New Directions for the ARCHIVES

IN THIS issue of the ARCHIVES, we publish our revised instructions to authors. There are a number of changes and new features we would like to call to the attention of both prospective authors as well as our readers.

• Improving the timely reporting of important new findings. We continue to work at decreasing the time between manuscript submission, acceptance, and publication in the ARCHIVES. We encourage authors to submit manuscripts electronically, allowing us to send the electronic copy to peer reviewers, which should facilitate the process. In addition, we will be instituting Archives Express. This will provide a rapid, expedited peer review, processing, and publication of articles with great clinical or public health importance. Studies eligible for this expedited process are those of high scientific quality that might have an immediate important effect on the health of children and adolescents. A number of steps are required to achieve this rapid publication of studies. First, authors should contact the editors by e-mail at apam@u.washington.edu about submitting a manuscript to Archives Express and send a draft of the manuscript for informal review. Within 2 days, the editors will notify the authors whether the manuscript is appropriate for Archives Express, and if so, ask that the manuscript and all appropriate forms be formally submitted. We will ask peer reviewers to complete their reviews within 5 working days and in turn ask authors to have an equally rapid response to these comments. We believe that Archives Express will help to provide our readers and the public with rapid information on rigorously peer-reviewed articles of the most important studies in pediatrics.

• Changes to improve methodological rigor and quality of published studies. The essence of any journal is the scientific methodological rigor and quality of its published studies. These new guidelines require authors to follow a standard format in reporting results of randomized controlled trials. At the journal, we take our responsibility to safeguard against inappropriate analyses seriously. The ubiquitous availability of computers and statistical programs increases the likelihood of inappropriate analyses, and all-too-great an emphasis on the magic "P<.05." We specify new guidelines for statistical testing and have added a statistical consultant, Peter Cummings, MD, MPH, to insure the validity and clarity of what we report.

• Improving clinical decision making. One of the main goals of the ARCHIVES is to help clinicians provide the best possible care to our patients. Increasingly, numerous—and at times conflicting—studies address important clinical topics, challenging readers who struggle to remain informed on current issues. A new section of systematic reviews will endeavor to identify and critically appraise all the relevant literature on a topic and summarize it in a clear objective fashion. In addition, a new series on clinical problem solving will combine our popular features, such as "Picture of the Month," "Radiological Case of the Month," and "Pathological Case of the Month," in the context of a single case. Our aim is to demonstrate the thinking process of a master clinician involved in approaching a patient with an unknown illness. The discussions of such cases will attempt to place the clinician's expertise into the context of the prevailing medical literature on the topic.

• Enhanced readability. Two new formatting details are intended to help busy clinicians determine the content of the journal of most interest to them. "This Month in the ARCHIVES" will provide brief outlines of a few of the more important articles found within the journal's covers. In addition, a box will now accompany each original contribution. Written by the authors themselves, this box will succinctly answer 2 questions: "What is known on this topic?" and "What does this study add?" The medical literature is an ongoing dialogue between past and present. We expect new studies to add to previous ones and would like our authors to communicate this directly to our readers.

• Evidence-Based Journal Club. The peer review process is but one step in the critical path of improving the care of patients through the publication of research. Equally important is the postpublication process of evaluating the validity and applicability of a study's findings. Ultimately, providers must decide individually or collectively how or if to apply given results to their patients. Starting next month, the ARCHIVES will begin an occasional feature called "Evidence-Based Journal Club." This feature will serve several purposes: (1) to foster dialogue about an article's merits with structured critiques of important studies; (2) to help readers develop their critical appraisal skills; (3) to provide teachers with models of using evidence-based medicine (EBM) in residency-based journal clubs; and (4) to provide readers with a sense of the usefulness of the worldwide Web in performing EBM reviews. Working with residents at various teaching institutions, faculty with expertise in epidemiology and biostatistics will systematically review a study and present their opinions to a set of pertinent methodological questions. In addition, we will attempt to use the Web in novel ways to provide readers with the tools they need to conduct such reviews on their own. Ultimately, using the power of the Internet, we hope to expand participation to a large portion of our readership, creating a national virtual journal club.

• Author accountability. We have long required authors to attest that they take responsibility for the contents of their submission and to disclose any financial conflicts of interest. In our revised instructions to authors, we are now asking in addition that authors disclose to us their specific contributions to the study and to the manuscript. The issues of scientific integrity are much in the public's consciousness. The days during which authors were added as a "gift" to help young faculty or because the work was carried out in a senior faculty's laboratory or program are long over. The ARCHIVES has also limited the number of authors to 6. By asking authors to tell the editors their specific contributions to the study, we are further assuring the readers of the scientific integrity of the work.

• Inspiring as well as enlightening the reader. Our readers are busy professionals who work to improve the health of children and adolescents. The ARCHIVES helps achieve this goal primarily by providing new information on preventing, diagnosing, and treating illnesses. A scientific journal should also provide inspiration and enjoyment. We hope to enhance these qualities with a number of new and expanded features. Our book review section is being expanded to include reviews of other media and of books that enlighten us in different ways regarding the care of children and adolescents. We will be publishing poetry and will institute an "On My Mind" section of essays that capture heartfelt feelings or insights experienced while caring for children and adolescents.