Editorials

Types of articles in Advances in Clinical and Experimental Medicine

in 2021 and 2022: Editors’ perspective
Marek Misiak1,A–E, Donata Kurpas2,A,F
1
Wroclaw Medical University Press, Wroclaw Medical University, Poland
2
Division of Family and Pediatric Nursing, Faculty of Health Sciences, Wroclaw Medical University, Poland

A – research concept and design; B – collection and/or assembly of data; C – data analysis and interpretation;
D – writing the article; E – critical revision of the article; F – final approval of the article

Advances in Clinical and Experimental Medicine, ISSN 1899–5276 (print), ISSN 2451–2680 (online) Adv Clin Exp Med. 2023;32(12):1333–1346

Address for correspondence

Marek Misiak
Abstract
E-mail: [email protected] The present editorial summarizes the last 2 calendar years of Advances in Clinical and Experimental Medi-
cine (ACEM) publication (2021 and 2022). The specific aims were: 1) To clarify the classification of papers
Funding sources
None declared
published in ACEM; 2) To present motivations behind choosing this classification; 3) To show how this
classification is reflected in citations. Six categories of papers published in ACEM are presented: editorials,
Conflict of interest meta-analyses, reviews (including systematic reviews), multicenter studies, research-in-progress studies,
None declared and research letters; lack of clear definitions for editorials, research letters and research-in-progress studies
is discussed. Thematic fields covered by all categories in 2021 and 2022 are presented and differences in this
Acknowledgements
Marek Misiak thanks Iya Sudoplatova, PhD, for her assistance
regard between 2021 and 2022 are highlighted. Reasons for not publishing case reports (CRs) are discussed,
in searching for and selecting the literature. with some of the debate on this issue in medical literature summarized. The article type classification used
in ACEM in only one of many possible solutions and may be modified in the future – it should be both clear
for the authors and allow for orientation in the journal’s content. The motivation for choosing the employed
Received on October 26, 2023 categories stem both from their position on the accepted levels of evidence in evidence-based medicine
Reviewed on November 27, 2023 (EBM) and their potential to be cited.
Accepted on November 28, 2023
Key words: editorial, case report, meta-analysis, article type, research letter
Published online on December 12, 2023

Cite as
Misiak M, Kurpas D. Types of articles in Advances in Clinical
and Experimental Medicine in 2021 and 2022: Editors’
perspective. Adv Clin Exp Med. 2023;32(12):1333–1346.
doi:10.17219/acem/176003

DOI
10.17219/acem/176003

Copyright
Copyright by Author(s)
This is an article distributed under the terms of the
Creative Commons Attribution 3.0 Unported (CC BY 3.0)
(https://creativecommons.org/licenses/by/3.0/)
1334 M. Misiak, D. Kurpas. Types of articles in Adv Clin Exp Med

