Author Affiliation: Dr Golub is Senior Editor, JAMA (robert.golub@jama-archives.org).
Letters entertain you, letters make you smile. But they also perform a very important and serious function, providing a forum for the scientific interaction between JAMA’s authors and its readers. The peer review system, which is the foundation for evaluating medical studies, includes multiway dialogues among authors, editors, and expert peer reviewers in an iterative process that results in evolution and refinement of a manuscript, ultimately leading to publication. However, the process does not end at this point—postpublication peer review is an integral part of the system and for JAMA this is manifest in Letters to the Editor.
This issue of JAMA contains a set of letters1 that exemplifies this process. It consists of a number of letters sent in response to a companion set of clinical trials on ventilation strategies for acute lung injury and an accompanying set of editorials.2 - 5 The letters raise questions about physiological assumptions in the studies and the study designs, concerns about the interventions chosen, and alternate explanations for the findings, as well as whether randomized controlled trials are actually the best approach to answering this type of question. The assertions in the letters and the authors' replies are well-referenced, and this interchange is intended to augment readers' understanding of the issues and to allow them to reach their own conclusions.
This type of interaction is a vital part of a successful peer review process and is something JAMA is eager to promote. The editors are always seeking letters that raise reasonable and important questions about a study or its appropriate interpretation. As part of the responsibility that authors assume in return for having their articles published in JAMA, they are held accountable for responding to critical points.
To facilitate the submission of the highest quality letters, we would like to offer some tips to our readers to maximize the likelihood of getting your letter published:
Letters are meant to be focused pieces and therefore are limited to no more than 400 words, 5 references (including reference to the JAMA article being addressed), and 3 authors. Because our interest is in timely correspondence, letters will only be considered if they are submitted within 4 weeks of the article's publication date. Adhering to these limits when writing your letter is a very important starting point.
Recognize that your published letter will be a scientific article. Letters are indexed in MEDLINE as JAMA publications, so we take their content, including accuracy and professional quality, seriously.
We recommend that you limit your letter to 1 or 2 points. It is usually difficult to clearly and precisely raise more issues than this within the limits of the format. Less focused letters are less likely to receive priority for publication.
Support all assertions by peer-reviewed literature; generally, this should be primary research rather than review articles. Check the accuracy of cited data very carefully. Describe the limitations in the literature that you are citing (eg, denote case series as such).
Include your financial disclosures in an Acknowledgment at the end of the letter. These include potential conflicts of interest not just related to the specific content of your letter, but also to the content of the JAMA article and other related areas. (Include any disclosures that would have been relevant had you been the author of the JAMA article.)
Recognize that letters essentially in agreement with the authors without providing additional insights and letters that point out study limitations that were adequately addressed in the article or accompanying editorial will generally have low priority.
Realize that letters that primarily highlight the writers' own research or are otherwise self-promotional will also generally have low priority. Supporting references are better if they are not limited to self-citation.
Be certain that the reference list is accurate. The editors and authors use these lists extensively. This is true of electronic as well as print citations.
Please accept the need for editing—for length and for style. Realize that the article itself was subject to similar editing.
Use civil and professional discourse.
Don't be anecdotal. While personal experience can have great value in patient care and hypothesis generation, it is generally not strong enough evidence to include in a published letter.
Don't include unpublished data. Letters generally do not undergo external peer review, and JAMA cannot support unpublished data.
Please don't submit letters about articles published in other journals. Those letters should be sent to the journals in which the original article was published.
Don't rehash arguments that have been made for years or decades (particularly in response to controversial social issues).
Don't adopt a tone that might be misconstrued by the authors or readers to be in any way insulting. As scientific discourse, published disagreements should further the field. (Ad hominem attacks in a letter will generally lead to quick rejection, or in the rare case that the letter is ultimately published will certainly be removed before acceptance.) Don't write a letter while you are upset or angry or, if you do, put it aside for 24 hours and review it again objectively before sending it.
In the Letters section, JAMA also publishes Research Letters. These are brief (600 words or less) scientific reports of original research studies that undergo full peer review. The criteria JAMA uses for considering these for publication (quality of the research and appropriateness of the topic for JAMA readers) are similar to those used for full-length articles, the major difference being that the methods and results can be clearly presented in a short format. More information is available in JAMA Instructions for Authors.6
The JAMA editors strongly encourage readers to be active participants in the postpublication peer review process. These letters help to advance the understanding of our articles, provide important challenges to other readers as well as to authors—and at times may even make you smile.
Financial Disclosures: None reported.
Editorials represent the opinions of the authors and JAMA and not those of the American Medical Association.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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Comments are moderated and will appear on the site at the discretion of the Journal of American Medical Association editors. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
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