While it will be February 2010 by the time that you read this Editor’s Page , I am writing it as 2009 winds down. It seems fitting to me, as I finish my second year as Editor-in-Chief of the Journal of the American Society of Echocardiography (JASE), to reflect back on what we have accomplished in the past year, and also to look forward in anticipation of implementing a few new “improvements” in JASE in the New Year.

The process of reviewing, selecting, and publishing manuscripts is more complicated that I would ever have imagined, but one thing is crystal clear— it all starts with submissions of manuscripts for our consideration. We can only publish in JASE manuscripts that are submitted to JASE— so having a sufficient number of manuscripts of quality submitted for editorial consideration is an absolute prerequisite for our success. In the past year, several notable new “Imaging” journals have come upon the scene, and these new competitors have excellent “bloodlines”. It would be naïve to think that authors who wished to publish their work in peer-reviewed journals did not consider carefully the choices of journals to which they might wish to send their manuscripts. In spite of the increased competition, when the final statistics are counted for 2009, I believe that the total number of manuscripts submitted to JASE will exceed the number of submissions in the preceding year. More importantly, if we exclude article types such as Case Reports, Editorial Comments, Letters to the Editor, and Review articles, the number of submitted Original Investigation manuscripts—which reflect the results of innovative clinical or laboratory research— will also be at or above the number of comparable articles submitted in 2008.

As I have written in a previous Editor’s Page , a journal’s acceptance rate (the percentage of manuscripts submitted that the journal ultimately accepts for publication) is a commonly expressed measure that some consider to be a surrogate for “quality”. The underlying concept is, of course, that the “choosier” the journal, the “better” the journal. I believe this concept to have significant flaws. For example, if a hypothetical journal was to receive 100 poor quality submissions for consideration in a given month and was to accept 10 of these for publication, the acceptance rate would be a very exclusive 10% but the journal would have published 10 poor articles! On the other hand, if another journal were to receive only10 superb articles for consideration in a given month and were to accept all of them, then the acceptance rate would be a very unselective 100%, but the journal would have published 10 excellent papers. One can always find ways to manipulate fractions, and for that reason I do not put too much stock in acceptance (or rejection) rates. Nonetheless, JASE’s acceptance rate has declined over the past several years, and the editors and I believe that we are appropriately selective in choosing manuscripts for publication.

While the quantity of new submissions has remained strong, the editors and I have the sense that the quality of manuscripts also may be improving. We are not unbiased observers— we certainly would like to think that the quality of papers we receive is steadily rising— but we do believe that on subjective grounds the general level of quality is increasing. Ultimately, measuring the quality of a journal in objective terms is a difficult task at best. One popular way to do this is by tabulating the frequency with which articles published in the journal are cited in the scientific literature— the idea being that more important articles are cited more widely by other authors. The journal’s Impact Factor (which, in simple terms, can be viewed as a numeric expression of the number of times an average article is cited during a two-year window) is reported annually, and many observers look upon this as an indicator of the journal’s “quality”. I am pleased to note that JASE’s Impact Factor has risen consistently since 2003. I would be remiss, however, if I did not make a few related observations. First, and foremost, the timeframe for the impact of a journal’s Impact Factor to be felt is a very long one. Consider, for example, an article published in this issue of JASE. Although the article appears in early 2010, almost certainly the initial manuscript was written in 2009 or perhaps even begun in 2008. The work that ultimately led to the manuscript may well have begun a few years earlier. The frequency with which this 2010 publication is cited will “count” toward the journal’s Impact Factor— but only when it is cited in publications appearing in 2011 and 2012. Therefore, citations of articles published in 2010 will first affect the 2012 Impact Factor, which will be made public in June 2013. In effect, this means that it takes many years for the impact of a given article to influence the journal’s Impact Factor. The JASE Impact Factor for 2008, which was announced last June, reflects citations to articles published in JASE in 2006 and 2007— before I was Editor-in-Chief of the Journal ! Stated differently, while I am delighted that JASE’s Impact Factor has grown steadily over the past 6 years, the credit for this goes to Dr. Harvey Feigenbaum, who ably steered the Journal over its first 20 years.

We have made significant efforts to include new types of content in JASE over the past year. As readers will have noted, we have made a commitment to publish quality articles for which readers could earn credits for continuing medical education (CME) by studying the articles carefully and answering questions correctly. During 2009, we published a total of 10 CME articles in JASE. Since physician echocardiographers and cardiac sonographers are expected to remain knowledgeable about advances in echocardiographic techniques and applications, earning CME credits has practical value to readers of the Journal . We are pleased with the interest level that our CME articles has engendered, and we believe that we are well on our way to providing at least 10 CME articles in 2010.