Introduction The classification used and the order of papers assigned

to different categories in each issue reflect the hierarchy
Genology is a branch of literary theory that is con- of evidence (levels of evidence) in evidence-based medicine
cerned with the study of artistic genres, e.g., types of nov- (EBM): 1) editorials; 2) meta-analyses; 3) original papers;
els (mystery, science-fiction, etc.). Similar studies are well 4) reviews; and 5) research letters. Editorials opens an issue
established in film theory. While scholars, specialists because they offer a more personal perspective and can
in the fields mentioned above, reflect on evolution of dif- serve as a guide from an experienced investigator to other,
ferent genres across time and frequently express doubt more focused studies. Editorials are followed by meta-
whether genres as a mode of classifying narrative works analyses because, in clinical research, the best evidence
of art should still be seen as something more than mere of treatment efficacy comes mainly from meta-analyses
convention, readers or viewers still intuitively use terms of randomized controlled trials (RCTs).9,10 Meta-ana-
like ‘horror’ or ‘comedy’ to have some basic orientation lytic results are considered the most trustworthy source
in literature, cinema and television. In scientific publish- of evidence by the EBM literature.11,12 Original papers
ing, there are also analogues of genres, called “types” are the primary source of new knowledge and represent
or “categories” of scientific papers. This editorial focuses the majority of each issue, with reviews offering theoretical
exclusively on these types/categories of medical articles summaries of complex issues, and research letters provide
and is an attempt of self-reflection of Advances in Clinical concise reports of original research findings.
and Experimental Medicine (ACEM) editors on the classi-
fication of papers employed in this journal from submission
by authors to publishing. Objectives
There is no universal list of scientific medical article
types, as evidenced by the editorial policy documents The specific aims of this editorial are as follows:
or instructions for authors disseminated by respected 1) to present the classification of papers published
journals, e.g., guidelines listed by the Yale Journal of Biol- in ACEM;
ogy and Medicine,1 New England Journal of Medicine, 2 2) to clarify definitions of specific categories of papers
The BMJ, 3 Frontiers in Medicine,4 The Medical Journal which may not be entirely clear to all readers, and to pro-
of Australia,5 and Springer Publishing.6 The above guide- vide context for these definitions from selected literature;
lines are examples of editorial practices. However, the sci- 3) to outline the role played in ACEM by papers of dif-
entific discussion regarding this topic has taken 2 different ferent categories;
directions. A similar classification was proposed by Peh 4) to present motivations behind choosing this classifi-
and Ng,7 organizing the medical research into introduc- cation (the scope of the journal is broad, but types of papers
tion, methods, results, and discussion (IMRAD). Röhrig accepted are limited);
et al.,8 on the other hand, classify medical research into 5) to explain why certain types of papers are not con-
primary research (including basic medical research, clini- sidered for publication in ACEM;
cal research, and epidemiological research) and secondary 6) to provide recommendations for the Editorial Board
research (including meta-analyses and reviews). of ACEM concerning possible modifications in classifica-
The declared scope of ACEM includes articles that deal tion used.
with all clinical and experimental medicine. The journal’s Since original papers constitute the broadest and larg-
scope is deliberately broad and general, since “advances” oc- est group of papers, they will be analyzed later in another
cur constantly in all fields of medicine and related sciences, editorial by the same authors. Presenting papers of this
and the leading research areas change as medical knowledge type requires a different approach, focusing not on defini-
progresses. However, this does not mean that all types of ar- tions but on thematic patterns observed in different years.
ticles are accepted. Since 2021, ACEM has been following Employing such an approach in the present paper would
a new classification of academic papers: 1) original papers deviate from the main discourse and deform the structure
(including randomized and nonrandomized clinical tri- of the paper.
als, retrospective studies, animal and cell line studies, and
others); 2) meta-analyses; 3) reviews (including systematic
reviews, scope, narrative, and other reviews); 4) multicenter Editorials
studies; 5) research-in-progress (encompassing all types
of experimental research in medicine); 6) research letters; Similar to research letters (discussed in one of the fol-
and 7) editorials. In 2023, ACEM introduced a new category lowing sections of this paper), editorials are often a source
– editorial commentary. However, the present article covers of confusion regarding their definition; however, while
the years 2021 and 2022, so it will not be discussed. Of other research letters are confused with other, distinct types
frequently encountered types of scientific medical papers, of texts published in scientific journals, the concept
case reports and case series are not accepted in ACEM, of an editorial is so vague that each perspective seems
which will be explained later in the text. to be equally deeply rooted in both tradition and practice.
Adv Clin Exp Med. 2023;32(12):1333–1346 1335

