I've struggled through the slow and often painful process of publishing, both as an author and peer reviewer. So I was curious about the medical journal Cureus, which aims to preserve scientific quality while making the process free, easy and efficient. I spoke with its founder, John Adler, MD, a Stanford professor of neurosurgery, emeritus.
Why did you start the Cureus Journal of Medical Science?
I started Cureus because I was dissatisfied with the existing world of medical journals, which have become increasingly preoccupied with tenure and prestige. The 'best journals in the world' are now largely the province of a small community of elite academics from places like Stanford, Harvard and Yale, but the large majority of patients are cared for outside these institutions. Unlike most journals, Cureus focuses on the observational and practical side of clinical medicine, which is of great importance to nearly all patients.
About eight years ago, I had trouble publishing a paper on a surgical procedure for which I'm an acknowledged world expert. It was such a hassle -- even for an insider, a big name doctor from a big name institution. This experience inspired me to start Cureus to enable more rapid and free publication.
How did you come up with the name?
Cureus embodies a double entendre: 'Cure' 'us,' the goal of community-supported scientific journalism. And 'curious,' the embodiment of the best scientific thinking.
Why does Cureus focus on case studies?
We're moving towards a world of precision medicine with the basic premise that we're all unique and don't all have the same response to a treatment. So I argue that the ultimate kernel of truth is at the individual patient level and therefore we need to be documenting the stories of individuals even more. Any important discovery of medicine started basically with a case study -- a key observation.
Surgeons learn many of their best tricks over the scrub sink, by talking to another surgeon about something she just figured out a few days ago. Cureus would like to be the digital scrub sink of the 21st century. The existing big journals play an important role, but their rigid standards prevent the publication of the myriad small, practical secrets that you learn as a practicing physician -- and that's what interests me.
How does Cureus work?
An efficient peer review happens before an article is published and then there is a post publication scoring process. Every reader is invited to give a numerical score. However, someone who has deep domain knowledge as a specialist in a specific field gets more votes over a general practitioner.
If an article is scored many dozens of times, then we get a very good measure of the article's quality. Ultimately, Cureus aspires to use the collective wisdom of all physicians.
What are your goals?
Today we are publishing just over 1,000 articles each year, but the goal is to annually publish millions of medical stories that are peer-reviewed, curated and widely disseminated. These published stories can then also provide the substrate for subsequent analysis through machine learning. Currently, so much of machine learning is based on mining electronic medical records, which are primarily billing records and therefore deeply flawed sources of information. So I want to make it easier for doctors -- who each day make important clinical observations -- to document them.
I'm not going to be the computer scientist who reveals hidden truths from this data. But I want to be the guy who changes the world by helping people collect the data. It takes a certain scale and we need to be about three orders of magnitude bigger. But once we are, watch out!
Previously: Health journalists focus heavily on initial, positive studies that may be refuted, says study, How important is it to publish negative results? and How open access publishing benefits patients
Photo courtesy of John Adler