Improving the submission,review and publication process for Prosthetics and Orthotics International

When we began our tenure as Editors-in-Chief in 2019, we presented a vision to make Prosthetics and Orthotics International the journal of choice for all those who wish to access and contribute to the ever-increasing body of knowledge in our field. ¹ Over the past 18 months, we have worked closely with the editorial board, associate editors and publisher to enact a number of key initiatives intended to increase the diversity of manuscript submissions, ² enhance the peer-review process ³ and promote quality and transparency of research published in the journal.^4,5 We have also worked diligently to improve the quality and timeliness of the manuscript submission, review and production process. To this end, we have recently implemented a number of substantial changes to the manuscript submission guidelines and the manuscript submission system. In this editorial, we present our rationale for making these changes and highlight several areas where authors and readers are most likely to notice changes.

Why are we making these changes?

Using metrics available in the publisher’s manuscript management system, we have systematically evaluated our submission, review and production processes in order to identify opportunities for improvement. These metrics, along with information from the publisher and our subjective experiences, have helped us identify a number of issues that often contribute to delays in processing manuscripts. For example, we discovered that many authors were submitting manuscripts on topics that did not align well with the journal’s focus and readership (e.g. orthopaedic hip and knee implants or ocular implants). Triaging these manuscripts takes effort and time that might otherwise go towards expediting review of manuscripts that are better aligned with the journal’s readership. We also discovered that a large number of manuscripts were returned to authors after submission for revisions or to request additional information necessary for an efficient and effective peer review. Based on the regularity with which such issues were occurring, we concluded that the submission guidelines and manuscript submission system needed to be revised to better support authors submitting manuscripts. The changes below summarize several key changes we have made to improve the manuscript submission, review and production processes at Prosthetics and Orthotics International.

Revised aims and scope

The aims and scope for Prosthetics and Orthotics International have been revised to provide potential authors and readers with greater clarity about:

• The specific areas of interest covered by the journal (i.e. medical, clinical, rehabilitation, technical, educational and research aspects of prosthetics (artificial limbs), orthotics (braces) and rehabilitation engineering, as well as their related topics).

• The journal’s readership (i.e. prosthetists, orthotists, physical therapists, occupational therapists, rehabilitation medicine physicians, kinesiologists, engineers, rehabilitation technicians, researchers and educators).

By clarifying the journal areas of interest and readership, we aspire to help authors make an informed decision as to whether their work is appropriate for Prosthetics and Orthotics International.

Updated acceptable article types

The types of articles considered for publication in Prosthetics and Orthotics International have been revised to include new article types (e.g. qualitative research reports) and remove article types that we no longer publish (e.g. book reviews). We have also enhanced the descriptions of all article types and provided examples to help authors more effectively categorize their submission. Table 1 provides a brief description of the primary article types. Authors are encouraged to visit the updated submission guidelines for additional details. By revising this list and making these descriptors clearer, we hope to help avoid negative experiences where authors submit research that does not align with the types of articles published in the journal.

Table 1.

Short descriptions of article types acceptable for submission to Prosthetics and Orthotics International.

Article type	Description
Original Research Reports	Articles that describe the results of experimental studies, observational studies, instrument development and validation efforts, prosthetic/orthotic device development studies, health economic evaluations, and quality improvement initiatives. Secondary analyses may also be considered under this type of submission.
Qualitative Research Reports	Articles that describe studies of people’s experiences, behaviours and perspectives using research methods focused on systematically gathering, synthesizing and interpreting data from a wide range of sources such as interviews, focus groups or text documents. A wide range of qualitative research are acceptable, including ethnographic, narrative enquiry, grounded theory, phenomenological or mixed-methods studies, as illustrative examples. Qualitative Research Reports are described in more detail in our recent editorial on this article type. 3
Reviews	Articles that describe efforts to synthesize knowledge from other (i.e. typically original or primary) sources of evidence.
Clinical Notes	Articles that describe innovative clinical developments, techniques or procedures (e.g. rehabilitation interventions, therapies or programmes; diagnostic tests; assessment methods; and implementation efforts).
Technical Notes	Articles that describe new or modified technological developments, techniques or procedures (e.g. orthotic/prosthetic devices or technologies, manufacturing or fabrication techniques, testing methods or procedures, experimental or computational approaches).
Case Reports	Articles that present details of an individual patient or group of patients that share a similar condition or receive a common intervention.
Letters to the Editor	Short communications that express commentary, offer an alternative perspective or provide constructive criticism of articles published previously in Prosthetics and Orthotics International.
Editorials	Commentaries authored by the Editors-in-Chief (or at the invitation of the Editors-in-Chief) used to inform the readership about relevant policies, procedures or issues.

