crash of 1929. In 2020, we are experiencing yet another period of enormous disruption and change driven by a new pandemic, coronavirus disease 2019 (COVID-19).1 While the health impact of COVID-19 in Australia has been limited by prompt public health interventions, its social and economic costs have been enormous, the death rate continues to climb overseas, and the long term consequences remain unclear. With the bushfires and now COVID-19, Australia has certainly been living through some interesting times in 2020.

The international health and medical community has stepped up magnificently during this crisis, providing excellent frontline care at some risk to themselves, as well as driving the delivery of desperately needed new knowledge to combat COVID-19. However, we are now drowning in data: the number of published articles related to the pandemic is astonishing (currently more than 23 000) and growing daily.2 Many of these papers appear on pre-print servers, where authors can place un-refereed manuscripts in the public domain before they have been accepted by a peer-reviewed journal, and the popularity of this approach has been facilitated by Twitter, even though some of these pre-prints never (or should never) progress to journal publication because of serious flaws.3 All journals, including the MJA, have been affected by this acceleration of data sharing.

We have been incredibly busy at the MJA and have rapidly adapted to the new environment. Local data and guidelines are potentially vital for frontline health care workers and policy makers. In March, we introduced rapid review of COVID-19-related manuscripts and established a new pre-print facility on the MJA website for articles that, after internal (and sometimes rapid external) review, are deemed likely to progress to publication in the Journal.4

We recognise that rapid pre-print publication is not without risk, and this is why we undertake more due diligence than most pre-print servers. The Lancet and The New England Journal of Medicine were recently required to retract two peer-reviewed COVID-19 articles because a health care analytics company declined to make the underlying data available for independent audit.5 This  has emphasised how relevant rigorous peer and editorial review are for eliminating major errors and, albeit more difficult, for detecting fraud.

All our COVID-19 and SARS-CoV-2 preprints and published articles are freely available for all to read on mja.com.au, as are all research articles published in the MJA. A number of our COVID-19 papers — such as the consensus statement on airway management6 and modelling of intensive care bed capacity7,8 — have been highly influential, receiving widespread attention in the traditional and social media, supporting the public health relevance of a high quality national journal. Our new review processes have also reduced average decision times across all manuscripts, despite the dramatic increase in submission numbers.

Medical and scientific journals play key roles in advancing and communicating knowledge, as shown by the current crisis. But the traditional journal model was facing mounting disruptions even before the COVID-19 pandemic. As more and more studies are published every year in each specialty, clinicians are swamped with new information and do not have the time to critically evaluate every paper in their field. More disturbingly, it has been pointed out that many studies providing definitive results cannot be replicated.9 Systematic reviews can help, but they can be rendered out of date by new findings and cannot provide guidance if evidence relevant to a problem is lacking. Predatory journals — publications that provide, at best, only inadequate peer review and poor editorial checks and balances — continue to conduct business around the world,10 damaging the reputation of all and imperilling the standing of those who carelessly publish or associate themselves with them.11,12

For these reasons, and despite arguments to the contrary, journals that meticulously curate content and commission expert editorials, review articles and perspectives that place new findings in context continue to be influential and highly regarded. According to all major metrics, the MJA is one of these premier journals.

Of the many measures of journal standing, global prestige (ranking), reach (readership and article downloads), and impact (on practice and policy) are arguably the ones that matter most. In terms of prestige, the MJA is pleased to report that Clarivate has just announced that our Journal Impact Factor has again increased, climbing from 5.44 for 2018 to 6.11 for 2019, placing our Journal among the top 15 general medical journals globally (Box - available in PDF). The mja.com.au readership has markedly increased in 2020. During the first five months there were 2.5 million page views, with visitors from almost every country, compared with 1.7 million for the equivalent period in 2019: an increase of nearly 50%. In terms of impact, the number of submissions to the Journal continue to rise, as does media interest in our articles. Almost twice as many manuscripts were submitted during the first half of 2020 as during the same period last year, about one-third of which were COVID-19-related. As space in the pages of the MJA remains limited, we focus on excellence and must regrettably decline many worthy articles.

