Editorial Policies

Focus and Scope

Open Medicine is a peer-reviewed, independent, open-access general medical journal. The mission of Open Medicine is to facilitate the equitable global dissemination of high-quality health research; to promote international dialogue and collaboration on health issues; to improve clinical practice; and to expand and deepen the understanding of health and health care. The Journal will examine issues relevant to health and clinical medicine both in Canada and internationally.


Section Policies


The Journal’s editors write the lead editorial.


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Analysis and Comment

Most commentaries are commissioned, but unsolicited submissions reviewing recent papers in the Journal or topical health-related issues are welcome. These should be less than 1000 words and 7 references.


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Open Medicine gives priority to original research reports that are likely to have important implications for human health and clinical practice.
Research papers may be submitted as clinical trial protocols that have been registered at www.clinicaltrials.gov, registered clinical trials, prospective cohort and case-control studies, research letters, case reports, as well as new studies examining health care science, education and practice, descriptions of advances in health care technology, and re-analysis or updating of previously published data. All reports are published immediately online after peer and editorial review and editing.
 All randomized controlled trials are fast-tracked, and the journal endeavours to publish accepted trials within two weeks of final acceptance. Fast-tracking is considered for other papers at the authors’ request. 

To be considered for publication, all clinical research results must derive from trials whose protocols have been registered in a non-profit electronically searchable database (if patient recruitment commenced on or after July 1st 2005). 

All papers must meet established criteria for authorship and for disclosure of conflict of interest. 

Clinical trials, diagnostic accuracy studies, observational studies, meta-analyses of observational studies, and systematic or narrative reviews should conform to accepted reporting guidelines for their respective study types. 
Original research reports should aim to be less than 3 000 words and have no more than 50 references. Authors wanting to publish longer papers should consult with the Journal about adding extra detail (e.g., methods, results, figures) through electronic links in the paper.


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Systematic and narrative reviews on clinically relevant topics are commissioned, although other contributors are encouraged to propose potential review topics. Authors must meet the Journal requirements for competing interests. Reviews should aim to be 3000 words with 80 references or fewer. 

Short reviews on clinically relevant questions are also included in our Teaching Corner. 

Both review types are peer-reviewed.

 Reviews that are under consideration for publication with the Cochrane Collaboration or that have already been published by Cochrane are not eligible for publication in the Journal.


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Clinical Practice

Open Medicine encourages submissions describing clinical cases that provide useful teaching points. 

Submission of instructive clinical images is also encouraged. 

Prior consent for publication must be obtained from the patient.


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Book reviews, short essays, fiction, poetry, and multi-media pieces reflecting on health and medicine are welcomed. 

Reviews of books and of visual and performing arts are solicited by the editors.


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Contributions addressing health-related issues in Canada and internationally are commissioned or written at the Journal.


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Case Report

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Clinical Hypothesis

This section invites novel clinical hypotheses.

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If you are interested in working with the Journal on a supplement we invite you to contact info@openmedicine.ca to discuss this with the Editorial team. We encourage you to read our competing interest statement prior to this.

  • Stephen Choi, University of Ottawa
  • Dean Giustini, UBC Biomedical Branch Library
  • Claire Kendall, University of Ottawa
  • Sally Murray, University of Notre Dame Australia
  • Anita Palepu, University of British Columbia
  • Alison Sinclair, Independent writer and consultant
  • Anne Marie Todkill, Independent Writer and Editor, Ottawa
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Peer Review Process

Unbiased, independent, critical assessment is an intrinsic part of all scholarly work, including scientific investigation. Peer reviewers are experts in their field who are not part of the editorial staff and thus are an important extension of the scientific process. Manuscripts will be reviewed by at least 2 reviewers. Peer reviewers are asked to submit their review within two (2) weeks. All randomized controlled trials will be fast-tracked through the peer-review and editorial process and we will endeavour to publish accepted trials within 2 weeks of final acceptance. Fast-tracking will be considered for other papers at the authors request.


Publication Frequency

Open Medicine publishes accepted papers online immediately after completion of peer-review and editorial processes. Papers will subsequently be collated as quarterly editions for indexing and citation purposes.


