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AME循证杂谈018|“惊心动魄”?我在 CHEST 杂志发文的搞笑故事

Published at: 2015年第1卷第S1期

谷万杰
关键词:

[自 2014 年 12 月 AME 科研时间循证杂谈专栏“开业”以来,一直深受大伙儿的喜爱,在感谢粉丝们的支持同时,小科今天还要和大家分享个好消息——循证杂谈专栏作者又添一名猛将啦!AME 携手丁香园循证医学版 07 版主谷万杰,定期给大家推荐其“ 07 循证趣谈专栏”的精彩文章,敬请期待!

今天,我们一起来看看 07 老湿在审稿严格的 CHEST 杂志上成功发表文章 Single-Dose Etomidate Dose Not Increase Mortality in Patients with Sepsis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies 一波三折的故事吧。]

 

前阵子一直给小伙伴们推送烦人的理论知识,07 老湿自己也觉得枯燥无味了,今天我们换换口味,和大家分享一下我在 CHEST 杂志发表文章的蛋疼搞笑故事,希望能够给伙伴们带来快乐的同时也能够有所收获。

先大致介绍一个 CHEST 这个杂志吧,说他牛逼哄哄一点不为过,呼吸界的伙伴们应该知道这个杂志的知名度和实力,美国胸科医师学会的唯一官方杂志,最新影响因子 7.132,主要录用三大方面的文章:呼吸,睡眠和重症。说到这个杂志就不得不说这个杂志的主编,这个杂志的主编 Richard S. Irwin 教授,他屌爆了,很会做宣传工作,在中国做的也非常好,所以来自中国的稿源那是大大滴有,欧洲呼吸杂志 ERJ 和 CHEST 相比较,在中国的影响力和知名度就不是一个级别的了,CHEST 还有中文版,太亲民了,对国人这么好,其实不是这样的,有点坑我们啊,仔细看看才发现每年接受国人文章包括港澳台和大陆一起也就 10 篇左右,基本上一个月一篇,甚至有时候还没有。

CHEST 这个杂志有个很多杂志不具备的优点,也是我们最喜欢的,拒绝太神速,审稿太尼玛快了,这是好事,不耽误咱们找第二家,不好的地方就是拒绝率太高,要求还挺多,浪费咱们的时间和精力,有时候还不给什么审稿意见。CHEST 总体对论著(注意,meta 分析在这个杂志是被当做论著的)的接受率是 10% 左右,注意是总体,对于国人的接受率呢,估计也就 5% 吧,这个杂志快到什么程度呢,如果不是周末或节假日,你的文章投过去,如果没有过第一关,编辑部内部审核,基本上三天之内会收到拒稿信,也有更快的,一天,慢的话不会超过一周,如果通过编辑部内部审核,就会让你在线签版权转让和利益冲突协议,这个就代表文章要送外审了,外审时间一般是 3 周,快的话是 2 周,慢的话一个月,外审回来又会拒绝一大批,剩下的就是他们想要的了,如果外审回来还没悲剧,恭喜你,离成功发表还差一步,就是你好好修改,但是不认真对待也是可能会被拒绝的。顺利的话,一篇文章投稿过去,从投稿到接受一般是 3 个月左右,接受之后一个月左右校对 online,正式见刊往往还需要在 online 之后四个月左右。