The MJA is a source of trusted and valuable information in a world awash with wild beliefs and unscientific and untrustworthy advice, often irresponsibly promoted via social media. We will continue to apply rigorous editorial appraisal and double blind peer review, and to work closely with the authors of all accepted articles to ensure that information is presented clearly and accurately. The MJA thanks our dedicated peer reviewers and readers, and congratulates all our authors. We look forward to continuing to work with you during 2020 and beyond.

Competing interests: A complete list of my conflict of interest disclosures is found at https://www.mja.com.au/journal/staff/editor-chief-professor-nick-talley.

Provenance: Not commissioned; not externally peer reviewed.

References

1. Caly L, Druce J, Roberts J, et al. Isolation and rapid sharing of the 209 novel coronavirus (SARS-CoV-2) from the first patient diagnosed with COVID-19 in Australia. Med J Aust 2020; 212: 459-462. https://www.mja.com.au/journal/2020/22/10/isolation-and-rapid-sharing-2019-novel-coronavirus-sars-cov-2-first-patient
2. Brainard J. Scientists are drowning in COVID-19 papers. Can new tools keep them afloat? Science Magazine [online] 13 May 020 (updated 15 May 2020). https://www.sciencemag.org/news/020/05/scientists-are-drowning-covid-19-papers-can-new-tools-keep-them-afloat (viewed May 020).
3. Chiarelli A, Johnson R, Pinfield S, Richens E. Preprints and scholarly communication: an exploratory qualitative study of adoption, practices, drivers and barriers (version 2: updated 25 Nov 2019). F1000Res 2019; 8: 971.
4. Talley NJ. Rapid publishing in the era of COVID-19. Med J Aust 2020; 212: 535-536. https://www.mja.com.au/journal/2020/212/11/rapid-publishing-era-coronavirus-disease-2019-covid-19-0
5. Piller C, Servick K. Two elite medical journals retract coronavirus papers over data integrity questions. Science Magazine [online] 4 June 2020 (updated 10 June 2020). https://www.sciencemag.org/news/2020/06/two-elite-medical-journals-retract-coronavirus-papers-over-data-integrity-questions (viewed June 2020).
6. Brewster DJ, Chrimes N, Do TBT, et al. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Med J Aust 2020; 212: 472-481. https://www.mja.com.au/journal/2020/212/10/consensus-statement-safe-airway-society-principles-airway-management-and-0
7. Fox GJ, Trauer JM, McBryde E. Modelling the impact of COVID-19 on intensive care services in New South Wales. Med J Aust 2020; 212: 468-469. https://www.mja.com.au/journal/2020/212/10/modelling-impact-covid-19-intensive-care-services-new-south-wales
8. Meares HDD, Jones MP. When a system breaks: queueing theory model of intensive care bed needs during the COVID-19 pandemic. Med J Aust 2020; 212: 470-471. https://www.mja.com.au/journal/2020/212/10/when-system-breaks-queueing-theory-model-intensive-care-bed-needs-during-covid
9. Ioannidis JPA. Why most published research findings are false. PLoS Med 2005; 2: e124.
10. Munk P, Coupal TM, Peh WCG. A shift in scholarly publishing practices and the growing menace of predatory journals. Med J Aust 2018; 209: 149-150. https://www.mja.com.au/journal/2018/209/4/shift-scholarly-publishing-practices-and-growing-menace-predatory-journals
11. Bolshete P. Analysis of thirteen predatory publishers: a trap for eager-to-publish researchers. Curr Med Res Opin 2018; 34: 157-162.
12. Cukier S, Helal L, Rice DB, et al. Checklists to detect potential predatory biomedical journals: a systematic review. BMC Med 2020; 18: 104.