Open Access Policy

Open Medicine applies the Creative Commons Attribution Share Alike License to works we publish, because we believe that there should be no financial barriers to access to information that can benefit medical practice.

We also believe that authors should retain copyright to the article they have worked so hard to produce. This Creative Commons license means that anyone is able to freely copy, download, reprint, reuse, distribute, display or perform the work we publish.

They are also free to make derivative works (alter, transform, or build upon) so long as they distribute the resulting work only under a license identical to this one. This work may not be used for commercial purposes. Any derivative or non-derivative work must be attributed to the author and to Open Medicine.

Any of these conditions can be waived with permission from the copyright holder, including the right to modification or commercial distribution. These conditions do not negate or supersede Fair Use laws in any country.

For more information, please follow this link:
Creative Commons Attribution-Share Alike 2.5 Canada License.


Competing interest policy

Public trust in the peer review process and the credibility of published articles depend in part on how well competing interests are handled during writing, peer review, and editorial decision making.

Competing interests exists when an author (or the author’s institution), reviewer, or editor has financial or personal relationships that inappropriately influence (bias) his or her actions. These relationships vary from those with negligible potential to those with great potential to influence judgment, and not all relationships represent true competing interests. The potential for competing interests can exist whether or not an individual believes that the relationship affects his or her scientific judgment.

Financial relationships (such as employment, consultancies, stock ownership, honoraria, paid expert testimony) are the most easily identifiable competing interests and the most likely to undermine the credibility of the journal, the authors, and of science itself. However, conflicts can occur for other reasons, such as personal relationships, academic competition, and intellectual passion.

All participants in the peer review and publication process must disclose all relationships that could be viewed as presenting a potential competing interest. 

Editors may use information disclosed in competing interest statements as a basis for editorial decisions. Editors will publish this information if they believe it is important in judging the manuscript.

Potential competing interests related to individual authors’ commitments

When authors submit any manuscript they are responsible for disclosing all financial and personal relationships that might bias their work. To prevent ambiguity, authors must state explicitly whether potential conflicts do or do not exist. Authors should do so in the manuscript on a competing interest notification page that follows the title page, providing additional detail, if necessary, in a cover letter that accompanies the manuscript. Investigators must disclose potential competing interests to study participants and should state in the manuscript whether they have done so. 

We believe that financial conflicts of interest can be sufficiently great to preclude the publication of certain types of articles due to the potential for bias. In particular we draw attention to reviews (especially narrative reviews), commentaries and guidelines. Based on the experiences and guidelines of other medical journals, narrative reviews or commentaries (or similar articles) will not be accepted for consideration of publication (for either commissioned or spontaneously submitted pieces), if the any author has financial investments (equity, shares, derivatives, bonds, but excluding public traded mutual funds), received royalties or similar payments that in total over the past year have exceeded US $10,000 per company; or holds a patent (or is likely to or has applied for one or more) in a company that markets a product (or a competitor product) mentioned in the article. We will also refuse to publish papers by authors who are employed by such companies, who have a contractual relationship of any type with such companies, or who are named officers or board members of such companies. Authors of guidelines also fall within this remit. 

Potential competing interests related to project support

Increasingly, individual studies receive funding from commercial firms, private foundations, and government. The conditions of this funding have the potential to bias and otherwise discredit the research. Scientists have an ethical obligation to submit creditable research results for publication. Moreover, as the persons directly responsible for their work, researchers should not enter into agreements that interfere with their access to the data and their ability to analyze it independently, to prepare manuscripts, and to publish them.

Authors should describe the role of the study sponsor(s), if any, in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the report for publication. If the supporting source had no such involvement, the authors should so state. Biases potentially introduced when sponsors are directly involved in research are analogous to methodological biases of other sorts. We therefore, choose to include information about the sponsor’s involvement in the methods section.

Editors request that authors of a study funded by an agency with a proprietary or financial interest in the outcome sign a statement such as, “I had full access to all of the data in this study and I take complete responsibility for the integrity of the data and the accuracy of the data analysis.” Editors may also review copies of the protocol and/or contracts associated with project-specific studies before accepting such studies for publication.

Editors may choose not to consider an article if a sponsor has asserted control over the authors’ right to publish.

We do not accept guideline submissions that have been funded by a single-industry sponsor. 

