Five Modes of Sudden Death

You may know from the “House of God”[1] that cardiac patients simply die. So do manuscripts.

As I am currently preparing a presentation for the annual meeting of the European Association of Science Editors (EASE) bearing the same title as this editorial I thought it suitable to let you know some of the content. In order not to become suspected of double publication (see below), I won't go into the details and numbers of the analysis, but simply share some of the causes for acquiring a dreadful professional disease known as Editor's Chagrin.

A bit more than 20%, i.e., a good fifth of the manuscripts submitted to this journal never see a reviewer, because the Editor-in-Chief rejects them offhand. Officially this decision mode is known as “Reject without review” and is used by all reasonable journals. Internally we call it “Sudden Death.” Cardiothoracic surgeons are disproportionately familiar with this form of demise, but still often wonder what really caused it. To shed light on this question we performed a consecutive autopsy series including all sudden deaths seen since January 2014.

Five modes could be identified and are listed below in order of frequency.

1. Submission of a Case Report. This is a manuscript category no longer published by the journal and for which we specifically founded our Open Access publication The Thoracic and Cardiovascular Surgeon Reports. All this is clearly explained in the Instructions for Authors. By nature this is a very rapid but totally avoidable death.

2. Subject outside the scope of the journal. Although cardiothoracic surgeons tend to be rather versatile it still escapes me why we should publish a paper on “diced cartilage in nasal septoplasty.” Even papers comparing the alleged advantage of one coronary stent versus another one in the treatment of left main stem stenosis are out of place here. (And this is not because our reader community tends to eye this treatment modality with a good deal of suspicion.) Again, this is a rather rapid variation.

3. Lack of originality. A meticulous report demonstrating that 789 hydatid cysts could be successfully removed from 653 lungs of 581 patients often exhibits all signs of a diligent and thorough data collection and analysis. The problem is that the result merely shows that white is still white and also lighter than black – which is something our readers already knew. Although eventually deadly, the decaying process takes some time because the editor has to weigh the novelty, respectively the lack thereof.

4. Faulty Science including (Self-) Plagiarism. This mode ranges from blatant attempts at double publication to unethical treatment of patients with toxic substances without ethics committee approval or even a valid study protocol. Other, less virulent examples are lack of control groups or wonky statistics - “a p-value of 0 (p = 0.000)”-, drug dosages which do not make sense, conclusions contradicting the results, etc. The various forms of (self-) plagiarism do deserve and will get their own analysis and report. Although eventually fairly obvious, these cases do take their time to dissect and apprehend. Overall, they must be considered to be the by far nastiest excrescences of the sudden death syndrome and should be reported like a contagious disease to confine the currently observed global epidemic.

5. Incomprehensible English. As an introduction to this theme the reader is referred to the last editorial.[2] There are manuscripts the reading of which is simply impossible, sometimes starting even with the title. Dissolution is, of course, extremely rapid.

It is an Editor's obligation to guide and teach authors, even and maybe especially the unsuccessful ones. Our death certificate invariably contains a detailed autopsy report and usually some recommendations for avoidance in the future. Things take a particularly nasty turn when the Rising Dead return to the scene, which has been repeatedly illustrated by respective movies. In editors this phenomenon invariably leads to a severe outbreak of the Chagrin mentioned above. In such cases some cynicism should be excusable.

“It is difficult to understand that you submitted this paper to our journal again, virtually unchanged. Alzheimer's disease has so far not been diagnosed among the members of the Editorial Board. But thank you for double-checking. Yours sincerely…”

• References

• 1 Shem S. The House of God. Black Swan Publ., Penguin Random House, London, UK: 1998
• 2 Heinemann MK. Broken English. Thorac Cardiovasc Surg 2018; 66 (03) 205