Gratitude can transform common days into thanksgivings, turn routine jobs into joy, and change ordinary opportunities into blessings.
William Arthur Ward, American writer (1921–1994)
The last 18 months have been a very positive time for Anesthesia & Analgesia and a very rewarding experience for both of us. We highlight here some of the recent accomplishments of the Journal. These accomplishments represent the collective outstanding contributions of our authors, peer reviewers, publishing team, and fellow editorial board members. We express our tremendous gratitude for their tireless and innovative efforts, without which Anesthesia & Analgesia could not continue to flourish. We also acknowledge the continued vital relationship between the Journal and its 12 affiliated societies.
In his landmark 1966 article, “Evaluating the Quality of Medical Care,” Donabedian1,2 first proposed using the triad of structure, process, and outcome to evaluate the quality of health care. We have applied this triad in our efforts to evaluate and to optimize the quality of Anesthesia & Analgesia.3
The scope and practice of contemporary anesthesiology unquestionably encompasses not only immediate intraoperative care but also perioperative medicine, critical care medicine, acute and chronic pain medicine, and palliative and supportive care. In response, a number of proactive structure and process changes have been made to Anesthesia & Analgesia.3
- The Journal successfully implemented sections dedicated to and thus published papers on Blood Management, Geriatric Anesthesia, Cancer and Supportive Care, and Trauma. A new affiliation was established between the Journal and the Society for Airway Management, which naturally aligned with its Trauma section.
- The innately interrelated sections on Regional Anesthesia and Acute Pain Medicine, Chronic Pain Medicine, and Pain and Analgesic Mechanisms are functioning very cohesively. The November 2017 thematic issue on “The Practice of Anesthesia and Pain Medicine and the Opioid Abuse Epidemic” comprehensively addressed this major clinical, public health, and health policy topic.
- The Journal successfully strengthened its commitment to Global Health, with a series of papers from low- and middle-income countries and members of the World Federation of Societies of Anaesthesiologists. A timely thematic issue on Global Health is scheduled for early 2018.
- A new affiliation was established between the Journal and the American Society for Enhanced Recovery. The resulting separate section devoted to Perioperative Medicine has brought surgeons to the Journal editorial board, further strengthening our team’s perspective, voice, and likely audience.
- The reestablishment of a separate Ambulatory Anesthesiology section reflects the increasing demand for and thus scope of fast-track, short-stay (“extended ambulatory recovery”) surgical admissions and the expansion of complex procedures outside the mainstream operating room.
- The Neuroscience and Neuroanesthesiology and Geriatric Anesthesia sections have been well aligned so as to foster and capitalize on their cross-disciplinary expertise.
- The reconfigured section on Healthcare Economics, Policy, and Organization is attracting a greater number and diversity of papers, including novel, timely, and controversial topics.
- The consolidated and dedicated section on Medical Education has promoted submissions, including original research, in this arena.
Virtually all manuscripts accepted by Anesthesia & Analgesia (except for editorials and thematic issue content) are now published ahead of print, accelerating their being indexed on PubMed (initially designated as “[Epub ahead of print]”) and thus citable by and available to our authors and readers.
Consistent statistical rigor remains a challenge for medical journals.4,5Anesthesia & Analgesia has thus implemented a more standardized statistical review process, in addition to a statistical checklist and a corresponding author attestation. Rather than being draconian, this required attestation corresponds to a list of common statistical errors and deficiencies that are now clearly delineated in our current “Instructions for Authors.” Anesthesia & Analgesia is also undertaking a series of approximately 18 monthly statistical tutorials, which cover fundamental concepts in a practical way that nonformally statistically trained individuals can comprehend—with ample-specific published examples provided.5
To further promote the existing expanded scope of A&A Case Reports—specifically, to publish content of practical appeal to a wide audience—the name of this journal will become A&A Practice starting in January 2018. Additionally, as of January 2018, all Echo Rounds and Echo Didactics articles will be published in A&A Practice. A&A Practice will remain fully editorially aligned and operationally integrated yet distinct from Anesthesia & Analgesia. A&A Practice will continue to be published only online but will be indexed on PubMed. A&A Practice welcomes diverse submissions that are consistent with its stated expanded scope and content, especially, descriptions of innovative approaches to common or unique challenges in our field.