Potential competing interests related to commitments of editors, journal staff, or reviewers

Editors will avoid selecting external peer reviewers with obvious potential conflicts of interest, for example, those who work in the same department or institution as any of the authors.

Authors often provide editors with the names of persons they feel should not be asked to review a manuscript because of potential competing interests, usually professional. When possible, authors will be asked to explain or justify their concerns; that information is important to editors in deciding whether to honor such requests.

Reviewers must disclose to editors any competing interests that could bias their opinions of the manuscript, and they should disqualify themselves from reviewing specific manuscripts if they believe it to be appropriate. As in the case of authors, silence on the part of reviewers concerning potential conflicts may mean either that such conflicts exist that they have failed to disclose, or that conflicts do not exist. Reviewers must therefore also be asked to state explicitly whether conflicts do or do not exist. Reviewers must not use knowledge of the work, before its publication, to further their own interests.

Editors who make final decisions about manuscripts will have no personal, professional, or financial involvement in any of the issues they might judge. Other members of the editorial staff, if they participate in editorial decisions, will provide editors with a current description of their financial interests (as they might relate to editorial judgments) and disqualify themselves from any decisions where they have competing interests.

Editorial staff will not use the information gained through working with manuscripts for private gain. Editors publish regular disclosure statements about potential competing interests related to the commitments of journal staff.


Competing interest statements of Open Medicine editors

The editors of Open Medicine are required to complete the following statement regarding potential competing interests:

  1. Have you accepted monetary compensation for any of the following from an organization that might gain or lose financially or in any other way because of a relationship with Open Medicine? Reimbursement for attending a symposium; Speaker Fees Fees for educational event; Research funds; Funds for a member of your staff;Consulting fees
  2. Have you been employed by an organization that may in any way gain or lose financially from the publication of papers in Open Medicine?
  3. Do you hold stocks or shares in an organization that might benefit or lose from an existing relationship with Open Medicine?
  4. Do you wish to disclose other competing interests, financial or otherwise?

The statements have been updated in November 2011 and relate to activities over the past 12 months and are found under the Editor profiles


Confidentiality statement

The editors of Open Medicine are required to agree to the following statement regarding editorial content:

As a member of the Open Medicine editorial team, I agree to keep confidential the content of accepted submissions until publication. I also agree to respect the privacy and intellectual property rights of authors who submit material to the journal.

I will not disclose information concerning the journal’s receipt of a submission, its content, or its review, other than in discussions with the journal’s editors and peer reviewers in the normal process of evaluation.

I understand that the final editorial decision will be disclosed to peer reviewers, who are bound by a similar obligation of confidentiality. Peer reviews of rejected material will be shared with other journals only with the author’s explicit consent.


No embargo policy

Open Medicine does not impose media embargos on content. Authors, as the owners of their original work, are free to disseminate advance information about forthcoming articles that they have contributed to Open Medicine.

All Open Medicine content will be freely available to everyone from the moment of publication.


Advertising policy

Open Medicine is a non-profit medical journal whose mission is to provide a venue for scientific publishing that is independent of commercial interests which can influence editorial objectivity.

Therefore, Open Medicine will not accept advertisements from for-profit pharmaceutical or medical device companies, nor will we accept advertisements for Continuing Medical Education that is funded by these companies.

We reserve the right to refuse advertising from any business or organization whose activities we believe are inconsistent with the mission of Open Medicine.

Please contact info@openmedicine.ca if you are interested in advertising with Open Medicine, inserting "Advertising" in the subject line.


Sponsorship policy

Companies, individuals and other organizations are invited to support the development of Open Medicine by becoming a journal sponsor.

Sponsorships provide unrestricted funds that will help Open Medicine advance its service to authors and readers and fulfill its mission.Sponsors will be highlighted on a Sponsors page.

The mission of Open Medicine is to facilitate the equitable global dissemination of high-quality health research within the health community; to promote international dialogue and collaboration on health issues; to improve clinical practice; and to expand and deepen the understanding of health and health care.

Our open-access publishing platform is key to accomplishing our goals. To ensure their commitment to the integrity of debate within the pages of Open Medicine, and to the independence of our editors, sponsors of Open Medicine will be asked to endorse the following sponsorship statement: We support the mission and principles of Open Medicine and recognize the potential for competing interests while providing financial support to the Journal. We hereby state that we will not attempt to influence any editorial decisions made by the editors of Open Medicine, in return for our support.

