Astute readers will have noted already that this issue of the Journal of the American Society of Echocardiography (JASE) contains two very large documents, and a smaller than usual number of original investigations or other types of articles. In general, the editors of JASE prefer to include only one long guideline document, or expert consensus statement, in a given issue. Therefore, it would fair for readers to ask “Why two large articles in the same issue? How will I find the time to read both of these long papers?”

A few words of explanation seem warranted. The answer has to do with “co-publication”. Without getting too technical, I will try to explain the relevant issues that pertain when a given article is published jointly in two or more different journals (which is often termed “co-publication”).

Why would two journals want to publish the same paper? Consider, for example, the article entitled “ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography”, by Douglas et al, in this issue of JASE . This document reflects an update, extension, and synthesis of two prior publications that discussed a number of clinical scenarios in which transthoracic, transesophageal, or stress echocardiography studies might be ordered. Using a process initially developed under the guidance of the American College of Cardiology (ACC), a panel representing broad clinical expertise rated each vignette, categorizing the use of echocardiography in that situation generally “appropriate”, or “uncertain”, or “inappropriate”. The current article was developed with the support of a number of professional organizations that represent providers of diagnostic imaging as well as other specialists who often order diagnostic imaging studies. Similar documents have been, or are being, developed for other imaging modalities besides echocardiography. The relevant processes are described clearly in the document itself.

It seems self-evident that cardiac sonographers and echocardiographers would have a high level of interest in whether echocardiography procedures were deemed appropriate, inappropriate, or of uncertain value in specific clinical circumstances. Hence, while the article by Douglas et al was developed for publication in the Journal of the American College of Cardiology ( JACC ), the editors of JASE thought it important to publish this document jointly in JASE. It is important to note that while more than one journal may co-publish a given paper, in general only one journal (or the organization that owns that journal) can hold the copyright to that article. Optimally, who will own the copyright is decided when an article that might be of interest to different groups is developed jointly. In the case of Douglas et al, the copyright belongs to ACC, and for this reason the responsibility for developing the final version of the paper falls to JACC and its publisher. Any other group wanting to co-publish the paper must publish the exact same content, verbatim. Modifying the style of the article (for example, by using a different typeface or changing the colors used for subtitles) is acceptable; changing the content of the article is not. For this reason, the article is produced for the copyright holder’s journal, and then the same production proof is used to develop “their” final print version by any other journals that have agreed to co-publish.

This means, in effect, that the timing of publication in a second journal ( JASE , in this example) is determined by the timing of production for publication in the first journal ( JACC , in this example). Sometimes this process is a fluid one; if the authors or the publisher make last minute changes in the course of producing a final print version, then the timetable may be delayed, resulting in final publication in a different issue than originally planned. Most important, however, is the point that the second journal cannot proceed with preparing a final print version of the paper until the journal holding the copyright has completed its final version and released this to the other parties who plan to publish it. It is ideal when the article can be released at or near the same time, but since some journals are published every week, while others are published monthly, and still others are published in certain months but not others, aligning publication dates exactly can be problematic.

In any event, by the time you read this Editor’s Page, the article by Douglas et al will have been published in JACC , with the JASE version of the article (with identical content, as just discussed) appearing soon thereafter. In effect, publication of this article in this issue of JASE was determined by the timetable for production and publication of the article by JACC .

At this point you may be wondering why a second long article, “Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications”, by Mor-Avi et al, is also being published in the same issue of JASE ? If you were paying attention earlier, you would know that the answer, again, is “co-publication”. As the title of the article by Mor-Avi et al indicates, a writing group commissioned by the American Society of Echocardiography (ASE) and the European Association of Echocardiography (EAE) developed the document. When development of this expert consensus statement was initiated, the leaders of both sponsoring organizations decided that ASE would own the copyright to this document (EAE will own the copyright to other documents, currently in development). Once the leadership of both ASE and EAE approved the final version of Mor-Avi et al, it became evident that the article would be ready for publication in March 2011. I discussed the timing of co-publication with my friend and counterpart, Dr. Gerald Maurer, who is the new Editor-in-Chief of the European Journal of Echocardiography ( EJE ), and we decided that a March publication would be feasible for both journals. Since JASE owns the copyright for this article, it would be customary and proper for the article to be published first in JASE , and then (as soon thereafter as is feasible) in EJE . In effect, this means that if JASE chose to delay publication of Mor-Avi et al until a later issue (in order to avoid publishing two long articles in one issue), EJE would also have to change its plans for publication.

Perhaps all of this sounds complicated, and you may be wondering why JASE would want to co-publish an article that is being published elsewhere. I can think of several good reasons. First, an article that might be published jointly typically represents the work product of a broad collection of constituents. The expert consensus document on Myocardial Mechanics is probably more broadly based that if a writing group from ASE alone had developed it. Equally important is the fact that co-production (and co-publication) of a document means that the same standards and recommendations apply more broadly; in essence, the recommendations that were developed jointly will apply to practitioners and patients in both North America and Europe. This seems more logical than having both groups develop and publish their own documents in their own journals. When this has been done in the past, not all recommendations have been the same, leading to confusion. A final benefit of co-publication is wider dissemination of the information contained in the document. For example, if the Appropriateness Use Criteria for Echocardiography were published only in JACC and not also in JASE , some physicians and many cardiac sonographers would not have easy access to that article. Publishing it jointly in JASE makes the article more readily available to practitioners of echocardiography, for whom it is most pertinent.

In summary, joint publication of an article in more than one journal does create some logistic complexities in the publication process and does influence the timing of release of the article. Those factors contributed to the decision to publish two long articles in the current issue of JASE . In my view, both of these documents are of high relevance, and it seems likely to me that most readers will not try to digest them carefully at one reading. Rather, I suspect that readers will turn to these documents repeatedly, and use them more as reference sources than as papers to be read once and then left behind. As noted above, the upsides of co-publication are important: development of uniform recommendations that are based on broad input from experts with a variety of backgrounds, and broader dissemination of those recommendations to the practitioners affected most directly by them. I believe that joint publication of these two long papers is a “win-win-win” for practicing echocardiographers and sonographers, our patients, and the sponsoring organizations that commissioned these articles in the first place.

As always, I would be pleased to hear your comments or suggestions, and can be reached at jaseeditor@asecho.org .