这个杂志就介绍这么多,下面 07 老湿分享一下自己发表的文章的一些信息。这个篇文章构思来源于脓毒症拯救指南,对于脓毒症病人,往往需要进行机械通气,需要进行气管插管,但是气管插管对这类危重病人是一个很大的刺激和打击,为了减少对病人的损害,提倡快速诱导插管,但是使用哪种诱导药物进行气管插管呢?脓毒症病人的一个特点就是血流动力学很不稳定,和其他诱导药物相比较,依托咪酯这个药物就有个最大的好处,心血管稳定性较好,但是对于脓毒症病人插管诱导药物的选择,脓毒症拯救指南没有相关推荐和介绍,看了一些文献,只有前两年发表在 critical care medicine 上面的一篇 meta 分析提示使用依托咪酯能够增加脓毒症病人的死亡率,下载全文仔细看看,发现漏洞太多啊,再看看最新的证据,果断决定我要更新,当然我这里只是轻描淡写说了一下我的大致思路,其实具体过程没这么简单,我查阅并阅读了很多文献才决定选这个题目,于是临床问题构建出来了:在成人脓毒症病人,单次使用依托咪酯进行快速诱导插管是否增加此类病人的死亡率?接下来就是大家熟悉的过程了,文献检索,研究筛选,数据提取,质量评价,统计分析,写文章投稿。2014 年 4 月 25 号投稿 CHEST 了,很快收到杂志的确认投稿邮件,07 老湿比较幸运,文章给送外审了,大概 5 月 13 号左右,状态由 under review 变成 EIC decising, 心里紧张了,晚上看一下,状态又变成 under review 了,根据 07 老师多年的投稿经验判断应该是审稿人意见相左,编辑再找第三个审稿人,一直等到 6 月 7 号,邮件提醒有新邮件,打开一看是 CHEST 杂志的决定信,心情紧张啊,内容如下:

CHEST - Decision on Manuscript ID CHEST-14-1012

07-Jun-2014

CC: Gu, Wan-Jie; wang, fei; Tang, Lu; Liu, Jing-Chen

 

Dear Prof. Jing-Chen Liu:

Manuscript ID CHEST-14-1012 entitled "Single-Dose Etomidate Dose Not Increase Mortality in Patients with Sepsis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies" which you submitted to CHEST, has been reviewed by the Editorial Board with the aid of out of office consultation.

We and the reviewers have suggested further consideration of the manuscript,contingent on completion of recommended revisions. Any comments fromthe reviewer(s) are included at the bottom of this letter.

Therefore, we invite Prof. Jing-Chen Liu, the corresponding author for thismanuscript, to respond to the reviewer(s)' comments and revise and resubmit the manuscript in accordance with their comments.

。。。。。。。。。。。。

Once again, thank you for submitting your manuscript to CHEST and we look forward to receiving your revision.

Sincerely,

Richard S. Irwin, MD, Master FCCP

Editor in Chief, CHEST

 

Reviewer(s)' Comments to Author:

 

Reviewer: 1

Comments to Author

 

The authors performed a meta-analysis on 18 studies (2 randomized controlledtrials [RCTs] and 16 observational studies) examining the effects of singledose etomidate on adrenal function and mortality in patients with sepsis,severe sepsis and septic shock. Not surprisingly, the authors found that single dose etomidate increased the risk of adrenal insufficiency; however, contrary to other investigators, they found that single dose etomidate was not associated with an increased risk of death. The strengths of the paper are the number ofstudies (and patients) included in the analysis and the low degree of heterogeneity in the observational studies. However, the vast majority of the studies were indeed observational in nature and subject to selection bias. Nonetheless, I believe this meta-analysis provides important andup-to-date information on the use of single dose etomidate in the septic patient.

 

Reviewer: 2

Comments to Author

 

A well designed study that took in consideration weaknesses and flaws of prior meta-analyses addressing the effect of a single dose Etomidate on sepsis mortality. The manuscript is well written and the discussion addressed the important findings and potential limitations. The reviewer is not familiar with the intricacies of advanced Meta-analysis statistical methods, while the methods appear to be sound a statistical review would be advisable.

 

Reviewer: 3

Comments to Author

 

Overall, the paper is very thorough, detailed and complete. However, there are a few comments by page and line number for your consideration:

 

Page 5, Line 6-7, Line 13-17 – consider using a table / figure for this listed information.

Page 5, Line 9 - After screening titles and abstracts for relevance, a second round of full-text screening is a good practice.

Page 6, Line 2 – What is meant by the most informative article? Please be more specific here.

 

Excellent work!