Open Medicine reserves the right to refuse sponsorship from any business or organization. In keeping with our policy on advertising, Open Medicine does not accept sponsorships from pharmaceutical or medical device companies.

Our sponsorship policy is based on the sponsorship policy of the Public Library of Science, an organization of scientists and physicians committed to making the world's scientific and medical literature a public resource.

Please contact info@openmedicine.ca if you are interested in becoming an Open Medicine sponsor, inserting "Sponsorship" in the subject line.


Editorial board terms of reference

  1. The volunteer Editorial Board will provide input, oversight, contacts and moral support, and establish the journal’s first Board of Directors.
  2. The Journal’s Editorial Board will consist of highly skilled, committed professionals in Canada and internationally. It will represent the Journal’s various constituencies: readers, researchers, physicians, policy makers and patients, using their skills to achieve the Journal objectives. The Journal's Editorial Board will include a maximum of 30 members.
  3. By agreeing to sit on the Board, Editorial Board members will assist the Editor-in-Chief(s) of the Journal to review, solicit and submit relevant papers for the Journal and support Journal efforts to secure ongoing funding.
  4. The Editorial Board will support the Editor-in-Chief(s) to maintain Journal principles underlying the editorial integrity and independence of the Journal eg supporting editorial independence, Journal advertising policies and the open access platform.
  5. The Editorial Board will meet once per year to receive a report on Journal progress from the Editor-in-Chief(s) and to review a report on the performance of the Editor-in-Chief from the Chair of the Board of Directors.
  6. Initial membership of the Editorial Board will initially be determined by the ‘Friends of the Journal’ group who came forward to work to create the Journal.
  7. Ongoing membership of the Editorial Board will be determined by the Editor-in-Chief(s) in conjunction with the existing Editorial Board. A new member can be nominated by 2 editors and/or board members, and is approved by a two-third vote of existing editorial board members. Members will serve for a staggered period of 3 years, renewable once.


Data sharing policy

At Open Medicine we believe that original and novel research is vitally important, so too are the studies that follow to confirm or repudiate their findings.

We also believe in the creative re-use of data. Allowing other researchers access to the data that you have collected considerably extends its value. Creative re-use offers the opportunity to validate your findings as well as exploring new ways of using it. It also means that funding bodies and patients involved in the research see their initial investment grow.

Like other journals starting to build upon the value of data sharing and publishing (see PLoS Medicine & Annals of Internal Medicine ), we would like to you to indicate your willingness to share your protocol, dataset and the statistical code used for your analysis with other authors. We encourage authors who publish secondary analysis to use the same Creative Commons licence that we use; encouraging ongoing open access to your data and the knowledge derived from it.

Regardless of your commitment to dataset sharing, the Editors at Open Medicine sometimes need protocols or data sets to ensure the methods and results in papers are as clear and accurate as possible. We will continue to request these for this purpose as necessary.

We strongly encourage you to discuss sharing your data on the Open Medicine website with our Editorial team (info@openmedicine.ca) after we have accepted your paper. We look forward to working together on this exciting open initiative.


Ghost and guest authorship policy

Ghost authorship occurs when someone makes a significant contribution to a manuscript without due acknowledgement of their role.

Guest authorship occurs when an individual is named as an author of a manuscript when they do not meet authorship criteria.

Open Medicine considers that both ghost and guest authorship are breaches of publication ethics, and believes they violate readers’ trust in scientific reporting and can potentially bias medical literature. The Journal’s editors and readers need to be confident that authors listed have undertaken the work and that the written manuscript reflects their work; public confidence and scientific integrity depend on this.

This is particularly important in the context of manuscripts reporting the results of drug trials, since significant problems related to the use of ghost authorship have been reported in this area.[1] Commercial interests should not inappropriately influence our scientific knowledge base.

Open Medicine acknowledges the role of professional medical writers and requires that all writing assistance be disclosed.

