Looking Back

As the workload increased, however, I remembered making a statement to the selection committee when I interviewed in 2005 as a candidate being considered to become the second Editor-in-Chief of JASE. When asked in effect what I would bring to the position of Editor-in-Chief, I clearly recall saying “In my view, it is not about the Editor, it’s about the Journal.” Given that perspective, I thought it best to spend my time working on submitted manuscripts by reading them carefully, considering the input provided by peer reviewers, discussing the manuscripts with my wonderfully accomplished group of editorial colleagues, and working with authors to help them to make their papers “better.” Rather than spending time telling JASE readers about my own opinions, I thought it best to spend my time helping authors to enhance their manuscripts, whether they were published eventually in JASE, or elsewhere. For that reason, I have not written an Editors’ Page for some years.

Now, as my term as Editor-in-Chief of JASE draws to a close, the time has come to share some observations made over the past 10 years. As I did in January 2008, I think it fitting to look back at the Journal’s progress up to this point, and then to look ahead as the responsibility for the ongoing evolution of JASE passes to the new Editor-in-Chief and his team.

Longtime ASE members will recall that the first issue of the Journal of the American Society of Echocardiography was published in early 1988 under the direction of Founding Editor Dr. Harvey Feigenbaum. Twenty years later, when I took over responsibility for the Journal, I wrote that “the ASE exists, and the JASE has become the premiere publication in our subspecialty, because of Dr. Feigenbaum’s extraordinary vision and passion for echocardiography”. In a more recent article that I contributed to ASE’s ECHO magazine, I noted that “Several of us might have been a good choice to serve as the second Editor of JASE, but there was only one right choice for the first Editor.” The Journal entrusted to me in 2008 was, as I described it, ‘a well-established journal that is already widely recognized and acclaimed.’ My initial goals were to “continue to give high priority to original clinical research describing advances that lead to improved patient care. We will also continue to publish preclinical articles that describe important and novel research findings that we believe ultimately will lead to new approaches to diagnosis or treatment. We have high interest in timely state-of-the-art reviews of topics of general interest to our readers.” In the past 10 years, we have found no reason to change those goals. Since echocardiography is a dynamic modality that involves moving images of the beating heart, we also indicated our intent to provide a means to include video clips, when appropriate, in any article. A related goal was to provide a means to print color images on every page of the Journal, at no charge to authors, since some of the modalities we use on a daily basis involve color displays of blood flow, myocardial velocities, and, more recently, strain curves. With the help of our publisher, Jane Grochowski of Elsevier, we were able to meet these goals.

As submissions to JASE grew during its first 20 years, the Journal also grew. Initially published on a bimonthly schedule, JASE began to evolve in 1997 toward a monthly publication; volume 11, published in 1998, was the first to include 12 issues. In 2008, I estimated that during the first 20 years, Dr. Feigenbaum reviewed at least 6,000 manuscripts submitted by prospective authors. During the past 10 years, the current editorial group has reviewed almost the same number of submitted manuscripts. This increase in the rate of submissions is particularly noteworthy when considered in light of two points. First, while in its early days many case reports were published in JASE, in 2010 the editors and I decided–after much discussion–to stop publishing case reports so that we could focus on full-length original scientific reports and relevant review articles on topics of interest. As a clinical cardiologist who has used echocardiography to take better care of my patients over a 40-year career, I am well aware that we all learn from the cases we have seen. As an educator, I know that the findings from an interesting case can be an extremely effective means of teaching. I am delighted that earlier in 2017, ASE was able to launch CASE (Cardiovascular Imaging Case Reports), a new e-journal, and I believe that this is an important addition to ASE’s educational offerings. However, as a wave of “multimodality imaging” journals appeared on the scene about 10 years ago, the editors and I thought it particularly important to provide a place where novel applications of echocardiography (especially those where technical details were key) could be published. When my term as JASE Editor-in-Chief began, there were a total of 74 journals in the “Cardiac & Cardiovascular Systems” category; at last count, this same category now includes 126 journals. Despite increasing competition and our decision to focus on author-initiated original research, submissions have increased over time, and continue to grow.

Changes in the way that information is exchanged also influenced our operational structure. The development of an online submissions mechanism in the years before I came on board allowed us to work in an electronic format and abandon “paper-based” submissions and communications by mail or fax. This meant that I could communicate electronically with colleagues, and that editorial “meetings” did not require that a group of associate editors had to sit in the same room in order to discuss the strengths and weaknesses of articles being considered for publication while looking over piles of paper-based manuscripts. The ability to communicate easily and inexpensively by email and phone, and the capacity to hold teleconferences, meant that I could choose the best experts to assist and advise me, regardless of where they were located. Over time, Victor Mor-Avi took on the important role of Deputy Editor, while Jules Gardin, Jeff Stevenson, Alan Waggoner, Sherif Nagueh, Brian Hoit, Jonathan Lindner, Wyman Lai, and Philippe Pibarot became members of a remarkably savvy group of Associate Editors. This arrangement has been exceptionally beneficial. The wise counsel of these colleagues has enhanced the quality of the feedback we provide to prospective authors, and their contacts in our field have allowed us to expand our pool of knowledgeable physicians, sonographers, and scientists from less than 700 peer reviewers, at the start of my term, to more than 2,000 at present.