The first concept stems from the popular press, especially In 2021, the solicited editorials addressed a specific topic
from prestigious newspapers and weekly journals of opin- or issue in the field of medicine, research, or healthcare.
ion, and views an editorial as mean of presenting the stance They explored different aspects of medical research, clini-
of the whole journal concerning a specific problem; in mod- cal systems, and health-related concerns. For instance,
ern scientific journals, editorials understood as “content some editorials discussed the issues of monitoring the kyn-
provided by the editors” can also direct readers’ attention urenine system19 and validating medical equipment.20
to certain papers published in a given issue, announce calls In 2022, these articles reflected the ongoing advances
for submissions or other initiatives, offer personal or more in the field of clinical and experimental medicine, address-
generalized reflection on a topic related to editing a sci- ing current issues, innovative treatments, and the impact
entific journal (e.g., propose definitions of different types of global events like the COVID-19 pandemic on medical
of papers or instruct authors on how to prepare them), research. The articles covered several problems, including
describe journal achievements, plans or policies, as well the neurobiological advances of learned fear in humans21
as present various guidelines and other similar documents. and the comorbidities of depressive and anxiety disorders.22
The second concept sees an editorial as an opinion piece Editorials provide a valuable forum for expressing
that expresses reflections on topical issues, explains com- viewpoints, shaping discussions, and guiding research-
plex research, and/or highlights strengths, weaknesses and ers in their work. Among the top 10 most cited works
alternative interpretations of studies. The 2 above views are in the ACEM for the 2021–2022 period are 4 editorials,
not mutually exclusive because editorials of both types can namely Tanaka and Vécsei19 (2nd most cited), Battaglia21
appear in a single journal, sometimes even in a single issue. (3rd most cited) and Chen 22 (4th most cited; all citation
Papers within this category are usually by-invitation only, data as of September 30, 2023). Such high citation rates
although there are journals (e.g., British Journal of An- raise the question why this category of papers receives so
aesthesia) that accept unsolicited editorials after a pre- much attention in the scientific community. In the opinion
submission approval process. of the ACEM editorial staff, these reasons differ regarding
The literature on editorials in scientific journals is di- specific papers. Below are the assumed reasons divided
verse. Nundy et al. authored a chapter explaining the basic into categories for clarity.
concepts of this scientific literary genre, presenting both Perspective and opinion: Editorials often present the per-
of the above views and focusing of the role of an edito- spectives, opinions, and insights of experts or key figures
rial as an opinion maker.13 This perspective was shared in a particular field. Researchers may cite editorials to sup-
by Singh and Singh, who offered a more personal view port or align their own viewpoints or arguments.
and concentrated on expressiveness of opinions and style Guidance and recommendations: Editorials may provide
of formulating them.14 Van Teijlingen et al.15 provided more guidance, recommendations, or commentary on emerg-
specific advice and examples of appropriately prepared ing trends, methodologies, or practices within a field. Re-
editorials for prospective authors, while Gray concisely searchers may cite editorials when discussing best prac-
described 5 rules of writing and editing an editorial.16 How- tices or adopting recommended approaches.
ever, the paper by Leslie and Hemmings Jr. had the broadest Critical Analysis: Editorials provide a critical analysis
scope – they discussed how an editorial can be defined of current research, policies, or developments. Therefore,
and described the structure of an excellent paper of this researchers may cite editorials to support their evaluations
type, while also providing examples and more literature or to acknowledge influential critiques.
on the topic.17 Guidelines for authors publishing in Springer Historical context: Editorials can provide a historical
Open journals18 should also be mentioned – several jour- context for a particular field or topic. Citing editorials
nals established clear stipulations regarding word and ref- helps researchers anchor their work within the historical
erence count in an editorial; there can also be more or less evolution of ideas, theories, or practices.
severe limitations concerning tables and/or figures. Debates and controversies: Editorials often focus on de-
Editorials were introduced in ACEM in 2021 and are so- bates or address controversial topics within a field. Re-
licited from members of the Editorial Board and Scientific searchers may cite editorials to highlight or participate
Committee, as well as from seasoned researchers among in ongoing discussions, acknowledging the influence
journal’s experienced peer-reviewers. Only editorials sub- of these debates on the field of study.
mitted by invitation are considered for publication. This Expert commentary: Editorials may include expert com-
category of papers was introduced to provide authors with mentary on scientific breakthroughs. Researchers may
an opportunity to present their own opinions, commen- cite editorials to include authoritative perspectives and
taries and perspectives concerning selected issues within acknowledge the influence of recognized experts.
a selected research field. Editorials are meant to provide Editorial policies and journal direction: Editorials can
readers with context, analysis and reflection regarding discuss changes in editorial policies, journal direction,
specific subjects or problems. The popularity of this type or broader trends in publishing. Researchers citing this
of paper in ACEM is increasing: 6 editorials were published type of editorials may refer to shifts in the academic land-
in 2021 and 12 in 2022. scape or to the direction of a particular journal.
1336 M. Misiak, D. Kurpas. Types of articles in Adv Clin Exp Med

