Ultrasound Research Part Three: Publication Pearls and Pitfalls

Michael Gottlieb, MD, FACEP, Rush University Medical Center
Lynn Roppolo, MD, FACEP, University of Texas Southwestern Medical Center
Frances Russell, MD, FACEP, Indiana University
Lindsay Taylor, MD, FACEP, Virginia Commonwealth University
John DeAngelis MD, FACEP, University of Rochester
Petra Duran-Gehring, MD, FACEP, University of Florida – Jacksonville
Chris Moore, MD, FACEP, Yale University

Point-of-care ultrasound (POCUS) research is vital to evaluate the diagnostic accuracy and clinical application of POCUS, to advance the field of ultrasound, and to inform future innovations. Publications also serve as a major component used by promotion and tenure committees for academic advancement and can help increase competitiveness for grant funding.¹

While early POCUS research began with case reports, the field has substantially advanced over time. There are many different types of research to consider, and the specific type will often inform the journal to which you submit your manuscript. A summary of common types of ultrasound research is included in Table 1.

Start thinking about where to publish your study as soon as possible, ideally during the planning phase of your study. Waiting until your study is completed to plan for publication may be too late, and it is beneficial to design the study with the end-point in mind. Journals want to publish papers that are meaningful to their readers, that answer clinical questions, can add to the current literature, are appropriately designed and accurately analyzed, and are well-written. Having a good research mentor, thoroughly reviewing the literature, involving a statistician early in the process, reviewing your study design with experienced researchers, and having your manuscript edited by an individual who has experience publishing in the medical literature can help mitigate these fatal flaws in publishing your research. It is also important to review reporting guidelines and use them to inform your study design and manuscript, as these are the criteria utilized by many journals to determine if a study is of publishable quality. The EQUATOR Network is an organization that was established to improve the quality of healthcare research publications and of research itself. Their website contains reporting guidelines for the main study types used in healthcare research.

Once your project has been completed, determine how best to disseminate your findings. While this may initially involve an abstract presentation at a local, regional, or national conference, this form of dissemination is limited to conference attendees and is not valued nearly as much in the academic community as publishing your work in a peer reviewed medical journal.² There are many options available, but it is not always readily apparent which journals are more likely to accept POCUS research. This list continues to expand as a growing number of non-emergency medicine journals are publishing POCUS-related research. A list of potential journal outlets is included in Table 2. This list is not intended to reflect all outlets, but rather provide a starting point for potential submission.

Given the large number of journals available, we have compiled several strategies to help narrow down the list and increase your likelihood of successful publication. First, ensure that the journal aligns with your particular project with regard to content, quality, and readership. For example, general emergency medicine journals may be less likely to publish those isolated to a very narrow POCUS niche than ultrasound-specific subspecialty journals (particularly if the specific application would require advanced training). Similarly, some journals routinely publish case reports and visual diagnosis, whereas others rarely publish these. Successful case reports are generally those with atypical presentations of commonly known pathology or exceedingly rare pathology. The images need to be of excellent quality and patient consent is sometimes required. In order to determine which journal is the best fit, make sure to read the author guidelines and review prior issues for similar submission types.

Next, consider the impact factor of the journal. The impact factor is a measure of how highly cited the journal’s articles are and is an indirect measure of the article’s potential reach. When deciding on journals, you must balance the higher impact factor with the likelihood of acceptance. It is important to keep in mind that there is not a single “right” journal and that many journals will likely be reasonable outlets for your research. Due to the overwhelming number of submissions, many journals quickly screen submissions before sending for peer review. Unfortunately, most submissions are rejected during this initial screening process. This is more likely to occur if the content, quality or readership of the manuscript is not aligned with the journal and is intended to provide the author a quick response so that they may submit elsewhere with minimal delay. If the manuscript is sent for peer review, the feedback from the reviewers may take weeks to months and does not guarantee acceptance. However, this can provide valuable feedback even if you need to resubmit elsewhere. It is critical to review and utilize this feedback to improve your submission before sending to another journal.

Finally, make sure to consider factors such as whether it is open access, has article processing charges, and is not a predatory journal. Open access journals allow all readers to access the article, as opposed to being locked behind a publisher’s paywall. This can increase the reach and potential for citations, as more researchers are able to read your work. While some open access journals are free to publish, many have article processing charges. These are fees paid for by the author or their institution to support the publication costs for open access journals. A particularly problematic scenario is predatory journals, which refer to journals who charge article processing charges but do not perform substantial peer review, are generally not indexed, and do not truly seek to disseminate research findings.³ It is important to avoid these. More junior researchers are advised to ask their mentors or other researchers when unsure if a journal is potentially predatory. Some reputable and legitimate open access journals may waive this fee or charge a discounted fee for invited articles or if they are sincerely interested in publishing your submitted manuscript.

By following these recommendations, we hope to help demystify some of the challenges encountered in submitting articles for publication. This form of scholarly productivity is highly valued by all academic institutions and is how we can continue to advance the field of medicine.

References

1. Gottlieb M, Chan TM, Yarris LM, Linden JA, Coates WC. Promotion and tenure letters: A guide for faculty. AEM Educ Train. 2022;6(3):e10759.
2. Gottlieb M, Ryan K, Alcorn T, et al. From presentation to paper: Assessment of successful abstract publications in emergency medicine over a five-year period. Acad Emerg Med. 2021;28(6):679-82.
3. Hansoti B, Langdorf MI, Murphy LS. Discriminating between legitimate and predatory open access journals: Report from the International Federation for Emergency Medicine Research Committee. West J Emerg Med. 2016;17(5):497-507.

Table 1. Common Types of POCUS Research

Table 2. Examples of Potential POCUS Journal Outlets

*Article Processing Charge