Paediatrics journals, like journals in any other speciality, play a key role in the main objective of contributing to advancing scientific knowledge, providing sufficient evidence to support decision-making and changes in clinical practice. Journals are useful to paediatricians and the larger scientific community in their double role as sources to increase knowledge and vehicles to disseminate the results of research.

On the other hand, we ought to discuss some of the current circumstances. For example, the immoderate growth of scientific evidence, which seems to not be reaching a plateau or have any bounds, as it is estimated that 75 randomised clinical trials and 11 systematic reviews are published each day, while 200 clinical trials are registered each week.1 On the other hand, there is the low reproducibility of the published studies (in a survey of 1576 researchers, 70% stated they had not been able to replicate the experiments of other researchers2), associated with the pressure to publish and the selective publication of data. In the field of paediatric journals, the scientific relevance of the studies in relation to the particular interests of the readership is a key factor in their selection. Yet, many journals with a high impact at the international level that rank in the first quartile acknowledge that they received many more high-quality manuscripts that they are able to accommodate in the number of pages contained in each issue, and this excess supply contributes to lower acceptance rates: for example, the manuscript acceptance rate is approximately 10% for the journal Pediatrics3 and 18.9% for the Journal of Pediatrics in 2019.4 The movement of open access journals, secondary or companion journals to consolidated, prestigious journals, emerged precisely to create room for scientifically relevant works that cannot be fitted in the main journal.

In addition to the surplus of studies, there are multiple reasons for rejection that mainly have to do with the scientific relevance and originality of the research, the methodological approach and strategy of analysis and flaws in the presentation, structure and writing of the manuscript (Table 1).

From this point, the article summarises 10 key points that paediatricians should take into account in the drafting of a manuscript to be able to compete successfully in the screening performed by high-impact journals to accept and publish outstanding works.

The scientific article is the final product of a research project. Needless to say, the odds that a manuscript will be published depend directly and nearly exclusively on the quality of the performed research, so it is essential to prioritise the study conception and design and ensure the suitability of the study protocol. Therefore, it is important to publish when the quality and suitability of the planned and performed study guarantee and interest in the dissemination of its findings, or, in plain terms, when “one has something to say” of scientific interest, that contributes knowledge and is useful based on the conceptual and methodological validity of the research.

For this to be possible, authors must have a multidisciplinary and integral understanding of the fundamentals of epidemiology and statistics, the characteristics and function of journals, the key stages in the editorial and peer review processes, ethics consensus guidelines, the structure of scientific articles and the rules of scientific writing.

Without an adequate review of what has been published in the recent past, it is not possible to provide adequate context for the research question or to proceed to the development of the research project. Having a rigorous and confident understanding of the current knowledge on the subject before undertaking the research confirms the scientific relevance of the study (in simple terms, the contribution the study will make) provides the necessary justification if funding has to be obtained. The errors that derive from an inadequate review of the literature and that therefore affect the foundations on which the study is developed are practically impossible to remedy at later stages. The potential for publication is directly proportional to the adequacy of the conception of the study.

Even within the specific field of paediatrics, journals may differ in the types of articles they publish, including originals, brief originals, letters to the editor, scientific letters, descriptive reviews, systematic reviews with and without meta-analyses, editorials, articles on commission (special articles), clinical cases, images and videos, news etc. For this reason, it is important to decide on the type of article and the corresponding format before starting on the manuscript, which evidently depend on the research that has been performed. Being thoroughly acquainted with the objectives and purpose of each section of the journal is not just important, but crucial in order to choose the ideal format for each work, as the degree of competition and the rate of acceptance vary (in some cases substantially) depending on the type of article. For instance, in cases in which it is possible to reduce the length of the manuscript and adapt the format to a brief original (or even a scientific letter), it is worth considering that the acceptance rates for these types of article tend to be higher compared to conventional original articles.

Independently of the type of article chosen, the authors must be aware of the need to convey the “message” of the article clearly and explicitly, both in the abstract and in the discussion and conclusion. The message is simply the interpretation of the primary outcome. With a simple but compelling sentence, the reader should be able to understand the scientific contribution of the study (what it contributes and what makes it relevant).

On this point, the main objective is to achieve acceptance of the manuscript in the first attempt, that is, to get published in the first journal to which the article is submitted. All authors should participate and agree in the decision regarding the most suitable journal for submission, which, whenever possible and for the purpose of efficiency, should be made along with the type of article before starting to write the manuscript.