 

仔细看完审稿意见惊呆了有木有,石化了,有没有,这这。。。,三个审稿人把文章一通夸奖,没有什么太大需要改动的吗?07 老湿此时内心无比复杂,这是写文章以来见过的最好的审稿意见啊,一时还不敢相信,仔细回过神来, 07 老湿终于明白之前会有状态由 under review 变成 EIC decising 又变成 under review 了,很大可能是主编看了最初两个审稿人的意见,觉得我找错审稿人吗?没啥意见啊,于是乎又找了第三个,结果第三个上来也是一顿狂夸,于是乎,主编无奈了,结合三个审稿人的建议,给 07 老师的文章一个 minor revision 小修。07 老湿确定这是真的之后,就开始修文章了,因为没啥太大的地方需要修改,包括第三个审稿人的几个 comments 也不算是 comments 的 comments。没啥需要修改的,简单按照他们说的修改一下,两天之后 6 月 9 号投回去了,心里想这下应该没啥问题,很快会收到接受信,等待一个月之后,7 月 11 号又来消息了,大修,07 老湿再次见到惊呆了,石化了,有没有,怎么变成大修了,难道又找了新的审稿人,决定仔细看看这个信件:

 

CHEST - Decision on Manuscript ID CHEST-14-1012.R1

11-Jul-2014

 

Dear Prof. Liu:

Manuscript ID CHEST-14-1012.R1 entitled "Single-Dose Etomidate Does Not Increase Mortality in Patients with Sepsis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies"which you submitted to CHEST, has been reviewed by the Editorial Board without-of-office consultation. The comments of the reviewer(s) areincluded at the bottom of this letter.

It is difficult to complete editorial evaluation of your report. Additional revision is required as noted in the reviewer(s) comments. Such revisions must be made if you wish to resubmit your manuscript for consideration for publication.

Please review to all comments point-by-point.

。。。。。。。。。。。。。。。。。。

Once again, thank you for submitting your manuscript to CHEST and we look forward to receiving your revision.

Sincerely,

Richard S. Irwin, MD, Master FCCP

Editor in Chief, CHEST

 

Reviewer(s)' Comments to Author:

 

Reviewer: 1

Comments to Author

 

I agree with the original comments of Reviewer #2 regarding the need for an independent statistical review of the paper. I believe the authors misunderstood what the reviewer was requesting. This must be done.

 

One grammatical change - page 8, lines 15-17: I suggest the following "Both RCTs generated an adequately randomized sequence, were conducted ina blindedfashion, reported the numbers and reasons for withdrawal/dropout and were free of other bias."

 

Reviewer: 3

Comments to Author

 

Overall, the systematic review and meta analysis is very thorough, detailed and complete. No major changes suggested.

 

看完之后,尼玛,这第一个审稿人真是。。。。,我也醉了,他把第 2 个审稿人的意见拿过来说我把第 2 个审稿人的建议理解错了,这这。。。,第 2 个审稿人都没有问题了,这狗拿耗子瞎操心啊,彻底无语了,但是没办法,硬着头皮接受他的建议吧,但是看了之后完蛋了,也没有明说要怎么做,需要做什么啊,只说我理解错了,这尼玛主编还给了大修,瞬间紧张起来,看来不能掉以轻心,果断写信给主编 Richard S. Irwin:

 

Consult you for further information on the comments from Reviewer #1 on our manuscript (ID CHEST-14-1012.R1)

 

Dear Dr. Richard S. Irwin,

 

Sorry to disturb you and thank you for taking the time to read my letter. Many thanks for you and all the reviewers for the comments on our manuscript (ID:CHEST-14-1012.R1; Title: Single-DoseEtomidate Does Not Increase Mortality in Patients with Sepsis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies). CHEST is a leading journal all over the world and it is our great honor to have an opportunity to publish our manuscript in it. Because we are not clear about what is the exact meaning of the comments from Reviewer #1, we want to consult you for further information in order to respond to the comments as soon as possible.

Part of the comments from Reviewer #1 is as follows: I agree with the original comments of Reviewer #2 regarding the need for an independent statistical review of the paper. I believe the authors misunderstood what the reviewer was requesting. This must be done.

We totally agree with Reviewer #1, but we still did not fully understand the exact meaning. For reviewing our manuscript,an independent statistical reviewer should be suggested by us or by editor of CHEST? If you need us to suggest an independent statistical reviewer, do you have any special requests on the statistical reviewer

We are looking forward to your early reply at your convenience.

Best regards,

Jing-ChenLiu and co-authors

 

他老人家很快回复邮件了,真是言简意赅啊!

 

Dear Jing-Chen,

An independent review means that someone who can have access to all of your data redoes the statistics.

If this is not possible, please reupload your manuscript and we will send the manuscript out for a purely statistical review.