For a variety of reasons, I thought it appropriate to locate the JASE Editorial Offices at ASE Headquarters in North Carolina, rather than across the country in Seattle where I live and work. This has facilitated our interaction with ASE’s activities in continuing medical education, development of standards, and implementation of the Society’s strategic goals, since JASE staff interact on a daily basis with other ASE staff. After some turnover in the JASE Editorial Office staff in the initial years, Debbie Meyer became JASE Managing Editor in the spring of 2013, and she has provided stability, effective oversight, and enhanced communications with authors, reviewers, and editors.

While JASE has evolved, so has our competition. In 2008, a total of 4 cardiac “imaging” journals were listed among the 74 journals in the Cardiac & Cardiovascular Systems category. By 2017, this same category had grown to 126 journals, including 9 journals focused on cardiac “imaging”. Several “multi-modality imaging” journals arrived on the scene about 10 years ago, and on more than one occasion I was asked the following question: “When is JASE going to change from an ‘echo’ journal to a multi-modality imaging journal?” My answer was generally along the following lines – “JASE is the official journal of the American Society of Echocardiography, and if ASE decides that it ought to reinvent itself as a multi-modality imaging society, then I suppose the Journal will follow suit.” I never thought that the journal ought to drive the direction of the Society that owned the journal–quite the contrary. Moreover, I believe that while understanding the strengths and limitations of all imaging modalities (they DO all have strengths AND limitations, after all) is important, and while considering which test would be best to address specific concerns in a given patient is also important, one cannot interpret images unless one has a good understanding of the technical nuances involved in creating those images. It is not clear to me that any one individual can have real expertise in three or four or five different imaging modalities, and I believe that there is merit in being truly expert in one discipline rather than “reasonably knowledgeable” in several disciplines. In addition, since echocardiography is widely available, non-injurious, and useful in virtually every form of cardiovascular disease, I believe that there is–and will be–a continuing need for technical as well as clinical expertise in echocardiography. The fact that submissions to JASE have continued to grow despite increasing competition seems to support my belief that there is a place for an “echocardiography” journal. This does not mean that the JASE editors want to publish only narrowly focused articles that deal exclusively with echocardiographic techniques and applications. To the contrary, we think it is important to compare echocardiographic findings with other modalities, perhaps as independent reference standards, or to compare the relative strengths and shortcomings of the different modalities in order to understand more clearly when one test, or another, would be most useful. However, we see plenty of good “echo research”, and we believe that ongoing technical improvements and innovations in ultrasound technology are likely to broaden, not narrow, the uses of echocardiography.

The success of Journal can be measured in many ways; some are probably more meaningful than others. The number of submissions might be one such metric; between 2008 and 2016, we witnessed a 20% increase in submission of original scientific articles to be considered for publication in JASE, and 2017 has been our busiest year yet. Another “quality indicator” that is sometimes discussed is the acceptance rate; proponents of this metric consider that the lower the acceptance rate, the more selective the journal and therefore the higher its quality. I have never been a fan of this metric because I’ve always believed that the quality of content in the journal is determined by the articles published, rather than by the number of articles rejected. To illustrate my point, if I wanted to lower the acceptance rate, I could (hypothetically) ask my friends to submit poorly written, scientifically questionable papers of little practical interest in order to inflate the number of submissions; I could then quickly reject these, which would have the effect of lowering our acceptance rate. This would do nothing to improve quality, of course. For those who are interested, nevertheless, our acceptance rate was around 30-35% early in my term as Editor-in-Chief, and has since fallen to close to 20%. I believe this indicates that JASE is focused on publishing high-quality papers, but is not so “exclusive” that authors should be afraid to submit their work for our consideration.

A third measure of success is the ranking of JASE among other journals in the same general scientific discipline. In 2008, JASE ranked 32 ^nd of the 74 journals in the Cardiac & Cardiovascular Systems group. The most recent data, released last June, indicates that JASE is now ranked 13 ^th out of the 126 journals in the same category; only one “imaging” journal is ranked higher. All of this is to say that as 2017 draws to a close, the position of JASE as a well-established and respected scientific publication has been solidified. As I noted in ASE’s recent ECHO magazine, “readers who want to keep up with ‘what is current’ in echocardiography find it important to read JASE, and authors who want to reach the ‘echocardiography’ audience find it desirable to publish in JASE.”