Meta-analyses guide in 8 steps, while Herrera Ortiz et al.11 provided a guide

concerning both systematic reviews and MAs. A useful
Meta-analyses (MAs) are considered the most trustwor- tool in preparing MAs is the Preferred Reporting Items for
thy source of evidence by the EBM literature.11,12,23 They Systematic reviews and Meta-Analyses (PRISMA) check-
have the capacity to compare and contrast results from list that was presented and explained by Liberati et al.,42
different studies, and identify both patterns and sources with an updated version of this checklist provided by Page
of disagreement among study results, or other relation- et al.43 Cochrane Handbook for Systematic Reviews of In-
ships highlighted by multiple studies.24 Therefore, MAs terventions is also an important resource of information
are considered the most valuable papers in ACEM and are and guidelines concerning this issue.44
always placed at the beginning of each issue, immediately Many otherwise diligently prepared papers in this cat-
following editorials. Moreover, the editors of ACEM aim egory have more or less serious flaws in the statistical
to publish at least 1 paper from this category in every issue. analyses. This cannot be overlooked since proper statis-
In 2021, a decision was made to classify MAs separately tics are a crucial part of each MA, and methodological
from reviews, but due to complex resources and demand- errors in this regard can disqualify the entire work from
ing research process involved in their preparation, first publication. Harrer et al.45 and Schwarzer et al.46 wrote
6 MAs were published in ACEM only in 2022. Two the- 2 fundamental papers on how to conduct a MA using
matic fields were prominent in these papers: statistical methods and the R language. Other important
Diagnostic and therapeutic efficacy: Several of the articles sources on statistical methods in MAs are: Borenstein
focused on assessing the accuracy and efficacy of various di- et al.47 (Introduction to Meta-Analysis), Borenstein48
agnostic and therapeutic approaches. This included evaluat- (Common Mistakes in Meta-analysis and How to Avoid
ing the accuracy of machine learning algorithms for the as- Them), Cooper et al.49 (The Handbook of Research Syn-
sessment of upper-limb motor impairments in patients with thesis and Meta-analysis), Hedges and Olkin50 (Statistical
post-stroke hemiparesis25 and the efficacy of home-based Methods for Meta-analysis), Cooper51 (Research Synthesis
exercise programs in knee osteoarthritis treatment.26 and Meta-analysis: A Step-by-step Approach), Lipsey and
Disease comorbidity and risk factors: Another com- Wilson52 (Practical Meta-analysis), Littell et al.53 (System-
mon theme was the exploration of how certain conditions atic Reviews and Meta-analysis), and Pigott54 (Advances
or factors influence the risk and outcomes of specific dis- in Meta-analysis). Resources presenting the above issues
eases; e.g., the impact of diabetes on patients receiving in a specific medical context are (among others): Egger
reperfusion therapy for acute ischemic stroke,27 along with et al.55 (Systematic Reviews in Health Care: Meta-Analysis
the role of tumor necrosis factor alpha promoter polymor- in Context), Sutton et al. 56 (Methods for Meta-analysis
phism in susceptibility to sepsis.28 in Medical Research) and Whitehead57 (Meta-Analysis
Meta-analysis is one of the most thoroughly theoreti- of Controlled Clinical Trials). Rothstein et al. 58 (Pub-
cally discussed type of papers – its complex methodol- lication Bias in Meta-Analysis: Prevention, Assessment
ogy requires deep understanding in order to be properly and Adjustments) and Hunter and Schmidt59 (Methods
translated into practice (i.e., a meta-analytic article fit of Meta-analysis: Correcting Error and Bias in Research
for publication). Shorten and Shorten 29 provided a pre- Findings) presented the issues of bias and error in a sta-
cise definition and explanation of the term ‘meta-anal- tistical context. Finally, Brockwell and Gordon60 provided
ysis’, while Haidich30 and Stangl and Berry31 presented a comparison of statistical methods used in MAs.
it in the context of medical research. Egger and Smith32 and
Egger et al.33 discussed its theoretical premises, and Levi
et al.23 provided exhaustive reflection on both MAs and Reviews and systematic reviews
systematic reviews. Ahn and Kang34 and Uman35 discussed
the common characteristics and mutual relations between The number of reviews published annually in ACEM
systematic reviews and MAs, and explained the impor- remains stable. In 2021, there were 15 reviews of various
tance of articles of both types among all scientific medical methodologies and 2 systematic reviews (SRs), compared
papers in the context of hierarchy of scientific evidence. to 16 reviews complemented by 6 MAs (presented above)
There are several methodological problems regarding MAs, in 2022. There were no SRs in 2022 and no MAs in 2021.
with publication bias and other types of bias being the most Systematic reviews often include a MA component, which
significant. These issues were discussed by Sterne et al.36 involves using statistical techniques to synthesize the data
and Sterne and Egger,37 who used funnel plots to detect bias from several studies into a single quantitative estimate
in MAs. Measuring inconsistency in papers from this category or summary effect size.23,35 In 2021, Ambros-Antemate
was reflected upon by Higgins,38 while Higgins and Thomas et al.25 published a combined SR and MA to assess the ac-
further discussed quantifying heterogeneity in a MA.39 Some curacy of machine learning algorithms for the assessment
limitations of MAs were pointed out by Naylor.40 of upper-limb motor impairments in patients with post-
Numerous guidelines concerning MAs have been re- stroke hemiparesis; that paper has been classified as a MA.
leased: among others, Hansen et al.41 who offered a general While the concept of review seems to be understood
Adv Clin Exp Med. 2023;32(12):1333–1346 1337

