In my editorial capacity, I have the opportunity to read, read, read, and then re-read many articles, which I surely enjoy! However, usually the beginning "salvo" of a letter to the journal starting with the well-worn phrase, "We have read with great interest the manuscript written by," is a signal that more is about to follow! For the most part, if a reader or several colleagues invest the time to write a letter, it's usually not to compliment the authors on a well-written manuscript or to thank them for their contribution to the literature. To underscore the point, I like the phraseology of Anstey,1 "Fulsome praise of a manuscript or damning criticism is not enough (and is speedily rejected)." Typically, letters to the editor are well crafted and tactfully presented. They are specifically used to let the authors and readers know that there are numerous considerations of interest, such as methodological concerns, the conclusions are not backed up by the methods, or just simply other points of view. Biomedical journals use this dialogue to strengthen the peer-review process by essentially being open to a tertiary round of reviews (peer review by the readers). The main function of the traditional letter to the editor is to be a voice of the readership.1,2 Most biomedical journals have specific guidelines about letters to the editor.2
In 2003, we developed and published a policy3 for the process and outcomes of such letters, which we must now review with the readers and our editorial board to ensure that we are following our policy. Some of the more salient parts of the policy include the following:
* The editor-in-chief will review every letter to the editor to determine its suitability for publication.
* If the letter addresses a specific article published in the journal, the letter will be sent to the corresponding author of the article for a response (if indicated).
* The response will be shared with the letter writer, even if the letter is not selected for publication.
* An additional peer reviewer will be selected to evaluate the letter's scientific and clinical accuracy.
* Letters that are not based on scientific evidence and contain no references will not be accepted for publication.
* Letters that simply vent the writer's opinions, contain inappropriate comments, and lack scientific merit will not be accepted.
* An ombudsman from the editorial board will be appointed as a final level of review to help resolve disputes between authors and the letter writer in an impartial manner.
At this writing, we begin the process of reviewing and updating our policies and procedures on letters to the editor. I will ask the senior clinical editors and some of the senior members of the editorial board to guide this effort. As a special request to the readership, please think about your contributions to the literature. Editors and publishers like letters; it shows us you avidly read our journal. We continue to make efforts to enhance the experience for the readers, the peer reviewers, and other customers of the journal.
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