Richard

 

都这么说了,就是让我自己找人在审核一下我的统计学部分,如果我找不到,他们将会再找其他人,人我当然能找到了,于是乎,我很快通过扣扣联系了香港中文大学那边的专家,他们了解情况后,很乐意审稿我的文章,我通过邮件把所有数据资料发给他们,7 月 16 号收到他们的审稿意见:

 

Dear Dr.Wan-Jie Gu,

Thanks for inviting me review your manuscript in terms of methodology aspect. I have finished review and the comments is listed as follows. You can forward this email to editor concerned.

I read the manuscript by Gu et al. with great interesting. The research question is very important and significant for ICU patients with sepsis. The manuscript is generally well written and the statistical methods used in this study are appropriate. I got the data from Dr. Gu and re-did all the analyses mentioned in the manuscript. All the results were consistent with the results from manuscript. So I thought the results were reliable if the data extracted from original studies were correct. I have several comments and concerns on this study.

Firstly, this study is mainly performed in ICU patients with sepsis. So I think the title of this manuscript should be slightly changed.

Secondly, the author should search The Cochrane Central Register of Controlled Trials (CENTRAL), because this database included the most comprehensive citations for RCT. Although this database has some overlaps with MEDLINE and Embase, there are also some differences.

Thirdly, please clarify which types of observation studies were included in your study, prospective cohort study or retrospective cohort study?

Fourthly, please clarify the comparison groups of included studies in table 1 or 2. The author should clarify when compared with what treatment the single-dose Etomidate did not increase mortality in patients with sepsis.

Good luck!

Best,

Mao Chen

Research Assistant Professor

Division of Epidemiology

School of Public Health and Primary Care

The Chinese University of Hong Kong

 

我看了审稿意见之后,认同的部分作出修改,不认同的部分给出解释,然后将我和香港中文大学来回的邮件再次转发给我们的 Richard S. Irwin 主编,投稿的时候也一起附上来自香港中文大学的审稿意见和我的回复,带着忐忑的心情 7 月 16 号修回去了,这次想应该没问题了吧,我的这个第一个审稿人祖宗,把我折腾残了,过了一段时间,8 月 5 号来邮件了:

 

CHEST - Decision on Manuscript ID CHEST-14-1012.R2

05-Aug-2014

CC: Gu, Wan-Jie; wang, fei; Tang, Lu; Liu, Jing-Chen

 

Dear Prof. Jing-Chen Liu:

 

Your Manuscript ID CHEST-14-1012.R2 entitled "Single-Dose Etomidate Does Not Increase Mortality in Patients with Sepsis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies"which you submitted to CHEST, has been reviewed by the Editorial Board without-of-office consultation. The comments of the reviewer(s) areincluded at the bottom of this email letter.

We and the reviewers have suggested further consideration of themanuscript,contingent on completion of some minor recommended revisions.

。。。。。。。。。。。。。。

Once again, thank you for submitting your manuscript to CHEST and we look forward to receiving your revision.

Sincerely,

Richard S. Irwin, MD, Master FCCP

Editor in Chief, CHEST

 

Reviewer(s)' Comments to Author:

 

Reviewer: 1

Comments to Author

 

The authors have satisfactorily answered all of my questions and comments. I appreciate Dr. Mao's thorough and independent statistical analysis. One minor change is needed: in Table 2 under the comparison column, please change"no specified" to "not specified".

 

尼玛,我彻底无语了,又是小修,这是闹哪样啊,还有啥问题嘛,这么来回折腾人,看了半天,需要我修改一个单词,no 改为 not,我彻底醉倒了,请问,第一个审稿人,你是德国人吗?太严谨认真了,抓紧修改吧,当天投稿回去,很快状态变成 under review ,此时 07 老湿已经不敢很自信的说应该没问题,应该接受了吧,不不敢了,说不定这哥们还有什么问题,半路在杀出个程咬金,这个状态一直持续了将近一个月,到了 9 月 3 号:

 

CHEST- Decision on Manuscript ID CHEST-14-1012.R3

03-Sep-2014

CC: Gu, Wan-Jie; wang, fei; Tang, Lu; Liu, Jing-Chen

 

Dear Prof. Jing-Chen Liu:

It is a pleasure to accept your revised manuscript entitled "Single-Dose Etomidate Does Not Increase Mortality in Patients with Sepsis:A Systematic Review and Meta-Analysis of Randomized Controlled Trials andObservational Studies" for publication in CHEST.