To support transparent and complete authorship reporting, Open Medicine expects authors to fulfill the following requirements:

1. Authors must provide a contributor statement that describes the specific contribution of each author to the manuscript and shows how each author meets the 3 authorship criteria of the ICMJE. For example:

"Alex Twinning participated in finalizing the study methodology, managed the quantitative component and was the principal writer of the manuscript. Gerry Masters conceived the project, oversaw the data collection and analysis and participated in all phases of the writing. Grant Smith helped implement the study, worked on finalizing the methodology and contributed to the writing and editing of the manuscript. Julie Matthews supervised the data collection, described the qualitative methods used in the study and reviewed all manuscript drafts. Elizabeth Summers conducted the data analysis and participated in editing and reviewing manuscript drafts. Sharon Levy conceived the study and oversaw its implementation and participated in the writing of the manuscript. Sally Little helped guide the analysis and participated in the writing. All of the authors approved the final version of the manuscript."

2. Authors should specify who wrote the first draft of the article (and for research studies, who wrote the protocol and did the statistical analyses). If the people named are not authors, the Journal editors will contact them to confirm their contribution.

3. Contributors who do not meet the criteria for authorship should be named in an Acknowledgements section with their contribution clearly described. Vague statements in the Acknowledgments section, such as “We thank XX” (without specifying for what), or “XX provided editorial assistance,” will not be accepted.

4. Authors should retain copies of drafts to facilitate investigations of possible misconduct.

5. Any and all assistance from professional medical writers must in every case be appropriately acknowledged and described and their funding source named.

6. Professional medical writers whose contribution to a manuscript qualifies them as an author according to the ICMJE criteria for authorship must be listed as authors, with their affiliations and competing interests provided and the source of their funding named.

7. Professional medical writers whose contribution to a manuscript does not qualify them as an author according to the ICMJE criteria for authorship must be named in the Acknowledgements section, with their contribution clearly described and their funding source named. Authors are requested to contact the Open Medicine editors to obtain clarification as to the appropriate place in the manuscript to acknowledge and describe the contribution of a medical writer.

The following checklist* is for authors who have used medical writers and is provided to aid the appropriate disclosure of writing assistance.

1. (a) Did the medical writer meet the three criteria for authorship as specified by the ICMJE?

(b) If not, has the writer been identified in the Acknowledgments?

2. Has the source of funding for the medical writer’s services been identified in the Acknowledgements?

3. Did the author(s) make the final decision on the main points to be communicated in the manuscript, particularly in the interpretation section?

4. Did the author(s) make the final decision on the primary and secondary outcomes and relevant data to be reported in the manuscript?

5. If requested by the Journal, can the medical writer provide evidence that the manuscript was prepared in accordance with international guidelines for ethical medical writing (e.g., Uniform Requirements for Manuscripts Submitted to Biomedical Journals;[3] Good Publication Practice for Pharmaceutical Companies;[4] position statements from the European or American medical writers’ associations or the International Society for Medical Publication Professionals[5])?

The checklist is adapted from Gøtzsche et al.[2]

In line with other significant breaches of scientific conduct, articles found to have used ghost or guest authors will be retracted by Open Medicine.

In accordance with the guidelines of the World Association of Medical Editors,[6] the editors of Open Medicine will also:


  • inform the authors’ institutions of the breach and ban further contributions by the authors to the Journal; 
  • publish a notice on the Journal website that the manuscript used ghost or guest authors, along with the names of the responsible companies (if relevant) and the authors; 
  • give the names of those involved to the media and to government organizations if contacted; and 
  • share their experiences with the editors of other medical journals.


Open Medicine strongly believes in transparent reporting. Ghost and guest authorship are dishonest, and the Journal editors intend to maintain processes that improve public accountability and the credibility of scientific research reporting.


1. The PLoS Medicine Editors. Ghostwriting: The Dirty Little Secret of Medical Publishing That Just Got Bigger. PLoS Med 2009; 6(9): e1000156.

2. Gøtzsche PC, Kassirer JP, Woolley KL,Wager E, Jacobs A, et al. What Should Be Done To Tackle Ghostwriting in the Medical Literature?. PLoS Med 2009; 6(2): e1000023.

3. International Committee of Medical Journal Editors. Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication. 2008.

