Correspondence Address:
K A Eaton
Chair of the British Dental Editors Forum, Visiting Professor, University College London, Eastman and King�SQ�s College London Dental Institutes Honorary Professor, University of Kent
United Kingdom

Full Text

Only a small percentage of papers submitted to international dental journals are accepted. The majority are rejected. Why is this and how can the current situation be improved? These were two questions which were considered during a symposium for dental editors, publishers, reviewers and authors, held during the June 2014 annual International Association for Dental Research (IADR) meeting in Cape Town. Many of the reasons had been identified during a previous symposium held during the 2013 IADR meeting in Seattle. [1]

In virtually all countries there is pressure for any scientist who wishes to progress in an academic career to publish in an international peer-reviewed journal, ideally one with an impact factor. This is as true for clinical scientists as it is for others. Unfortunately, clinical education has been geared to produce clinicians and historically in most countries and at most medical, and dental schools there has been very little, if any training in critically reviewing scientific literature to assess the validity of clinical procedures and evidence to support them, designing research or writing scientific papers. In my own case when I graduated in the late 1960s from a highly prestigious dental school in London, I had never read or been asked to read a scientific paper and thought that a scientific reference was something that I asked the dean for when applying for a job! It was only when I started to study for a Masters degree that I learned how to review papers critically, design research and write scientific papers. I was lucky because I studied at a solely postgraduate institute, where all the staff were scientists as well as clinicians and had these skills.

Things have changed little in many countries and it is still not uncommon for the senior staff to have very poor understanding of how to review the literature critically, design research and write scientific papers. They have never been trained in these skills, are unaware of research ethics and the concept of conflict of interests and are often apparently too embarrassed to acknowledge their deficiencies. At the same time, junior staff are told that they must publish in international peer reviewed journals if they are to obtain promotion. This is truly a case of the blind leading the blind. The consequence is usually very poorly designed research and very poorly written papers reporting this research. It is, therefore, hardly surprising that the resulting papers are rejected by journals. Apart from this fundamental problem, which in the main is due to ignorance, there is also a small minority of authors who are deliberately devious, or some would say totally unethical. The publishing "crimes" they commit include plagiarism, invention of fraudulent results and multiple submission of the same paper, sometimes with different titles to multiple journals. Knowledgeable reviewers and editors should be able to detect these "crimes" and the Committee on Publication Ethics has standards and guidelines [2] to aid editors and authors.

Two further problems are that even if they are published, many dental papers are then rarely cited [3] and that without a track record of meritorious publications on a particular topic the authors concerned are unlikely to obtain research funding.

Hence, how can these problems be addressed? At a global level, the two recent IADR symposia have shown that leading dental editors and publishers have recognized the problems and are keen to help young researchers and authors to acquire the necessary knowledge and skills to improve. It would be a formidable task for editors to give personal tuition to the authors of all papers that they reject. Good reviews should help authors to understand their shortcomings and take time to prepare. With the vast increase in the number of papers submitted to journals, there is also a problem in finding large numbers of reliable reviewers. However, there is much excellent training material for authors online and one suggestion, which will be explored by a number of the authors who have attended the IADR symposia, is to create a database of these resources so that authors can find them easily. It is hoped to develop this idea and others during the 2015 IADR annual meeting.

Another method is to work from the "bottom up". This approach requires collaboration between dental licensing authorities (usually National Dental Councils and/or Ministries of Education) and dental schools. The licensing authorities require all dental schools to teach undergraduates how to review the scientific literature critically, the principles of research design and research and publishing ethics and they are formally assessed in these skills. They also require students to cite references in their written work. The staff of all schools are required to demonstrate that they have these skills and are assessed, by independent assessors, to ensure that they have them. If they fail to demonstrate that they have, they are required to undergo training to develop them.

Rather more drastic measures are required to tackle the "publication crimes" detailed earlier in this editorial. One suggestion is that if the editor of any Medline/PubMed listed dental journal detects any of these crimes, he/she warns the author(s) and the Dean of the dental school concerned and explains the exact nature of the "crime". He then advises all the other editors of Medline/PubMed listed journals of the occurrence, and if there is any further paper, which breaches the guidelines for ethical research and publication from the school concerned, they all refuse to accept any further papers from that school for 5 years. It is to be hoped that this would be a very rare occurrence.

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