Editor’s note: This editorial concludes a two-part series on open access journals and predatory journals. The first editorial appeared in the January issue of AAOS Now.

Over the past several years, the orthopaedic literature has absorbed an avalanche of new journal offerings, many utilizing an online-only, open access format. Many are legitimate and useful scientific vehicles, often sponsored by a major orthopaedic subspecialty organization. Unfortunately, others represent predatory publishers with poorly vetted content. Here, we continue our discussion of these publications and offer some guidance in differentiating the results of solid peer review versus shoddier practices.

Technical underpinnings

A publisher has few barriers to entry when starting a new journal. For example, Open Journal Systems is open source software that allows rapid creation and easy management of scientific journals by one person on one computer.

Traditionally, medical professionals and researchers have used indexing services such as PubMed to identify studies relevant to their areas of inquiry. More recently, Google Scholar has been a convenient way to retrieve similar information. Although Google Scholar has the advantage of indexing 80 percent to 90 percent of all articles published in English, it has been criticized for not vetting the included journals. As a result, predatory journals can be found there. PubMed, started by the U.S. National Library of Medicine in 1996, indexes 500,000 articles a year, but it may not include as wide a range of journals as Google Scholar. More recently, Index Copernicus was established to offer an “alternative to the English-language dominance of publication indexing systems,” but it also has been criticized for including many predatory journals.

One proxy for a journal’s quality is its impact factor, which relates to the average number of times an article in that journal has been cited elsewhere in the scientific literature. For example, the journal Nature’s high impact factor of 41 means that the average Nature article has been cited 41 times. By attracting higher-quality submissions and garnering high-level peer review, prestigious journals publish high-level research, which warrants widespread citation, thereby confirming the quality of the journal.

The “real” impact factor for indexed journals is published annually by Clarivate Analytics (previously Thomson Reuters) in Journal Citation Reports. More than 8,000 scientific journals are included. A new journal must have published at least two full years of issues to receive its first impact factor. Therefore, even many sound journals are too new to have an impact factor.

Typically, a journal’s impact factor for a given year is published in June of the following calendar year. As a result, a new, nonindexed predatory journal will not be able to promote its impact factor to potential authors. Yet, in 2015, Mehrdad Jalalian, MD, published an account of his investigations into the rapid growth of “fake impact factors”—such as Scientific Journal Impact Factor, Global Impact Factor, and Journal Impact Factor—instead of “real” impact factors issued by Clarivate Analytics, called the Universal Impact Factor. Of course, some predatory journals simply make up impact factors. Orthopaedic surgeons, especially those who are primarily clinicians and not researchers, are not well positioned to identify such frauds.

According to Rupp et al., biomedical research is especially vulnerable to predatory publishing because a rapid increase in knowledge has contributed to new specializations and subspecializations. These, in turn, have given rise to a huge increase in biomedical scientific journals. In addition, medical research is particularly demanding and time consuming due to the extra work required to collect data from human samples or participants and permission from ethical and institutional authorities. Yet, many of the individuals involved often have other responsibilities, such as clinical, teaching, or administrative duties. These same time challenges also affect the peer-review process, slowing it down considerably.

Why does predatory publishing matter?

As with patients’ online research of their conditions and treatment options, “the rise of predatory journals in the internet era gave birth to another problem of searching relevant authentic information in a vast sea of heavily contaminated, fake, plagiarized, or manipulated data in the name of biomedical researches,” according to an article by Sharma and Verma.

The similar names of some publications can easily confuse anyone—from a community orthopaedic surgeon trying to understand the value of an article to an academic promotion committee trying to gauge an article’s potential impact.

When a naïve researcher is duped into publishing legitimate work in a predatory journal, the journal’s transient nature and lack of indexing will render the data unavailable to other scientists. Even journals that manage to exist for a few years have no clear policy for archiving past content. Christopher M. Bono, MD, Harvard professor and editor-in-chief of The Spine Journal, admitted that even he was fooled by a predatory journal.

Predatory journals are more likely to pursue other unethical practices, such as delaying or burying legitimate work to allow predatory reviewers to “steal” data or study ideas and publish them elsewhere. Also, some journals encrypt their material in order to hide plagiarized content, which makes legitimate data published through such journals nearly impossible to access.

Ultimately, predatory practices muddy the waters for science in general and medicine in particular. From people who deny global warming on the right to anti-vaxxers on the left, there appears to be an epidemic of “fake news” in science now. As medical library science specialist Jeffrey Beall noted, predatory journals have routinely published “advocacy research,” whereby questionable scientific methods that would not typically pass peer review are used to reach conclusions supporting a particular political, religious, or social agenda. This can take the form of the asbestos industry reporting on the safety of the material to efficacy claims about new treatments in an attempt to woo investors or gray market care.

A variety of hoax submissions to predatory journals have been covered in the lay media. For example, in 2013, John Bohannon submitted to 304 predatory journals a hopelessly flawed, error-ridden study describing the benefits of a new cancer drug under the name of an imaginary African researcher affiliated with an imaginary institute in Eritrea. A total of 157 journals either processed the manuscript for further review or immediately accepted it for publication.

As Gina Kolata reported in The New York Times, a group led by University of Sussex School of Psychology researcher Katarzyna Pisanski reported on a similar sting operation in Nature. In that case, the authors created a fake scientist with a list of fake degrees and publications. Her name, Anna O. Szust, means fraudster in Polish. Ms. Kolata wrote that, in Ms. Szust’s name, the authors “applied to 360 randomly selected, open access academic journals asking to be an editor, 48 accepted her, and four made her editor-in-chief. She got two offers to start a new journal and be its editor. One journal sent her an email saying, ‘It’s our pleasure to add your name as our editor in chief for the journal with no responsibilities.’” Other publishers relayed lucrative offers such as the suggestion that she “organize a conference, whose papers would then be published; she would get 40 percent of the proceeds. Another invited her to start a new journal and offered her 30 percent of the profits.”

