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Continuing the Terra Firma and Establishing a New EQUATOR for Anesthesia & Analgesia

Pittet, Jean-François MD; Vetter, Thomas R. MD, MPH

doi: 10.1213/ANE.0000000000001304
Editorials: Editorial

From the Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

Accepted for publication February 16, 2016.

Funding: University of Alabama at Birmingham, Department of Anesthesiology and Perioperative Medicine internal funds.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Thomas R. Vetter, MD, MPH, Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, JT862, 619 19th St. South, Birmingham, AL 35249. Address e-mail to

“Change is inevitable. Change is constant.”

—Benjamin Disraeli (1804–1881)

Anesthesia & Analgesia has been continually published by the International Anesthesia Research Society (IARS) since 1922, and the Journal celebrated its rightly so-coined 90th “Silicon Jubilee” in 2012.1 As the storied history of Anesthesia & Analgesia enters its next chapter, changes are inevitable. We would like to take this opportunity to highlight some of these changes, which seek to continue the proverbial terra firma (solid ground) of the Journal, while establishing a new equator (reference point) for it.

However, we want to first acknowledge the outstanding efforts of Steven Shafer, the out-going Editor-in-Chief of Anesthesia & Analgesia. During his decade-long tenure, Dr. Shafer worked passionately and tirelessly not only to enhance the stature and impact of the Journal, but also to ensure the quality and the integrity of the science it published. Leading by example, Dr. Shafer perpetually displayed enthusiasm and optimism and fostered both intellectual rigor and collegiality.

In 1858, Louis Pasteur introduced the methods section of the scientific report, creating what is referred to as the IMRAD (Introduction, Materials and Methods, Results, And Discussion) format.2,3 Not surprisingly, in the interim heady 150 years, as investigators have applied various research study designs, there has been wide variability in their application as well as in the content and organization of their published reports.

In response, a plethora of guidelines for study design and reporting of research findings have been promulgated.4 The sheer number (currently an estimated 284a) and the pervasiveness of these guidelines have prompted the observation that “a cynic might be forgiven for thinking that there are now so many publication guidelines that nobody can keep track of and that they will all sink quietly into oblivion.”4

In response, the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network has been created to monitor, propagate, and promote the proper use of such guidelines.5 The primary goal of the EQUATOR Network is “to improve the quality of scientific publications by promoting transparent and accurate reporting of health research.”b Furthermore, an increasing number of major, high-impact basic science, clinical, and health services journals recommend or require authors’ adherence to the applicable set of such guidelines for submitted manuscripts.

In keeping with this trend, Anesthesia & Analgesia has incorporated the recommendations of the EQUATOR Network into its new “Instructions for Authors.” As advocated by the EQUATOR Network, Anesthesia & Analgesia now requires adherence to the applicable statement/guidelines and checklist for all submitted research-related manuscripts, while knowingly limiting those requirements that are unique to Anesthesia & Analgesia.

This is not a pedantic exercise. To the contrary, we believe that adhering to the applicable statement/guideline and checklist will promote consistent study design and transparent and accurate manuscript structure and content, which will be major advantages for the Journal’s authors, reviewers, editors, and readers. This should in turn allow for a timelier and more reliable consistent peer review process as well as a more readable and impactful published product.

The scope of anesthesiology, which now includes perioperative medicine, critical care medicine, and pain medicine, palliative care, and related research disciplines, continues to rapidly expand. In response, Anesthesia & Analgesia has created new sections dedicated to Blood Management, Geriatric Anesthesia, Palliative Care and Cancer, and Trauma. The Journal, the IARS, and Wolters Kluwer/Lippincott Williams & Wilkins have collectively further strengthened their commitment to global health, by actively supporting authors and soliciting manuscripts from low- and middle-income countries.

Three distinct yet interrelated sections now exist that are focused on Regional Anesthesia and Acute Pain Medicine, Chronic Pain Medicine, and Pain and Analgesic Mechanisms. There is a reconfigured section of Neuroscience and Neuroanesthesiology, which will closely align and collaborate with Geriatric Anesthesia. There is also a reconfigured section on Healthcare Economics, Policy, and Organization. The sections on Graduate Medical Education and Continuing Medical Education will play a greater role, respectively, as the Journal seeks submissions, including original research, advancing the education and training of medical students, residents, and fellows, as well as for established consultant and attending physicians.

Charles Caleb Colton (1780–1832), English cleric, writer, and collector, noted, “Imitation is the sincerest form of flattery.” We will thus shamelessly emulate Anesthesiology and its innovative “Infographics: Complex Information for Anesthesiologists Presented Quickly and Clearly” and its 2-page section, “Science, Medicine, and the Anesthesiologist.”6 We have instituted a similar visual pictographic and a concise summary of articles recently published outside our specialty, which are relevant to its clinical practice and research agenda.

As a circle of both old and new friends, we enthusiastically present our cadre of talented and invested Executive Section Editors, Senior Editors, Associate Editors, and Assistant Editors. Our Executive Section Editors will play a more active and visible role in soliciting submissions, including visiting directly with investigators when they present their findings at major meetings. We and the Executive Section Editors will work closely with all of our colleagues across the Journal’s comprehensive masthead.

A very integrated approach to manuscript assignment and peer review will thus be applied both within subspecialties and across subspecialties. The Journal’s peer review process has been revised, including a new manuscript peer review template that includes more granular quantitative scores and narrative comments. All data-based manuscripts, for which a revision is requested, will undergo a formal statistical review, the content of which will be included in the initial communication (i.e., decision letter) to the authors.

The most recent Editor-in-Chief of Anesthesia & Analgesia astutely encouraged its authors to read and to adhere to the tenets of grammar and composition espoused in Strunk and White’s “The Elements of Style.”7 We ascribe to the pithy aphorism of English Victorian poet and literary critic, Matthew Arnold (1822–1888), who sagely observed, “Have something to say and say it as clearly as you can. That is the only secret of style.”8

With the support of the IARS, Anesthesia & Analgesia is exploring providing a prestudy design consult service. Although the final details have yet to be worked out, this ad hoc consult service would afford investigators access to a statistician, epidemiologist, and/or informatician. Although there would be no commitment for subsequent submission to or acceptance by Anesthesia & Analgesia, such prestudy recommendations could prevent irreparable design flaws and their major opportunity cost. This consult service would also likely be a cost-effective alternative for some investigators’ academic departments.

Lastly and perhaps most importantly, we heartily welcome input from the ultimate consumers of Anesthesia & Analgesia—its authors and its readers. With this in mind, with the able assistance of the Journal’s publishing team, we will be consistently surveying our authors and readers, and we will welcome and act on by responding to their constructive criticisms and suggestions.

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a Enhancing the QUAlity and Transparency Of health Research (EQUATOR): Library of Reporting Guidelines. Available at: Accessed December 25, 2015.
Cited Here...

b Enhancing the QUAlity and Transparency Of health Research (EQUATOR): Enhancing the Quality of and Transparency of Health Research. Available at: Accessed December 25, 2015.
Cited Here...

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© 2016 International Anesthesia Research Society