However, such structure and process changes would be for naught without associated positive outcomes. Fortunately, the above collective labors are bearing bountiful fruit.
The impact factor of Anesthesia & Analgesia has increased for 11 straight years. Specifically, the impact factor was 3.47 in 2014, 3.83 in 2015, and most recently, 4.01 in 2016. In 2016, Anesthesia & Analgesia had the fifth highest impact factor in its specialty and the third most total cites.
While the impact factor remains heavily emphasized and closely monitored, it is only 1 metric of scholarly and scientific publishing. For example, altmetrics and the generated “Altmetric doughnut” <https://www.altmetric.com/> are nontraditional metrics that have been proposed as an alternative or at least a complement to more traditional citation impact metrics like the impact factor and h-index.6,7Anesthesia & Analgesia has also demonstrated an increasing number of published papers with favorable altmetrics. A representative example is the recent article by Verkruysse et al8 on the feasibility of contactless, camera-based photoplethysmography, which has an Altmetric Attention Score of 552 (Figure 1).
Four other representative operational outcomes (“key performance indicators”) include the annualized total number of submitted manuscripts (Table), the diversity of the types of submitted manuscripts (Table), the overall manuscript acceptance rate (Figure 2), and the submitted manuscript review and decision cycle time (Figure 3). The total number of annual submissions to A&A Case Reports has remained essentially constant at 516 (2014–2015), 536 (2015–2016), and 536 (2016–2017). The most recent data are reported for July 2016 to June 2017, coinciding with the complete transition of journal stewardship to us and our editorial board. The aforementioned positive trends in key performance indicators have continued through the balance of 2017.
We fully expect 2018 to be another rewarding and successful year for Anesthesia & Analgesia. Additional changes under consideration include selective online-only publication, which will only be undertaken after mutual and thoughtful dialogue with all our stakeholders. We are poised to implement a stratified and more streamlined yet equally rigorous statistical review process. We are planning additional, timely thematic issues. Last, we will continue to explore and to adopt cutting-edge technology, including alternative delivery platforms and social media forums, to best reach our diverse, worldwide readership.
Name: Thomas R. Vetter, MD, MPH.
Contribution: This author helped write and revise the manuscript.
Name: Jean-François Pittet, MD.
Contribution: This author helped write and revise the manuscript.
1. Ayanian JZ, Markel H. Donabedian’s lasting framework for health care quality. N Engl J Med. 2016;375:205–207.
2. Donabedian A. Evaluating the quality of medical care. 1966. Milbank Q. 2005;83:691–729.
3. Pittet JF, Vetter TR. Continuing the terra firma and establishing a new EQUATOR for Anesthesia & Analgesia. Anesth Analg. 2016;123:8–9.
4. Dexter F, Shafer SL. Narrative review of statistical reporting checklists, mandatory statistical editing, and rectifying common problems in the reporting of scientific articles. Anesth Analg. 2017;124:943–947.
5. Mascha EJ, Vetter TR. The statistical checklist and statistical review: two essential yet challenging deliverables. Anesth Analg. 2017;124:719–721.
6. Chavda J, Patel A. Measuring research impact: bibliometrics, social media, altmetrics, and the BJGP. Br J Gen Pract. 2016;66:e59–e61.
7. Priem J, Groth P, Taraborelli D. The altmetrics collection. PLoS One. 2012;7:e48753.
8. Verkruysse W, Bartula M, Bresch E, Rocque M, Meftah M, Kirenko I. Calibration of contactless pulse oximetry. Anesth Analg. 2017;124:136–145.