4. Graf C, Battisti WP, Bridges D, Bruce-Winkler V, Conaty JM, Ellison JM, et al.Good publication practice for communicating company sponsored medical research: the GPP2 guidelines, BMJ 2009; 339: b4330

5. Norris R, Bowman A,Fagan JM, Gallagher ER, Geraci AB, et al. International Society for Medical Publication Professionals (ISMPP) position statement: The role of the professional medical writer. Curr Med Res Opin 2007; 23: 1837–1840.

6. World Association of Medical Editors. Ghost writing initiated by commercial companies. 2005.


Privacy and confidentiality

Patients and study participants

Patients have a right to privacy that should not be infringed without informed consent. Identifying information, including patient's names, initials, or hospital numbers, should not be published in written descriptions, photographs, and pedigrees unless the information is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication. Informed consent for this purpose requires that a patient who is identifiable be shown the manuscript to be published. Identifying details will be omitted if they are not essential. Complete anonymity is difficult to achieve, however, and informed consent should be obtained if there is any doubt. For example, masking the eye region in photographs of patients is inadequate protection of anonymity. If identifying characteristics are altered to protect anonymity, such as in genetic pedigrees, authors should provide assurance that alterations do not distort scientific meaning and editors should so note.

Authors and reviewers

Manuscripts must be reviewed with due respect for authors' confidentiality. In submitting their manuscripts for review, authors entrust editors with the results of their scientific work and creative effort, on which their reputation and career may depend. Authors' rights may be violated by disclosure of the confidential details of the review of their manuscript. Reviewers also have rights to confidentiality, which must be respected by the editor. Confidentiality may have to be breached if dishonesty or fraud is alleged but otherwise must be honoured. Editors will not disclose information about manuscripts (including their receipt, content, status in the reviewing process, criticism by reviewers, or ultimate fate) to anyone other than the authors and reviewers. This includes requests to use the materials for legal proceedings.

Editors will make clear to their reviewers that manuscripts sent for review are privileged communications and are the private property of the authors. Therefore, reviewers and members of the editorial staff must respect the authors' rights by not publicly discussing the authors' work or appropriating their ideas before the manuscript is published. Reviewers must not be allowed to make copies of the manuscript for their files and must be prohibited from sharing it with others, except with the permission of the editor. Reviewers should return or destroy copies of manuscripts after submitting reviews. Editors will not keep copies of rejected manuscripts. Reviewers will be anonymous and their identity will not be revealed to the author or anyone else without the reviewer's permission.

Reviewer comments will not be published or otherwise made public without permission of the reviewer, author, and editor. Reviewers' comments will be sent to other reviewers of the same manuscript, which helps reviewers learn from the review process, and reviewers may be notified of the editor's decision. 


Protection of human subjects and animals in research

When reporting experiments on human subjects, authors should indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.<5> If doubt exists whether the research was conducted in accordance with the Helsinki Declaration, the authors must explain the

rationale for their approach, and demonstrate that the institutional review body explicitly approved the doubtful aspects of the study. When reporting experiments on animals, authors will be asked to indicate whether the institutional and national guide for the care and use of laboratory animals was followed. 


Publication charges

Open Medicine will levy a publication charge for articles accepted on or after March 1, 2010. The fee is C$1500 for research and review articles and C$600 for commentary and analysis articles that meet our author guidelines in format and word count. The charge covers most of the copyediting costs as well as the production and layout costs required to ensure the article meets National Library of Medicine standards; the remaining costs are met by our editorial team of volunteers. Partial or complete fee waivers are available to authors with little or no means to pay. Authors requiring a partial or complete fee waiver must provide an explanation for this when their article is accepted. Since publication charges apply only after an article is accepted, the fees do not influence our editorial decisions.



Other editorial and publishing policies

1. Obligation to publish negative studies

Editors will consider seriously for publication any carefully done study of an important question, relevant to their readers, whether the results are negative or positive to avoid publication bias. Many studies that purport to be negative are, in fact, inconclusive; publication of inconclusive studies is problematic, since they add little to biomedical knowledge and consume journal resources. The Cochrane Library may be interested in publishing inconclusive trials.

2. Corrections, retractions and "expressions of concern" 

Editors assume initially that authors are reporting work based on honest observations. Nevertheless, two types of difficulty may arise.

