Rumorbusters.

Travel expands horizons and offers learning opportunities. Physical Therapy's Editorial Board members and I have found this to be true in many ways. For instance, in our travels, we have learned that the Journal has policies we never even heard off!

This year, for example, an Editorial Board member was asked by an attendee at a national conference why the Journal does not publish basic science research. She didn't know how to respond because we do publish it! Our Mission Statement, which appears on the Journal's masthead pages every month, includes the following: "Physical Therapy serves APTA members and other health care professionals by (1) documenting basic and applied knowledge related to physical therapy...."

Like those annoying spots you see before your eyes after a flash bulb goes off in your face, rumors about the Journal's "policies" are both persistent and elusive. These rumors contribute to "presubmission bias," a term that journal editors use to describe what happens when authors--due to a belief system, justified or not--choose not to submit articles to a given journal. To the extent that rumors go unchecked, authors may unnecessarily deprive themselves of the opportunity to publish in this Journal--and deprive Journal readers of the benefit of their efforts. This month and next, I'll use this space to debunk some of the myths about the journal and its editorial policies.

"The Journal doesn't publish basic science papers."

In the past 3 years, we have published at least 8 basic science papers. I say "at least" because it depends on how you define "basic science." My definition may be more narrow or more broad than that used by others. In the Journal, "basic science" refers to research that focuses on mechanisms--such as studies on subcutaneous drug delivery, basic kinesiology, cellular mechanisms, muscle anatomy, and motor control theory. Almost all of our special issues have a strong basic science component. We are proud that, among our 276 active reviewers, there are many basic scientists who come from a variety of fields--and from all over the world. Some are physical therapists; some are not.

Ironically, the Journal used to be criticized for publishing too much mechanistic research. Adding to the irony is the fact that, as our profession evolves, physical therapists have access to more avenues of publication. The Journal simply does not receive as many basic science submissions as it once did. We would love to have more of these types of papers to review.

"The Journal doesn't publish qualitative research."

In the past 10 years, we have published at least 20 qualitative research papers. A qualitative paper on expert practice is scheduled for December. Over the years, we've had provocative and fascinating papers on such topics as management of patients who have been abused, physical therapist biases, reactions to administrative reorganization in hospitals, and physical therapists' approaches to their own injuries. But once again, we can only publish more qualitative papers if we receive more!

"If you submit to Physical Therapy, it takes years to get published."

In the first half of 2003, time from acceptance to publication averaged 5.5 months, with 63% of manuscripts published within 5 months of acceptance and 28% of manuscripts published within 6 months. We believe that these are very competitive time frames. Most articles go through a revision process before acceptance, which means that the manuscript receives an initial disposition, is revised by the author based on the review team's comments, and then is reviewed one more time. In 2003 so far, time from submission to initial decision has averaged less than 3 months; time from resubmission of a revised paper has averaged 2 months or less.

Of the 131 manuscripts submitted to the Journal from January through June 2003, 72 manuscripts have completed the review process; of those, 78% received a decision in 3 months or less, and 97% received a decision in 4 months or less. For all manuscripts submitted in 2002, 75% of manuscripts received a decision within 3 months or less, compared with 51% in 2001 and 36% in 2000.

The Journal clearly has made great strides in reducing turnaround times, thanks in large part to the hard work of our reviewers and Editorial Board members. We have expanded the Editorial Board and will continue to do so in order to better serve our authors and readers. We have created an additional group that assists us in these efforts, our Associate Editorial Board members. We also have restructured the way we follow up when manuscripts are sent to reviewers, and, whenever possible, we assign three reviewers per manuscript, which often allows us to proceed with a paper even when a reviewer fails to complete the review within a reasonable time frame.

The best-laid plans of mice and men often go astray, however, and there are some authors who have to wait too long for a decision. The Journal regrets those delays, which usually are due to overcommitment, illness, or family emergencies on the part of reviewers, Editorial Board members, or Editors.

"The Journal makes it too hard to publish case reports."

When I became Editor almost 14 years ago, the first Editor's Note I ever wrote contained a call for case reports--and I still believe that our profession desperately needs a literature that describes practice as it is conducted. The patients in case reports do not have to be unique or special in any way. I would argue that a case report is worthwhile when it focuses on the management of any type of patient that has never been described before in the peer-reviewed literature. The Journal is so committed to case reports that we have an Editor for Case Reports, Dr Irene McEwen. In that role, Dr McEwen and a talented team wrote Writing Case Reports: A How-to Manual for Clinicians, which is now in its second edition and is available from APTA. We would love to see two case reports in every issue of the Journal.

We do not consider case reports to be "second-class citizens." A profession that is based on practice and composed almost entirely of practitioners can ill afford to describe patient management in an incomplete or inaccurate manner. Therefore, case reports undergo a peer-review process that is very similar to that used for all other types of articles. Unlike some publications, the Journal is very diligent in making certain that causality is never implied within case reports, because, in the absence of controls, claims of causality would be reckless. We also work with authors to eliminate jargon and to make certain that there are operational definitions for all important terms, even when those terms are widely used within a given specialty area. Our goal is for clinicians to communicate, and, toward that end, we work with authors to maximize clarity and credibility. This means more work for everyone--authors, editors, and staff--but we are committed to helping authors get their case reports published.

We ask authors of case reports to share with us their logic and decision-making processes, including why they chose to use certain measurements and how they came to apply interventions. This might mean a brief note, with the author taking into account what is known about the measurement (eg, reliability, validity, sensitivity, and specificity). We do not require a lengthy discourse on this or any of the theoretical considerations associated with patient management; we ask only enough detail for the case report to be respected as a thoughtful scientific reflection on practice. Physical therapist practice and patient management are too important to accept anything less.

"The Journal doesn't publish negative results."

Practice is shaped by confirming and by negating. Studies that show negative results for an intervention, for example, can dramatically help practitioners become more effective; so can findings that demonstrate the effectiveness or efficacy of interventions. People who report negative results have some unique obligations, however. Articles that demonstrate lack of viability of an idea that exists only in the author's mind are unlikely to be published. That is, negating something that few believed in the first place does not make a publishable paper.

Authors reporting negative findings also are obligated to demonstrate that the result was not a function of an underpowered study, with too few subjects and the statistics heavily weighted toward a negative finding--which is, in actuality, a type II statistical error. Authors deal with this issue by doing a power analysis. In order to do a power analysis, researchers must, among other things, estimate the "effect size" needed. In this Journal, we believe that the effect size should represent a meaningful change, and not merely be the size necessary to achieve statistical significance! The author has to make an argument for the effect size chosen; for instance, explain why a given change in range of motion would be meaningful or why a change in an SF-36 score might be useful.

Watch this space in October for more rumor busting!