The editorial staff at CHEST will contact Prof. Jing-Chen Liu, the corresponding author for this manuscript, if needed as the paper moves throughproduction. Anyqueries to CHEST regarding this manuscript should come from the corresponding author.

Prof. Liu will receive proofs to review before your article is published.

NEW POLICY: After you have approved the proofs, any subsequent requests for changes will incur a processing fee.

Thank you for your fine contribution. On behalf of the Editors of CHEST, we look forward to your continued contributions to the Journal.

Sincerely,

Richard S. Irwin, MD, Master FCCP

Editor in Chief, CHEST

 

我类个去呀,终于接受了,泪奔啊,我容易吗我,把我折腾死了,来来回回,本来觉得很快接受的了,看到第一次的审稿意见,结果到现在才接受,离最初投稿已经过去四个多月。

 

整体看下来,估计伙伴们也大概了解 CHEST 的发表难度了,这次投稿真是非常蛋疼搞笑的,一波三折,惊心动魄,不过最后是有惊无险,化险为夷,修成正果啊。从这个过程也可以看出 CHEST 杂志是多么的严格,就需要改一个单词的问题,还是硬生生的送外审,将近一个月,才给接收,这个审稿人呢,也是太敬业了,真的从内心敬佩感激他们,没有他们的严谨认真,我们的文章也不可能更精彩!后面文章正式见刊,无意中发现这文章竟然被维基百科收录,同时被编辑选为同期文章的三篇热点之一,编辑给出评价说:This meta-analysis provides an important next step in the understanding of the treatment of patients with sepsis and suggests that etomidate use may still bean option in this population.

 

作者|谷万杰

 

AME循证杂谈专栏

01 走出循证医学的八大误区

02 临床医生该如何高效的检索?

03 系统评价哪家强?

04 正确认识系统评价/meta分析在医学科研和临床实践中的作用

05 何为一篇好文章?

06 随机对照试验中那些真假难辨的亚组分析

07 随机对照试验的批判性阅读

08 系统评价的idea从哪里来?

09 顶级医学杂志发表什么样的meta分析?

10 如何画出人生第一张森林图?

11 亚组分析在meta分析中的应用

12 如何用图形完美展示临床研究中亚组分析的结果

13 随访资料的生存分析-基于Stata软件的统计学实现

14 Meta回归在Stata软件中的实现

15 如何提高高分杂志投稿命中率?

16 吴一龙教授谈循证医学

17 当现任遇到前任的时候,最新meta分析邂逅同选题分析,怎么办?

18 “惊心动魄”?我在CHEST杂志发文的搞笑故事

 

本文题图来自网络。

 

本文章首发于【 07 循证趣谈】微信公众号,由作者 07 老湿授权【 AME 科研时间】转载。

 

下面有请 07 老湿给大家打个招呼:

 

各位小伙伴们,大家好!我是丁香园循证医学版 07 版主谷万杰,07 循证趣谈公众号于已经正式开通啦!不管你是大牛还是草根,不管你是高富帅还是矮穷挫,不管你是白富美还是黑穷丑,不管你是……07 循证趣谈愿意和你一起,畅谈循证故事,分享循证快乐。欢迎您的关注和支持!公众号:happyEBM_007,公众号的原则是“分享快乐循证”,将定期向大家推送循证趣谈,比如循证杂谈,循证故事,循证找茬,循证方法等方面的内容,更期待您的加入!有兴趣的童鞋,可以发邮件至 wanjiegu@hotmail.com,和我分享自己的循证故事,我们将分享给更多的人!再次感谢您的关注和支持!希望 07 循证趣谈在带给你快乐的同时也能让你有所收获,因为我们旨在分享快乐循证!

 

欢迎识别下图二维码关注其微信公众号。

点击链接查看上期循证杂谈精彩文章《当现任遇到前任的时候,最新meta分析邂逅同选题分析,怎么办?》http://kysj.amegroups.com/articles/2875

Doi:

10.3978/kysj.2014.1.919
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