First, errors may be noted in published articles that require the publication of a correction or erratum of part of the work. The corrections will appear on a numbered page, be listed in the contents page, include the complete original citation, and link to the original article and vice versa if online. It is conceivable that an error could be so serious as to vitiate the entire body of the work, but this is unlikely and will be handled by editors and authors on an individual basis. Such an error will not be confused with inadequacies exposed by the emergence of new scientific information in the normal course of research. The latter require no corrections or withdrawals.

The second type of difficulty is scientific fraud. If substantial doubts arise about the honesty or integrity of work, either submitted or published, it is the editor's responsibility to ensure that the question is appropriately pursued, usually by the authors' sponsoring institution. However, it is not ordinarily the task of editors to conduct a full investigation or to make a determination; that responsibility lies with the institution where the work was done or with the funding agency. The editor should be promptly informed of the final decision, and if a fraudulent paper has been published, the journal will print a retraction. If this method of

investigation does not result in a satisfactory conclusion, the editor may choose to conduct his or her own investigation.

As an alternative to retraction, the editor may choose to publish an expression of concern about aspects of the conduct or integrity of the work. The retraction or expression of concern, so labeled, will appear on a numbered page in a prominent section of the print journal as well as in the online version, be listed in the contents page, and include in its heading the title of the original article. Ideally, the first author should be the same in the retraction as in the article, although under certain circumstances the editor may accept retractions by other responsible persons. The text of the retraction should explain why the article is being retracted and include a full original citation reference to it. The validity of previous work by the author of a fraudulent paper cannot be assumed. Editors may ask the author's institution to assure them of the validity of earlier work published in their journals or to retract it. If this is not done editors may choose to publish an announcement expressing concern that the validity of previously published work is uncertain.


3. Overlapping publications

3.1 Duplicate submission

Most biomedical journals will not consider manuscripts that are simultaneously being considered by other journals. Among the principal considerations that have led to this policy are: (1) the potential for disagreement when two (or more) journals claim the right to publish a manuscript that has been submitted simultaneously to more than one; and (2) the possibility that two or more journals will unknowingly and unnecessarily undertake the work of peer review and editing of the same manuscript, and publish same article. However, editors of different journals may decide to simultaneously or jointly publish an article if they believe that doing so would be in the best interest of the public's health.

3.2 Redundant Publication

Redundant (or duplicate) publication is publication of a paper that overlaps substantially with one already published in print or electronic media. Readers of primary source periodicals, whether print or electronic, deserve to be able to trust that what they are reading is original unless there is a clear statement that the article is being republished by the choice of the author and editor. The bases of this position are international copyright laws, ethical conduct, and cost-effective use of resources. Duplicate publication of original research is particularly problematic, since it can result in inadvertent double counting or inappropriate weighting of the results of a single study, which distorts the available evidence.

Most journals do not wish to receive papers on work that has already been reported in large part in a published article or is contained in another paper that has been submitted or accepted for publication elsewhere, in print or in electronic media. This policy does not preclude the journal considering a paper that has been rejected by another journal, or a complete report that follows publication of a preliminary report, such as an abstract or poster displayed at a professional meeting. Nor does it prevent the Journal considering a paper that has been presented at a scientific meeting but not published in full or that is being considered for publication in a proceedings or similar format. Press reports of scheduled meetings will not usually be regarded as breaches of this rule, but additional data or copies of tables and illustrations should not amplify such reports.

When submitting a paper, the author must always make a full statement to the editor about all submissions and previous reports that might be regarded as redundant or duplicate publication of the same or very similar work. The author must alert the editor if the manuscript includes subjects about which the authors have published a previous report or have submitted a related report to another publication. Any such report must be referred to and referenced in the new paper. Copies of such material should be included with the submitted paper to help the editor decide how to handle the matter.

If redundant or duplicate publication is attempted or occurs without such notification, authors should expect editorial action to be taken. At the least, prompt rejection of the submitted manuscript should be expected. If the editor was not aware of the violations and the article has already been published, then a notice of redundant or duplicate publication will probably be published with or without the author's explanation or approval.

