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The world moves at a far faster pace than even a decade ago. Instantaneous access to electronic communication via email and social media is available 24 hours a day, virtually anywhere in the world, on the ground and in the air, with video and audio on demand. Thus, no one ever needs to be—or ever is—disconnected from the world.
The speed of communication has clearly affected clinical and laboratory research. There appears to be an increasing rush to publish, or at least to make the results of studies immediately publicly available. It is unclear if flawed science is more common than in the past, but the number of accounts of serious problems with scientific reports appears to be increasing, with more high-profile retractions and increasing numbers of retractions with replacements (major inadvertent errors with a change in the findings and conclusions).1 However, because more research is being published, it is difficult to obtain precise numerator (retractions) and denominator data (all research conducted, published and unpublished).2
Nonetheless, concerns about the reproducibility of laboratory-based experiments3 and the need to reanalyze clinical data4 certainly suggest increasing challenges regarding the quality and transparency of research. High-visibility examples leave an impression of questionable science that is likely contributing to the public discourse over the meaning and definition of facts.
For example, an experiment that created stem cells in an acid bath was questioned shortly after being published and retracted within months.5,6 A number of articles reporting nutritional research on food preferences have been corrected and at least 1 has been retracted.7 A published analysis of flaws in baseline data distribution raised concern about the validity of thousands of randomized clinical trials,8 but in turn, concerns about majors flaws in this analysis were raised almost immediately after publication.9,10 These are but a limited number of examples, and coupled with the rise in predatory journals,11 contribute to the perception that the standards of science are slipping. As a result, the trust that the public and policy makers have in science may be jeopardized.
Yet, funders, professional societies, investigators, and journals contribute to this environment, and indeed this may be affecting the quality of published research. Journals proudly announce they will conduct peer review in a matter of days and publish the results of studies in a few weeks, even though most studies take many years to conceptualize, conduct, and complete. Professional societies create more and more late-breaking science sessions at their research meetings, often now including observational studies that are of interest, but not likely to change practice.
Investigators, responding to requests from funders and sponsors, the desire to publish simultaneously with presentation, and their own internal motivations, often request rapid review and publication by journals. Many journals acquiesce to these requests, in turn, placing more pressure on peer reviewers, most of whom are investigators, to complete review in a matter of days, and more pressure on journal staff and resources to expedite article preparation and distribution.
New interest in preprint servers in clinical medicine increases the likelihood of premature dissemination and public consumption of clinical research findings prior to rigorous evaluation and peer review. At JAMA and throughout the JAMA Network journals, the conclusions and interpretations of many research articles change substantially between the initially submitted manuscript and the published article as a direct result of careful peer review, editorial assessment, author revision, and postacceptance editing. For most articles, public consumption of research findings prior to peer review will have little influence on health, but for some articles, the effect could be devastating for some patients if the results made public prior to peer review are wrong or incorrectly interpreted.
Progress in human health is measured in years, not days, weeks, or months. Major breakthroughs in clinical medicine are rare, with very few research findings likely to be implemented immediately. No drug or device, regardless of how effective, is likely to improve health outcomes more than many common and important clinical practices such as measuring blood pressure and treating hypertension with well-known drugs that have been proven to be safe and effective.
It usually takes years for interventions that improve patient outcomes to become part of routine practice and few novel interventions are likely to be more important than those already known to be effective. Improving the health of the world’s population has little to do with the speed of publication (except in the case of major public health emergencies),12 but rather with effective interventions that have been properly tested, appropriate implementation of known or new interventions, and sustainable improvements in health systems.
Life is conducted at a far faster pace than in the past, and so too, the pace of science and scientific communication also has accelerated. But indeed if the desire for speed has contributed to poorer quality research, trust in science will erode. Funders, authors, societies, and journals need to move more deliberately; ensure appropriate rigorous external peer review and internal scientific and editorial scrutiny; redouble efforts to ensure that shortening the time to publication does not adversely affect scientific quality and accuracy; and perhaps, of necessity in some cases, slow the process of scientific publication.
JAMA and the JAMA Network journals continually monitor times from submission to acceptance and from acceptance to publication with the goal of ensuring timely editorial decisions and publication, and each journal publishes an annual audit with this information.13,14 Over the past 5 years, the time from manuscript submission to article publication has been halved for all of the journals. We will continue to evaluate requests for expedited review and publication and honor those that are appropriate, focusing on clinical trials and reports of public health emergencies.
In addition, when articles are judged to make critically important contributions to clinical care, public health, or public policy, the editors will ensure expedited peer review, moving quickly but without compromising thorough and rigorous evaluation. Sacrificing adequate and thoughtful peer review and editorial assessment is a mistake for research in medicine. Timely assessment and dissemination of medical research findings is certainly important, but for most articles, rushing to publication in days or weeks will not improve health outcomes.
Corresponding Author: Howard Bauchner, MD, JAMA and the JAMA Network, 330 N Wabash Ave, Chicago, IL 60611 (firstname.lastname@example.org).
Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Additional Contributions: I thank and acknowledge the contributions of Eric D. Peterson, MD, MPH, and Derek C. Angus, MD, MPH (Associate Editors, JAMA), Philip Greenland, MD, and Mary McGrae McDermott, MD (Senior Editors, JAMA), Phil B. Fontanarosa, MD, MBA (Executive Editor, JAMA), and Annette Flanagin, RN, MA (Executive Managing Editor, JAMA and the JAMA Network).
Bauchner H. The Rush to Publication: An Editorial and Scientific Mistake. JAMA. 2017;318(12):1109–1110. doi:10.1001/jama.2017.11816
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