Peer-Reviewed Journals and Quality

Author(s): Katherine Swartz

Source: Inquiry , Summer 1999, Vol. 36, No. 2 (Summer 1999), pp. 119-121
Published by: Sage Publications, Inc.

Stable URL: http://www.jstor.com/stable/29772816

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The View From Here
Peer-Reviewed Journals
and Quality

Harold Varmus, director of the National Insti? departing from my usual editorializing about a
tutes of Health (NIH), threw a bombshell into topic in health policy. Instead, I want to make
the academic world in June when he suggested a plea for better writing at the submission stage
that the NIH should create an electronic jour? of manuscripts.
nal where anyone could post a paper?without In my first "View From Here" column, I
first going through a peer-review process. The noted that: "A journal is only as good as the
proposal's goal is laudable?earlier release of articles submitted and the quality of reviewers'
findings, especially in fast-breaking scientific suggestions for changes in manuscripts"
fields where other researchers might then alter (Swartz 1995/96, p. 374). In the nearly four
their own research approaches or attempt to intervening years, I have come to suspect that
replicate the new paper's results. But electronic an increasing proportion of submitted manu?
journals without peer-review processes are sim? scripts has not been vetted by colleagues and
ilar to web-based auctions for antique china: friends. It seems as if authors are trying to
lots of speed and uncertain quality. The trick is short-cut the process of publishing a paper by
in trying to speed up dissemination without submitting an early draft and then using the
letting quality slide. reviewers' and editor's comments to revise the
Varmus' suggestion, and the furor it caused, paper. This approach may work occasionally,
stimulated me to think about how we could but it does not work as a general rule.
speed up dissemination of the manuscripts we Early drafts have two bad effects. First, con?
ultimately accept for Inquiry. It turns out that trary to expectation, early drafts lengthen the
you, dear readers, have a big role to play here. time to publication. If the reviewer takes a
With rare exception, if Inquiry published paper seriously, he or she will spend a great
manuscripts in their original submitted version, deal of time providing detailed comments
most of us would quit reading Inquiry (or any about what needs to be improved. Alterna?
other journal that accepted the papers). Most tively, the reviewer simply will reject the manu?
manuscripts are greatly improved by the rewrit? script in exasperation and the writer will have
ing that occurs in response to referees' reports. to go looking for another "home" for the paper.
Some of the rewriting is unavoidable?a good Second, the poor writing quality heightens
reviewer can always see things we authors can? cynicism about the whole publication enter?
not see. But a good share of the needed revi? prise. When a good referee has a bad experi?
sions reflects papers written too quickly in the ence, he or she typically will avoid reviewing
first place?without enough thought about the other manuscripts for some time. This is a big
audience or the clarity of exposition. The result loss for all of us. Authors themselves seem
is often good research buried in badly written content to abandon the craft of writing. Too
papers that take longer than they should to often, they just succumb to the urge to get it
review and to revise. For that reason, I am out, no matter what it is. If this attitude grows,
taking advantage of Varmus' challenge and electronic journals without peer review will be
Inquiry 36: 119-121 (Summer 1999) ? 1999 Blue Cross and Blue Shield Association and
Blue Cross and Blue Shield of the Rochester Area.
0046-9580/99/3602-0119$1.25 119

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 Inquiry/Volume 36, Summer 1999

run according to Gresham's e-law: the bad ? An introduction with a brief discussion of
papers will drive out the good papers, because
nobody with a good paper will want it posted on ? A background section discussing previous
a web site with a poor reputation.
To try to increase awareness of what's ex? ? A theoretical model or framework section
pected with manuscripts when they are submit?
ted to Inquiry, I am providing some advice.
Tips for Submitting Papers More Likely to
be Published
1. Write an article for Inquiry's niche in health
services research?that is, articles that provide
insights into how a health system works and the
effects of changes to such systems. Preferred
articles focus on: the effects of changes in
health care organization, medical care financ?
ing, and health insurance; how medical care
providers are paid and the incentives inherent
in payment schemes; how public sector pro?
grams interact with changes in the private sec?
tor; how innovative programs in states or those
targeted at specific population groups are
working; and how the private sector is respond?
ing to government incentives (or lack thereof)
to change. Changes that are occurring in other
countries' financing and organization of health
are also of interest. But papers that focus on
economic theory of health care, or are highly
demanding in terms of the level of mathematics
required, are not of great interest to most of
Inquiry's readers. Such papers belong in other
journals. Finally, articles must describe the im?
plications of the findings for policymakers. If
such implications are hard to extract, try an?
other journal.
2. Pay attention to Inquiry's style. When a
manuscript is first submitted to Inquiry for re?
view, I am much more concerned with sub?
stance than style. But at the revise-and-resub
mit stage, an author can save a lot of time by
making sure that citations, references, and the
general style of tables are done in the Inquiry
style.
Moreover, articles that are general research
papers (and not designated "Research Notes
and Data Trends" or a "Data Report") should
include the following:
why the topic is interesting;
research related to the topic;
describing the theoretical underpinnings of
the topic;
? An empirical model or methods section
laying out how the central issue is being
estimated;
? A data section describing the data used to
estimate the model;
? A section which presents the estimation
results and discusses the results; and
? A conclusion or discussion of policy impli?
cations, where the results are summarized
and placed in context for researchers and
policymakers.
3. Make the effort to write well. Short, declar?
ative sentences are far better than long, con?
voluted sentences with interlocking phrases.
Forget the English teachers in high school who
said that sophisticated writing requires longer
sentences with elaborate vocabulary. At the
same time, be precise in your use of language.
If something is statistically significant, say so?
don't just say its significant. It you are estimat?
ing a price elasticity of demand, call it a price
elasticity rather than just an elasticity. Also, if
a picture is worth a thousand words, a table is
worth at least 500 words. Tables are devices to
display information succinctly and we all know
how to read them. The most important aspects
of a table should be highlighted in the text but
a reader will start snoring if you discuss every?
thing that appears in the table.
4. Ask colleagues to read and critique a manu?
script before sending it off for review. If some?
thing is not clear to them or they have sugges?
tions for alternative methodologies, take the
time to revise the paper before sending it to a
journal. If you take the time to revise the paper
several times before submitting it, you improve
the chances the referees will like the paper on
the first round of reviews.
5. Be responsive to reviewers' comments if you
are asked to revise and resubmit a paper. As

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 Peer-Reviewed Journals

editor, I expect a summary letter of how you especially when I have to call on short notice
responded to comments by the reviewers (and because some other person has not done a
the editor) with your resubmission. The sum? review. Editors are supposed to be impartial
mary not only helps the reviewers and the and objective when making decisions about
editor?it also gives you a good check-list of manuscripts, but it is surprising how an author's
items that you need to be sure you addressed. record as a careful reviewer works in subtle
If you have sound reasons for not agreeing with ways on editors' minds.
a comment or suggestion, explain your logic. A To return to my opening gambit, peer-re?
reasonable explanation is likely to carry more viewed journals?whether print or electronic?
weight than a short response to the effect that need good writing as well as good subjects. The
the comment was "dumb."
health policy research world and health policy?
6. Finally, to put it gently, authors who submit
makers are the better because of good writing.
manuscripts need to be willing to review manu?
So keep sending in interesting papers,?but
scripts. Peer-reviewed journals are common
please, take the extra time early to write them
property. As such, they require some give and well.
take or they will collapse. I have been amazed
at the generosity of a fair number of people
who are always willing to review papers for Katherine Swartz, Ph.D.
Inquiry?and I am eternally grateful to them, Editor

References
Swartz, K. 1995/96. A Challenging Time. Inquiry 32(4):373
375.

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