The editors-in-chief of two of the world’s highest-impact general medical journals are weighing in to defend the time-tested, independent process that they and their colleagues use to “vet, challenge, and advance science.”
Kirsten Bibbins-Domingo, PhD, MD, MAS, editor in chief of JAMA® and the JAMA Network, joined with her counterpart at The New England Journal of Medicine, Eric J. Rubin, MD, PhD, to explain how the longstanding system of independent editorial review helps ensure scientific rigor and enables evidence-based advancements in health care.
“This is not just a system that works—it’s one we must defend,” the two editors wrote in an op-ed published last week in The Washington Post.
“Science advances because its toughest critics—scientists—demand proof,” they wrote. “This is an uncompromising standard that does not bend to untested assumptions, authority or trends. We know this not only as leaders of top medical journals but also as physicians and scientists who have worked for decades to ensure that our own work meets the bar for scientific publication.”
The op-ed comes in the wake of Health and Human Services Secretary Robert F. Kennedy Jr.’s recent threat to bar government scientists from publishing in JAMA, The New England Journal of Medicine and other top medical journals in favor of government-run, in-house publications.
Pressure-testing the science
In the op-ed, Drs. Bibbins-Domingo and Rubin outlined for a general audience how the process works, noting that it “starts with selectivity and scrutiny.” Each year, they added, “millions of scientific papers are submitted to journals worldwide,” yet only a small fraction “meet high methodological standards and have clear potential to influence clinical decision-making.”
The op-ed also details the peer-review process that is designed to be a pressure test, “not a rubber stamp,” of a study’s results and explains the amount of editing medical journal editors do to work with authors to ensure that findings are “communicated precisely, with appropriate cautions and with utility for practicing clinicians and researchers.”
That process often involves “substantial editing and, when warranted, tempering or even reversing the authors’ conclusions based on feedback gained during the review process. The goal is to publish not only facts but also applicable findings to improve care, without compromising rigor.”
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Ensuring integrity
None of these efforts are possible, says the op-ed, “without editorial independence.” And while research funded by industry may create problems, it is a reality in a world where government cannot and will not fund all the medical research that is needed.
“Medical journals didn’t create the problem of industry-funded research, but they are a critical safeguard against the bias that would exist if funders were the gatekeepers through which science is communicated,” says the op-ed. “Though funding might influence what is studied, it should never dictate how research is judged—nor how it is communicated to physicians, patients and the public. Independent journals protect that boundary by applying the same rigorous and transparent standards to every study, no matter who has paid to conduct it.”
The editors-in-chief added that competition among independent journals such as theirs to publish the best research “reinforces rigor and creates essential checks and balances.” They noted that their two journals “represent but a small fraction of the hundreds of high-quality general and specialty medical journals.”
Only permitting government scientists to publish in a government-run journal, says the op-ed, “would undermine these safeguards, risking the politicization of the scientific review process and resulting in the filtering of evidence through ideology.”
Dr. Bibbins-Domingo, a cardiovascular disease epidemiologist, took the helm at JAMA and the JAMA Network in 2022. Along with JAMA, 12 other journals comprise the JAMA Network.
This year, JAMA Network introduced JAMA+ AI, a new channel for physicians and other health professionals to understand the latest research, findings and applications related to AI. JAMA+ AI features curated content from across JAMA Network's 13 journals.