The open-access journal model involves making information available online permanently and with no restrictions to access. The term open access was defined as such through 3 official statements: the Budapest Open Access Initiative of February 2002, Bethesda Statement on Open Access Publishing of June 2003 and the Berlin Declaration on Open Access to Knowledge in the Sciences and Humanities of October 2003, although the first open-access journals started publishing content in the 1990s. The upsurge and acceptance of this journal modality have been enormous, with a yearly growth rate of nearly 20%.5 At present, two journal models coexist. The first consists of conventional journals distributed by subscription, and the second of open-access journals (such as Anales de Pediatría), although journals in the first model tend to have a hybrid format, so that they allow publication of select articles under open-access conditions if the authors desire. Any form of open-access publication nearly always (or in the case of hybrid journals, always) involves payment of article processing charges (APCs) once the manuscript has been formally accepted for publication. Table 2 presents the advantages and disadvantages of publishing in open-access journals.

When it comes to selecting an open-access journal, it is essential to verify that the editorial process includes the peer review system as a quality standard. The Directory of Open Access Journals (DOAJ, https://www.doaj.org) is a database that includes a considerable number of open-access peer-reviewed journals. Table 3 lists the paediatrics journals included in this database. The journal Anales de Pediatría is not included in the DOAJ, but the DOAJ website includes a link to apply for inclusion in the database in its home page, which can be used by any open-access journal. Table 4 lists the open-access paediatrics journals with an index factor indexed in the Journal Citation Reports (JCR)® database.

Leaving aside the type of publication, selecting the right journal can still be challenging. The suitability of the journal considered for submission of the article can be assessed by following a few simple steps, as proposed in the algorithm presented in Fig. 1, including considering the mission statement and scope of the journal, reading the guide for authors, to verify that the journal publishes the type of article at hand, search the journal to see whether it has published similar articles and, if so, check whether any of these articles can be included in the references of the manuscript. The authors of these articles can also be suggested as potential peer reviewers. A study conducted in the Journal of Pediatrics to compare reviews done by reviewers suggested by the authors versus reviewers selected by the editor in a sample of 140 manuscripts did not find significant differences in the quality of the reviews or how quickly the reviews were completed, but reviewers selected by editors were less likely to recommend acceptance compared to reviewers suggested by the authors (risk ratio, 0.67; 95% confidence interval, 0.53–0.85).6 Other studies have also found a tendency toward more favourable recommendations regarding publication by reviewers suggested by authors versus those selected by editors.7,8

Figure 1.

Algorithm for choosing the right journal.

(0.28MB).

Achieving publication in the first journal the article is submitted to has the advantage of saving time, especially in journals with an agile editorial process. In addition, it can be important to be the first in describing a novel scientific finding. The time intervals elapsed from the initial submission of a manuscript and final publication vary between journals, but it is reasonable to expect a median of 34–36 weeks for the entire process, including peer review and the revision by the authors.9,10 The cumulative delay resulting from a succession of rejections is among the most negative factors that may contribute to detract from the interest in the new evidence provided by the article.

To be sure, receiving a rejection letter is dispiriting, frustrating and disappointing, but it has other significant implications, such as the need to agree on a new journal, which can cause delays of several weeks in multicentre studies involving multiple authors, to update the references, which entails reviewing and rewriting portions of the text (chiefly the introduction and the discussion), and to adapt the manuscript to the guidelines for authors of the new journal, which is a significant additional effort if there are many differences between the rejected manuscript and the current version. If the language is different, the text needs to be translated. Also, ethical declaration forms (such as disclosures of conflicts of interest) need to be updated and signed again by each of the authors. In case of several rejections, the time lost may be of many months or even more than one year, and the scientific information may be altered by the changes introduced to the manuscript to adapt it for each newly selected journal. Lastly, if after switching to a journal with a lower impact factor, to a speciality journal or to a new type of article the manuscript is still not accepted, authors may end up losing interest and the manuscript ends up shelved. The proportion of papers that are never published after being rejected tends to range from 15% to 30%.11,12Table 5 summarises frequent errors in selecting a journal.