We also recognized considerable variation in the way authors describe their research in the abstract and methods. To reduce this variation, we have provided examples of study designs that are common to each article type to help authors correctly designate their study design (Table 2). We hope this helps authors more accurately describe the study design so that readers can better understand the methodological choices made by the author/s and to determine whether the methods used were appropriate.

Table 2.

Examples of study designs common to article types considered for publication in Prosthetics and Orthotics International.

Article type	Examples of common study designs
Original Research Reports	Randomized controlled trial, randomized trial, controlled trial, crossover trial, time-series trial, one group pretest-posttest trial, cross-sectional study, cohort study, case–control study, methodological research study
Qualitative Research Reports	Phenomenology, ethnography, grounded theory, mixed methods
Reviews	Systematic review, scoping review, narrative review
Case Reports	Case series, case study

Amended submission requirements

We have implemented several changes to the manuscript submission requirements to give authors more flexibility in presenting their work. The Clinical Relevance Statement, for example, will no longer be required. The Clinical Relevance Statement was envisioned as a means for authors to convey to readers (i.e. often clinicians or clinical researchers) the clinical applicability of the work, but is instead often used by authors to convey commentary not supported by the work, or to present information redundant to what is in the abstract or main body of the manuscript. As such, we ask authors to focus on conveying the clinical relevance of their work throughout the manuscript, rather than in a specific section. Removing the Clinical Relevance Statement also allows us to increase the abstract word count (i.e. from 200 to 250 words) so that authors can more effectively convey the clinical relevance and key findings of their work within the abstract itself, which is more often indexed in bibliographic databases. To help authors better disseminate their work, we have also revised our requirements and recommendations regarding keywords. Rather than choosing keywords from a limited, journal-specific database that can easily become outdated, authors are now required to identify between four and eight keywords of their own choosing. A number of databases that index Prosthetics and Orthotics International use the US National Library of Medicine’s controlled vocabulary for indexing journal articles. As such, we encourage authors to choose keywords from the Medical Subject Headings (MeSH) terms indexed by the US National Library of Medicine. ⁶

We have also made changes to the manuscript formatting requirements to facilitate easier peer review and subsequent manuscript revision. We now require authors to insert continuous line numbering in the main document because line numbers inserted by the manuscript submission system do not align well with the text, promoting confusion between authors and reviewers. Author-inserted line numbering ensures direct mapping between text and line numbers and makes it easier for reviewers and authors to relate their comments to the manuscript. We are also now more explicit regarding the methods authors must use to blind their submissions and provide blinded details to the editors during the submission process. We now require authors to use ‘xxxx’ in place of all identifiable information in the main body of the manuscript and to provide details of the removed material in a text field within the submission system. Alternative methods of blinding, like using a black ‘highlighter’ in word processing software, do not successfully de-identify text and subvert the double-blinded peer-review process.

Updated editorial policies

Revisions to the Prosthetics and Orthotics International manuscript submission guidelines and system have afforded us the opportunity to update and clarify our editorial policies and practices. The majority of changes have been made to better align the journal with core practice recommendations from the Committee on Publication Ethics (COPE) and best practices adopted by other respected rehabilitation journals. Some updates, such as those related to authorship, descriptions of funding and the role of funders, declaration of conflicts of interest (COI) and ethics review, are made to increase the transparency of work published in the journal and will require authors to report additional information about their submission or to present information with greater detail and specificity than before. Other updates, like revisions to our recommendations regarding use of reporting guidelines and sharing research data, are intended to help authors present their work in the best light, thereby expediting peer review and ideally minimizing the number of resubmissions required to obtain a decision.