The editors have also made a concerted effort to include occasional State of the Art Review articles in issues of the Journal . One such example is the excellent review article on Patent Foramen Ovale, by Marco Di Tullio, MD in the current issue of JASE. We plan to publish similar articles, on topics of high interest to both clinicians and investigators, in future issues of the Journal — assuming, of course, that somebody writes those review articles and submits them to us! We have invited a number of State of the Art Review papers, and to our surprise and pleasure, we occasionally receive excellent author-initiated Review papers as well.

A third type of article that we have tried consciously to include in JASE is the Editorial Comment. We believe that readers find it helpful to be able to place in context the importance and relevance of new scientific reports— and while we always encourage authors reporting the results of their own original investigations to discuss their findings in light of existing literature, it is often difficult for them to step back from their own work and to place it in context. We believe that balanced Editorial Comments, written by knowledgeable experts, help provide some relevant background and to point out, where possible, impediments to implementation of new concepts in clinical practice, or additional questions that will need to be answered through future research. In Medicine, our search for truth is usually incremental— and we believe that Editorial Comments have helped to place incremental advances in proper perspective. We were able to publish a total of 28 Editorial Comments in 2009, and intend to continue this practice.

One additional type of article that we would like to include in future issues of JASE is the practical, down-to-earth article emphasizing how to optimize the echocardiographic evaluation of common cardiac disorders. We believe that a significant segment of our readership— cardiac sonographers and practicing physicians alike— is interested not only in hearing about new developments such as three-dimensional transesophageal echo and left ventricular twist mechanics, but also in learning “technical tricks” so that they can better evaluate bread and butter issues such as valvular regurgitant severity, diastolic function, and regional dysfunction in the hard to image patient, to give just a few examples. We would love to review and consider articles written from a very practical point of view, ideally with significant input from teams of experienced sonographers and physicians. We have several mechanisms for publishing such articles, and would hope to include them, when appropriate, for CME credit. We have a few new ideas about how to make these kinds of papers a reality, and hope to publish some examples of this genre later in the year.

Working with Elsevier, our publisher, we continue to make some improvements in the “look and feel” of the Journal. We believe that an imaging journal ought to include high quality images, and now have the ability to include more than a single interesting illustration on the cover of each issue. We believe that in our field, sometimes a picture is truly worth a thousand words, and the cover illustrations are selected to stimulate readers’ interest and to encourage them to open the journal and read the articles therein. We are delighted with the ability to include color illustrations in JASE without charging authors for the production costs, and believe that the more widespread use of color illustrations has made the Journal more effective and visually attractive. We will also be using colors more often within the text and tables of articles, in order to highlight important sections and to make complicated tables easier to follow.

I am especially fortunate to work with such able colleagues, and thankful for their wisdom and guidance. I am delighted that Deputy Editor Victor Mor-Avi, PhD, FASE, and Associate Editors Julius M. Gardin, MD, FASE, Jonathan R. Lindner, MD, FASE, Sherif F. Nagueh, MD, FASE, J. Geoffrey Stevenson, MD, FASE, and Alan D. Waggoner, MHS, RDMS have agreed to continue their work as editors of JASE. They bring an incredible amount of insight, energy, and expertise to our editorial discussions, and make my job infinitely easier. From time to time, I continue to call upon Founding Editor Harvey Feigenbaum, MD, FASE for his wisdom and fatherly advice, and also appreciate the counsel of Senior Consulting Editors Bijoy K. Khandheria, MD, FASE, Donald C. Oxorn, MD, and Stephen G. Sawada, MD. Our Statistical Editors, Lydia C. Brumback PhD and Robyn L. McClelland, PhD and their colleagues have provided insightful advice on many manuscripts in which complex statistical analyses required expert evaluation. Our CME Editors Rebecca T. Hahn, MD, FASE and Priscilla J. Peters, BA, RDCS, FASE have made our successful CME program a reality, and have in addition made sure that we follow carefully the stringent rules of the Accreditation Council on Continuing Medical Education. Last, but surely not least, credit for the efficient and congenial operation of the JASE Editorial Office in Morrisville, NC goes to Editorial Assistants Chelsea Flowers and Cathy Kerr. JASE truly is a team effort, and I am lucky to have such a good team to depend upon!

Looking back, it seems to me that 2009 was a very good year for JASE. Looking forward, I am optimistic that 2010 will be at least as good, if not even better. I hope that the New Year is a healthy, happy and productive one for all of our readers. As always, if you have comments or suggestions, I can be reached at jaseeditor@asecho.org .