This point may seem obvious, but sometimes the guidelines for authors are vague or, on the contrary, extremely detailed and difficult to understand. In addition, some journals request that authors write the manuscript using a template that automatically adapts the submitted text to style guidelines regarding font, line spacing, attachment of tables and figures etc. In addition to having such guidelines printed on paper at hand while writing the manuscript in the computer, it is also useful to have the full text of an article of the same type published in the journal of interest to use as a model.

It is possible that depending on the study design, the selected journal requires completion of one of the consensus-based guidelines available in the Enhancing the Quality and Transparency of Health Research (EQUATOR) platform (https://www.equator-network.org). This is a collection of guidelines regarding specific and representative data in different types of epidemiological studies that authors may need to apply to different sections during the writing of the manuscript (for example, the CONSORT statement for clinical trials, the STROBE statement for observational studies, PRISMA statement for systematic reviews, etc.).

Any manuscript submission must be accompanied by a formal cover letter (transmittal letter) addressed to the editor in chief of the journal. The letter should include the title of the manuscript, the section of the journal for which it is submitted, a summary of the characteristics of the study and salient results, a brief statement about the scientific contribution of the study relative to the previous literature and the reason for choosing the particular journal for the submission. It is also possible to suggests certain reviewers or request that others be excluded. Any other detail that could be relevant to the assessment of the manuscript by the editor should de included the cover letter.

The letter must be signed by the corresponding author, but it should be read and approved by all authors before it is sent.

Journals are increasingly demanding compliance with different ethical principles concerning research and publication, so individual authors frequently have to fill out related forms personally. Table 6 presents a few comments on this subject. It goes without saying that any work submitted to a journal must be original, that is, has not been published previously and, of course, that there is no form of fraud involved in its publication, for instance plagiarism. The practice of publishing literal copies of articles published in Spanish in domestic journals translated to English in international online journals is absolutely reprehensible.13 The emergence of the so-called predatory journals (open-access journals that published articles in exchange for a fee paid by authors without applying minimum quality standards)14 may contribute to promoting duplicate publication and plagiarism.

A conflict of interest exists whenever an author has a personal economic, scientific, institutional, family or business relationship that could influence or bias the interpretation of the findings of the study or its conclusions. Frequent situations that involve conflicts of interest include employment by a pharmaceutical company or in a related industry, personal or professional relationships (being an advisor, speaker, opinion leader, member of an administrative board…), direct family relationships, receiving research grants (economic logistics), owning stock or stock options, ownership or patents (active), or fees or honoraria for other activities (consulting, congress registration fees, trips, courses, workshops). In the case of editors and reviewers, conflicts of interest may be any circumstance that could compromise the impartiality or confidentiality of the editorial process or the peer review.

In fact, the existence of a conflict of interest involving the pharmaceutical industry does not invalidate the neutrality of the scientists involved in the research, what does invalidate the work is the nondisclosure of such conflicts.

The following are some crucial aspects: a) never neglect any of the reviewers’ comments, or leave any question unanswered; b) if the concerns of the reviewers are not clear, this should be acknowledged openly as opposed to responding with tangential arguments; c) consider whether including critical comments by reviewers among the limitations of the study would be appropriate; d) respond exclusively and explicitly to reviewer comments; e) use a polite tone and be mindful of the length and breadth of the answers; f) modifying the text is not always necessary; g) when inclusion of a citation is suggested, accept the recommendation and add a small reference to this work in the text (it is possible that the reviewer is one of the authors of that source); h) it is not necessary to thank the reviewer, restate agreement with the reviewer or praise the perspective of the reviewer in each of the comments, instead, add a short note acknowledging the reviewer at the beginning or the end of the document (for example, authors may express gratefulness for the comments of the reviewer that were useful in improving the quality of the manuscript). Lastly, it is essential to adhere to the deadlines established for the revision or to officially request an extension. The revised manuscript and the responses to reviewers should also be approved by each of the authors.

Publishing is not easy for any of us, but it is not impossible. Success depends on the scientific quality of the study, but also on knowing how to address details and formalities that may seem of minor importance.15 Publishing can be thrilling, and each manuscript is a challenge to our intelligence, a learning experience and an exercise in patience and rigour. All of us have had good pieces rejected, and also, in some instances, we have to admit that the rejections were for the best. There is nothing wrong with it. We will strive to do even better next time around.

This work did not receive any funding.

The author has no conflicts of interest to declare.