JAY SIWEK, MD, Georgetown University Medical Center, Washington, District of Columbia
NOTE: This is an expanded version of the Editorial that appeared in the December 1, 2016 issue of AFP.
This begins what will be a regular report documenting the acceptance rates of our clinical review articles and timelines to publication. We are doing this to inform readers and authors of some behind-the-scenes details of how we craft the journal and to set benchmarks for continually improving our processes (Table 1 and Table 2). A few points of context:
To ensure comprehensive coverage of a curriculum of topics, we solicit most of the articles that we publish. Authors who propose topics go through a formal approval process before submitting a manuscript for consideration. During 2015, only about 10% of proposed topics were approved. For both solicited and proposed topics, we provide authors with detailed guidance on the focus of the article. This guidance includes links to previously published material in American Family Physician (AFP), a set of links to relevant evidence on the topic, and recommended sources of high-quality evidence.
For all of these reasons, the acceptance rates for solicited manuscripts and approved proposals are high: about 90% for solicited manuscripts and about 75% for proposed manuscripts in 2015.
Manuscripts that are not solicited or preapproved are rarely deemed acceptable. Common reasons are: (1) the topic does not fit AFP’s desired curriculum; (2) the topic has recently been covered or is currently in production (hence, our request that prospective authors contact us before starting to write); or (3) the format is not appropriate (e.g., original research reports, case reports on rarely encountered conditions, nonstandard review articles).
Our timelines to publication are longer than most journals because a lot goes into putting our articles together. However, we are working on reducing timelines, which have gotten shorter over the past couple of years, to be as current as possible. In addition, we provide timely information to our readers by publishing selected content online ahead of print and through platforms such as the AFP Community Blog(afpjournal.blogspot.com) and AAFP News: AFP Edition, which have shorter timelines to publication.
Here is what happens during each stage of a manuscript’s development, and what we are doing to shorten the timelines for each.
Submission to decision letter. The steps include (1) intake processing to ensure that all required elements are included (incomplete submissions can delay this step by weeks); (2) internal review by two family physician medical editors; and (3) external review by three reviewers (family physicians and content experts, who may be family physicians or subspecialists). Although we give reviewers a timeline of two weeks, identifying suitable reviewers who will complete their reviews in a timely manner can be challenging. This sequence of steps takes about two months. Action: Peer review was previously a two-stage process (internal review followed by external review). These reviews now occur simultaneously, which has shortened the process.
Decision letter to resubmission. This step includes the author revising the manuscript and providing a detailed letter outlining his or her responses to all comments from the internal and external reviewers. Action: We previously gave authors up to four months to revise their manuscript; we now ask that they complete this process in two months. This step is in the authors’ hands. Those who revise their manuscript more quickly can expect earlier publication.
Resubmission to acceptance. This step includes review and editing by two medical editors, followed by processing for transmission to our editorial and production office. This sequence takes about one month for uncomplicated revisions. Action: We ask our medical editors to complete their review and editing within one week; however, if subsequent revision is required, the manuscript goes back to the author, extending the time until acceptance.
Acceptance to publication. In the past, we built in a nine-month time frame to publication for our professional editors to complete the myriad of steps needed to edit and finalize an article, as well as to have a sufficient backlog of topics to provide variety issue to issue. Action: We recently reduced this time frame to seven months, and we will work toward reducing this further.
All in all, the changes we have implemented have reduced the total time from submission to publication by seven months. We welcome comments from readers and authors about ways to continue to improve our publishing processes.
EDITOR'S NOTE: Dr. Siwek is Editor of American Family Physician.
Type of submission
Acceptance rates by type of submission
Solicited manuscript (about 90% of solicited manuscripts are actually submitted)
90% (10% rejected)
87% (10% rejected; 3% withdrawn†)
93% (6% rejected;
Approved proposed manuscript (only about 10% of proposed manuscripts are approved for submission; about 90% of approved proposed manuscripts are actually submitted)
42% (50% rejected; 8% withdrawn†)
77% (23% rejected)
Unsolicited manuscript (no preapproval process)
7% (93% rejected)
4% (96% rejected)
0% (100% rejected)
Stage of manuscript
Rejection rates by stage of manuscript
Submission (all types)
12% rejected before external review (88% were sent for external review)
36% rejected before external review (64% were sent for external review)
19% rejected before external review (81% were sent for external review)
4% rejected after external review (96% were sent for revision)
8% rejected after external review (92% were sent for revision)
6% rejected after external review (94% were sent for revision)
14% withdrawn† (86% were revised and resubmitted)
10% withdrawn† (90% were revised and resubmitted)
1% withdrawn† (99% were revised and resubmitted)
0% (100% were published after revision)
2% rejected or withdrawn† (98% were published after revision)
0% (100% were published after revision
*—In 2015, there were 104 submissions: 73 were solicited, 13 were proposals submitted after preapproval, and 18 were unsolicited and submitted without preapproval.
†—The author withdrew the manuscript from consideration.
Table 2. Average Days to Publication, Excluding Unsolicited Manuscripts
From submission to decision letter
From decision letter to resubmission
From resubmission to acceptance
Total time from submission to acceptance
From acceptance to publication
Total time from submission to publication
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