Article Text


Thorax 1996–2002
  1. A Knox,
  2. J Britton
  1. Division of Respiratory Medicine, Clinical Sciences Building, Nottingham University Hospital, City Hospital Campus, Nottingham NG5 1PB, UK
  1. Correspondence to:
    Professor J Britton
    Division of Respiratory Medicine, Clinical Sciences Building, Nottingham University Hospital, City Hospital Campus, Nottingham NG5 1PB, UK; j.britton{at}

Statistics from

The year 1996 was a strange one. Dolly the sheep was cloned and Britain was embroiled in an epidemic of mad cow disease. Nottingham Forest football team were in the premier league. Amid this confusion, two different beasts were appointed to the editorship of Thorax, one a cell biologist and the other an epidemiologist. This was the first time Thorax had joint editors rather than a dictatorial structure. Would it work? How would we run the journal?

The main indicator of scientific quality of a journal then, as now, was the impact factor and, for all its failings, it at least provided something objective which was measurable against comparator journals. At that time the impact factor of Thorax was rather low and we were concerned that, as competitor journals expanded, we might be left in their wake. We decided that lean and mean was best. We would concentrate on quality at the expense of quantity and hope that by publishing only the best papers we would improve the impact factor. Hopefully this would then make the journal more appealing to contributors for their better papers, and there would be a positive spiral with this policy increasing the number of good manuscripts received. Interestingly, not all within the publishing house were convinced about this. The spectre was raised of an anorexic journal getting thinner and thinner and then imploding without trace. Another major change we made was to improve the turnaround time on decisions. As investigators ourselves, we had experience of papers being in review for inordinate lengths of time before being rejected. We hoped that a quick decision—especially if it was negative—would allow the authors to send their work elsewhere with speed.

At first life was difficult. Irate authors who were used to getting their work published in the journal were horrified that their papers would have to find a different home. There were protests that papers had been rejected so speedily that we could only have given them a cursory glance. Unfortunately, if the message is not compelling, then no amount of reviewing is likely to turn a paper into something which will have a major impact in the field. We may have made some mistakes, but authors could always turn to other journals. We also suffered from the assumption by the British Thoracic Society that guidelines written by them would automatically be published in the journal, irrespective of quality. These were interesting times.

Initially our policy resulted in a few lean issues of the journal but—lo and behold—as the impact factor of the journal rose, its perception did also and submissions increased steadily. Our ideas had been vindicated. Like Clinton in 1996, we stayed on for an extended term but all good things eventually come to a natural conclusion.

There were the issues of potential scientific misconduct, duplicate publications, ghost writing, etc. The former were often spotted by sharp eyed reviewers. These were inevitably a source of embarrassment to those involved and unnecessary hassle for us.

We were able to publish a number of papers which took respiratory medicine forward in new directions (and probably some which set it back!). Some examples of the former in common respiratory conditions were landmark papers highlighting the relationship between exacerbations and decline in lung function in COPD1 and papers characterising new phenotypes in asthma.2 There were also clinical papers with therapeutic implications in a diverse range of therapeutic areas such as a study defining the role of CPAP in mild sleep apnoea,3 a paper on bisphosphonates in treating osteoporosis in cystic fibrosis,4 and the occasional interesting anecdotal report such as a paper suggesting that GM-CSF was a novel treatment for alveolar proteinosis.5 On a more experimental note, laboratory studies suggested a potential for anti-TGFβ strategies in pulmonary fibrosis.6 These give just a flavour. In epidemiology and public health we published an excellent series of review articles on the health effects of passive smoke exposure,7,8,9,10,11,12,13,14,15,16 all of which have been extensively cited and used since. We published the UK smoking cessation guidelines and a subsequent update,17–19 which have had a major impact on clinical practice and health service development in this area. We published a wide range of respiratory epidemiology and, in particular, Thorax took a lead in reporting work on the relation between asthma, obesity, and body mass index during this period.20–26

At a management level we enjoyed the challenge of the emergence of online publishing during our period as Editors, and are pleased to see how these opportunities have since transformed the ways that journals operate and have increased their accessibility. We were proud to see the impact factor of Thorax improve from 1.96 to 4.08 in the year we finished. We did this without requesting contributors to cite past papers from the journal or from publishing multiple reviews quoting only work published in the same journal—the editorial equivalent of Selfcite27 that does wonders for the impact factor but is of minimal value to readers.

Editing Thorax was immensely enjoyable. We were supported superbly by our editorial assistants Hilary Hughes and Rachel Orme. Liz Stockman did an excellent job tidying up the errors in the papers we accepted, with unfailing discretion and tact. Alex Williamson and Richard Smith tried their best to make us toe the then BMJ Publishing Group line into education and what they referred to as “added value”, but never seemed to mind us ignoring them. However, after seven years we were more than happy, when the time came, to pass responsibility on to the current team. Their record more than justifies that change. It was very satisfying to look through issues of Thorax we edited when they were delivered to us as the finished product; it is even more so now that someone else is responsible for it. Thorax continues to go from strength to strength. It’s a shame the same can’t be said for Nottingham Forest.

Editors, 1996–2002


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