To reduce the potential for disputes about authorship and to be more transparent in the reporting of author roles, we have updated our authorship policies to better align with recommendations from the International Committee of Journal Medical Editors (ICMJE). ⁷ ICMJE recommends that authorship be based on four key criteria: (1) contributing to the work (i.e. conceptualization or design of the work or acquisition, analysis, and/or interpretation of the resulting data); (2) drafting or critically reviewing and revising the manuscript; (3) approving the work submitted; and (4) agreeing to be accountable for work described in the manuscript (i.e. being accountable for parts of the work done by the individual or identifying co-authors responsible for parts of the work performed by others should questions related to accuracy or integrity of the work arise). Each author must meet all four of these criteria in order to be listed among the co-authors. In addition, we will now ask authors to describe their roles in the submitted work using the Contributor Roles Taxonomy (CRediT), ⁸ a system that characterizes each author’s contribution to the submission using 14 distinct roles (i.e. conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, resources, software, supervision, validation, visualization, writing – original draft, writing – review and editing). These changes are being made to improve upon the traditional statement: ‘all authors contributed equally to this manuscript’. While recognizing that every author plays an important role in developing a manuscript, we feel it is prudent to better define and more transparently report each author’s contributions to the final work.

To promote greater transparency in articles published in Prosthetics and Orthotics International, we have updated several of our policies related to funding and to COI and revised how authors will provide this information during the submission process. First, we will require authors provide an explicit funding statement (and any disclosures that may be required by their sponsors) at the time of submission. These statements will be included with the manuscript if it is accepted for publication. Second, we now require authors to disclose the role of the funders in the design of the study, collection of data, analysis and interpretation of results, authoring or reviewing the manuscript, and decision to disseminate findings. This statement will also be published in the article if it is accepted. Finally, in an effort to improve reporting of potential COI, we have updated the Prosthetics and Orthotics International COI policy to describe potential conflicts that we deem relevant to work published in the journal. Each author will be required to review this policy, assess their potential COI and complete an ICMJE Disclosure of Potential COI form. ⁹ The form will automatically generate a summary COI statement for each author. The submitting author is required to provide this information during the submission process and upload copies of each author’s COI form. The COI summary statements will also be published in the article if it is accepted.

As noted in several of our recent editorials,^4,5 we are actively encouraging authors submitting their work to Prosthetics and Orthotics International to undertake efforts to enhance the quality and transparency of their research. While we currently require authors to take some actions (e.g. registration of any study that meets the World Health Organization’s definition of a clinical trial), ¹⁰ others (e.g. prospective registration of clinical trials and reviews, use of reporting guidelines and sharing research data) remain optional. As many of these optional activities are increasingly required to publish in other biomedical journals, we expect to re-evaluate our policies in these areas with our Editorial Board regularly over the next few years. In the meantime, we welcome readers’ feedback on whether these activities should be required. For now, we have updated our submission guidelines with additional information regarding clinical trial registration, use of reporting guidelines and data sharing so that authors can more easily access these resources.

New manuscript submission checklist

We recognize that the manuscript submission process can feel time-consuming and overly complicated. To facilitate the submission process and help expedite the timely peer review of manuscripts, we have introduced a new manuscript submission checklist. The checklist, which will be a required component for all submissions to Prosthetics and Orthotics International, is intended to ensure authors have prepared the information (i.e. title, abstract, keywords, funding disclosure statement, declaration of conflicting interests statement, details of blinded information, clinical trials statement and author contribution statements) required by the manuscript submission system, formatted their submission to comply with journal and publisher guidelines and obtained and completed the necessary declaration of conflicting interest forms. Proper use of the submission checklist (i.e. verifying all information and documents required have been prepared according to submission guidelines) is expected to expedite the submission, review and production process by standardizing submissions received by the journal. Improved standardization will mitigate return of submissions to authors for correction prior to peer review, provide editors and reviewers with submissions that are more consistent and easier to review and help the publisher’s production team more rapidly move accepted manuscripts into publication.

Conclusion

Recent changes to the Prosthetics and Orthotics International submission guidelines and manuscript submission system reflect our ongoing commitment to improving our submission, review and production processes. We anticipate that these changes will result in many benefits, including better quality and more transparent submissions, more timely decisions and more useful review feedback. While we are hopeful that the changes will have minimal impact on authors preparing submissions for the journal, we recognize that more effort may be required initially as we all adjust and become accustomed to these updated requirements. We appreciate your patience and understanding as we work together to make this transition. We encourage all authors to refer to the revised submission guidelines posted on the journal website prior to preparing your next submission. As always, we welcome feedback from our readers, authors, reviewers and editors as we work together to make Prosthetics and Orthotics International the journal of choice for all who wish to consume or contribute to our ever-growing body of knowledge.