3.3 Acceptable secondary publication

Certain types of articles, such as guidelines produced by governmental agencies and professional organizations, may need to reach the widest possible audience. In such instances, editors sometimes choose deliberately to publish material that is also being published in other journals, with the agreement of the authors and the editors of those other journals. Secondary publication for various other reasons, in the same or another language, especially in other countries, is justifiable, and can be beneficial, provided all of the following conditions are met.


  • The authors have received approval from the editors of both journals; the editor concerned with secondary publication must have a photocopy, reprint, or manuscript of the primary version.
  • The priority of the primary publication is respected by a publication interval of at least one week (unless specifically negotiated otherwise by both editors).
  • The paper for secondary publication is intended for a different group of readers; an abbreviated version could be sufficient.
  •  The secondary version faithfully reflects the data and interpretations of the primary version.
  • The footnote on the title page of the secondary version informs readers, peers, and documenting agencies that the paper has been published in whole or in part and states the primary reference. A suitable footnote might read: "This article is based on a study first reported in the [title of journal, with full reference]." Permission for such secondary publication should be free of charge.
  • The title of the secondary publication should indicate that it is a secondary publication (complete republication, abridged republication, complete translation, or abridged translation) of a primary publication. Of note, the National Library of Medicine does not consider translations to be "republications," and does not cite or index translations when the original article was published in a journal that is indexed in MEDLINE.


4. Competing Manuscripts Based on the Same Study

Publication of manuscripts to air co-investigators disputes may waste journal space and confuse readers. On the other hand, if editors knowingly publish a manuscript written by only some of a collaborating team, they could be denying the rest of the team their legitimate co authorship rights; they could also be denying the journal's readers access to legitimate differences of opinion about the interpretation of a study.

Two kinds of competing submissions are considered: submissions by coworkers who disagree on the analysis and interpretation of their study, and submissions by coworkers who disagree on what the facts are and which data should be reported. Setting aside the unresolved question of ownership of the data, the following general observations may help understand these problems.

4.1 Differences in Analysis or Interpretation

If the dispute centers on the analysis or interpretation of data, the authors should submit a manuscript that clearly presents both versions. The difference of opinion should be explained in a cover letter. The normal process of peer and editorial review of the manuscript may help the authors to resolve their disagreement regarding analysis or interpretation.

If the dispute cannot be resolved and the study merits publication, both versions will be published. Options include publishing two papers on the same study, or a single paper with two analyses or interpretations. In such cases it is likely that we will publish a statement outlining the disagreement and the Journal's involvement in attempts to resolve it.

4.2 Differences in reported methods or results

If the dispute centers on differing opinions of what was actually done or observed during the study, the journal editor will refuse publication until the disagreement is resolved. Peer review cannot be expected to resolve such problems. If there are allegations of dishonesty or fraud, editors will inform the appropriate authorities; authors should be notified of an editor's intention to report a suspicion of research misconduct.


5. Competing Manuscripts Based on the Same Database

Editors sometimes receive manuscripts from separate research groups that have analyzed the same data set, e.g., from a public database. The manuscripts may differ in their analytic methods, conclusions, or both. Each manuscript should be considered separately. Where interpretations of the same data are very similar, it is reasonable but not necessary for editors to give preference to the manuscript that was received earlier. However, editorial consideration of multiple submissions may be justified in this circumstance, and there may even be a good reason for publishing more than one manuscript because different analytical approaches may be complementary and equally valid.

6. Correspondence

Biomedical journals should provide its readership with a mechanism for submitting comments, questions, or criticisms about published articles, as well as brief reports and commentary unrelated to previously published articles. This will likely, but not necessarily, take the form of a correspondence section or column. The authors of articles discussed in correspondence should be given an opportunity to respond, preferably in the same issue in which the original correspondence appears. Authors of correspondence are asked to declare any competing or conflicting interests.

Published correspondence may be edited for length, grammatical correctness, and journal style. Authors should approve editorial changes that alter the substance or tone of a letter or response.

Although editors have the prerogative to sift out correspondence material that is irrelevant, uninteresting, or lacking in cogency, they have a responsibility to allow a range of opinion to be expressed. The correspondence column will not be used merely to promote the Journal's, or the editors', point of view. In all instances, editors must make an effort to screen out discourteous, inaccurate, or libelous statements, and should not allow ad hominem arguments intended to discredit opinions or findings.

ISSN 1911-2092