Many similar stories have received attention in the lay media, including a physics paper written by a nonphysics professor using Apple’s autocorrect feature and a group of MIT students getting their paper, created with a random number generator, accepted in a predatory math journal. Unfortunately, recent stories have included more than 120 retractions of randomly generated papers from respected publishers such as Springer and the Institute of Electrical and Electronic Engineers. Together, these stories have the effect of reducing lay readers’ confidence in the scientific method. Most readers do not understand peer review or the differences between types of journals and articles. Losses of patients’ and society’s trust and respect are key contributors to physician burnout. By hacking away at the very scientific underpinnings of allopathic medicine, predatory journals contribute significantly to this process.

There are, of course, other potential repercussions, such as unethical manufacturers’ misuse of invalid medical data to support their propriety therapies as evidence based. Research is cumulative and builds on a base of previous work. If previous work is fraudulent or error ridden, the ensuing work, no matter how well intentioned, will be compromised as well.

How do you tell?

Others have attempted to anonymously maintain Mr. Beall’s now-defunct blacklist of predatory journals. Yet, given the rapid changes in both legitimate and predatory publishing, such lists tend to be out of date and incomplete. Commercially available blacklists of predatory journals are now available. However, costs and lack of awareness limit their use by inexperienced researchers and those from low-income countries.

It might be more effective to check a “greenlist” of quality journals from which to cite and to which to submit. The Directory of Open Access Journals (DOAJ) maintains such a list. As of January 2017, it contained 9,456 legitimate open access journals from 128 countries. However, some nonpredatory journals have not yet made it on the list.

In October 2018, Mr. Rupp and his colleagues published a greenlist of high-quality orthopaedic journals in International Orthopaedics. They included 130 journals from the DOAJ and 96 from Thomson Reuters citation reports. Their article also offers a table of web-based resources to help readers and researchers alike detect predatory journals.

Mr. Rupp quotes other studies whose cross-sectional comparisons between potential predatory journals and legitimate open access and subscription-based journals led to proposed characteristics of predatory journals:

• Fees: Predatory journals offer an 18-fold lower article-processing fees than legitimate ones, often less than $150. Of course, once a manuscript is accepted, actual publication fees will be much higher.
• Indexing: Most are not indexed in MEDLINE, Web of Science, or Scopus.
• Editing: Sixty-six percent of predatory journals contained spelling mistakes compared to 6 percent in legitimate journals.
• Editorial board: Often, no individual editor is named, or the owner/published is presented as the editor-in-chief of multiple, disparate journals. When an editorial board is listed, the members often hail from different countries. Although this gives the journal an international look, the lack of background information or affiliation of editorial members is intentionally confusing. In one study, 73 percent of predatory journals had editorial boards whose members could not be identified. This was true only 2 percent and 1 percent of the time in open access and subscription-based journals, respectively. Sometimes, prominent scholars are named on these boards without their knowledge or permission.
• Promises of rapid publication: Predatory journals may attract young researchers, especially those with promotion committee deadlines, by ensuring them a fast review cycle, typically within a month. An extra fee can be charged to further reduce review time to a day or a week.
• Ethics and manuscript handling: Although some predatory journals carry logos purporting use of the guidelines from and participation with the Committee on Publication Ethics (COPE) or similar journalistic ethics organizations, the journals in question can’t be found on the COPE website.
• Appealing, important-sounding journal titles, including words such as global, international, universal, Asian, American, or European: On closer inspection, the journals will offer no society affiliations or editorial board membership to support their titles.
• Ancillary offers: Submissions may come with invitations to join an editorial board or even become an editor-in-chief. Often, authors are offered incentives to get their colleagues to submit or are offered speaking opportunities at predatory conferences.

Following the Fifth World Congress of Research Integrity in May 2017, representatives from the Association of Learned and Professional Society Publishers; DOAJ; Ligue des Bibliothèques Européennes de Recherche; Open Access Scholarly Publishers’ Association; International Association of Scientific, Technical, and Medical Publishers; individual publishers; and others initiated the global “Think. Check. Submit.” campaign. Along with the issues mentioned above, they recommend researchers and scholars look up the intended journal on PubMed, DOAJ, COPE, or other websites. They also propose asking a few questions about the journal:

• Do you or your colleagues know the journal?
• Have you read any articles in the journal before?
• Is it easy to discover the latest papers in the journal?
• Can you easily identify and contact the publisher?
• Is the publisher’s name clearly displayed on the journal website?
• Can you contact the publisher by telephone, email, and post?

Conclusions

For modern science, and medicine in particular, the internet has been a mixed blessing. The dissemination of information has never been easier, faster, or more convenient. Unfortunately, this great tool also is used by unscrupulous individuals seeking to enrich themselves by collecting article publication fees or selling poorly supported therapies. From believers in a flat Earth to dubious stem cell clinics, it has never been easier to publish in legitimate-sounding but pseudo-scientific venues.

As orthopaedic surgeons, it is incumbent on us to recognize potentially predatory journals and appropriately discount any data or conclusions arising from them.

Eeric Truumees, MD, is the chair of the AAOS Now Editorial Board, editor-in-chief of AAOS Now, and an orthopaedic spine surgeon in Austin, Texas, where he is also professor of orthopaedics at the Dell Medical School, University of Texas.

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