Have you heard of the newly published misogynist paper in the American Journal of Emergency Medicine? Here’s the start of the abstract:

It is unknown whether female physicians can perform equivalently to male physicians with respect to emergency procedures. Endotracheal intubation is one of the most critical procedures performed in the emergency department (ED). We hypothesized that female physicians are not inferior to male physicians in first-pass success rate for this endotracheal intubation.

There has been much outrage. But hold on. This might not be what it might look like.
Yes, this framing of the null hypothesis is highly problematic, to say the least. How did this happen? The authors were well intentioned. I’ll let the corresponding author explain in their own words. The text in this tweet says, “Let me explain why I made such dumb choice.” It’s worth clicking through to read the actual text of the response. In my opinion, this explanation is acceptable. It was bad choice, and they are learning:

https://twitter.com/joonghee_emdoc/status/1144606368705536000

This was a serious exercise in listening and doing the right thing:

https://twitter.com/joonghee_emdoc/status/1144082039307563009

The take-home message for this one paper is, I think:

https://twitter.com/medicaldork/status/1143512215774875648

But let’s not move on so fast. There is a party that definitely needed to know better here: The Editor-in-Chief.

In this case, the negligence of the Editor-in-Chief threw the authors of the paper under the bus.

To put this in some context, let’s look back to an incident of a paper three years ago, about biomechanics of the human hand. This paper’s abstract said, “The explicit functional link indicates that the biomechanical characteristic of tendinous connective architecture between muscles and articulations is the proper design by the Creator to perform a multitude of daily tasks in a comfortable way.” There are several references to “the Creator” in the paper, which can be interpreted as an endorsement of creationism and/or intelligent design. This paper was retracted, though, if you read through the paper, it’s quite possible the authors are not creationist whatsoever and the language about the “creator” is clearly an issue of translating language and culture into a paper into a western journal in English. But I don’t really know what to think of this one.

So: We have two papers that should never have come to press in their current form One is an unintentionally sexist emergency medicine paper, and one has distinctly creationist language. The editors of the journals are responsible here.

The handling editor should have made sure these problems were fixed in the editorial process. Without a doubt. And failing that, the ultimate responsibility comes down to the Editors-in-Chief, who should clearly have detected and returned the papers for further revision rather than giving the green light.

Can we really expect editors to be accountable for everything they publish? Of course we can! A proper academic journal can be expected to publish information that editors and readers disagree with. A legitimate academic journal can even allow authors to speculate, so long as it’s clearly identified as speculation. But when it comes to the use of language or rhetoric that is clearly destructive to members of the scientific community or misrepresents the science itself, then this is when the editors have to put on the brakes.

How can EICs enforce such standards? Well, they enforce them. For example, on one occasion, I received a bit of correspondence from a colleague, who is the EIC of a journal and wanted a second opinion. They were handling an article that contained an unnecessarily and overtly sexual and crude double entendre in the title. (Even though the paper had nothing to do with sex.) This paper had made it through the entire editorial process — the submitting authors, two reviewers, and a handling editor — before landing in at the EIC’s desk. They just wanted to make sure that they were seeing this matter clearly — and I agreed that they were. So then the EIC bounced it back to the authors to fix the error in judgment. Because, if it came to press, the EIC bears as much responsibility for allowing it as the authors have for writing it.

Editors don’t bear responsibility for everything that authors write. But they are at fault when they allow authors to publish content which is unnecessarily harmful to members of the scientific community.

 

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*I should probably mention that the researchers found that men were just as good as women when it came to performing intubations. Which is a public service to document, because apparently there are some folks who imagine this ability is somehow gendered. (Inbuation, by the way, is a tricky skill, if you’re not familiar with this stuff. I am passingly familiar with this because in college I was an EMT, and I still have some vague experience in my recollection, I’m not sure if I’ve ever mentioned that?)