intuitively in the scientific community, SR is a much than 1 medical center or clinic. The benefits of MSs in-
more clearly defined concept and there is an abundance clude a larger number of participants, different geographic
of literature clarifying it. The Centre for Reviews and Dis- locations, the possibility of inclusion of a wider range
semination at the University of York in the UK provided of population groups, and the ability to compare results
a detailed guide61 on how to prepare SRs; a book covering among centers, all of which increase the generalizability
this issue in detail was also published by Purssell and Mc- of the study. In light of these advantages, it is understand-
Crae.62 An overview of SRs was prepared by Silva et al.,63 able that in several scientific medical journals (e.g., Fron-
while Higgins et al.64 analyzed the process of synthesiz- tiers in Public Health, BMJ Open and journals specializing
ing quantitative evidence in SRs of complex health inter- in publishing clinical trials, e.g., Trials and Clinical Trials),
ventions, and Munn et al. offered guidance for authors MSs are a separate category of published papers. This is
when choosing between a systematic or scoping review also the case in ACEM, in which such category was intro-
approach.65 duced in 2017.
Finally, the resource utilized by many authors of re- The literature on MSs is not abundant, but there are
views and MAs (and frequently referred to in such pa- several papers offering advice to researchers who are not
pers) is the Cochrane Handbook for Systematic Reviews entirely familiar with this concept. Das74 prepared an in-
of Interventions helmed by experts from the Cochrane deep study on relevance, design and implementation
network led by Higgins et al.44 of MSs, while Serra-Aracil et al.75 provided a guide on how
Two SRs published in ACEM in 2021 discussed 2 dif- to start and develop a multicenter prospective RCT. Marsh
ferent topics. The article by Czubak et al.66 compared and Hawkins76 described statistical techniques most use-
the clinical differences among COVID-19, SARS, influ- ful in analyzing data harnessed when performing such
enza, and the common cold, while Springer et al.67 in- studies. More advanced knowledge was provided by Lane
vestigated whether the choice of a drug in pharmacologic et al.77, who outlined approaches for enhancing the in-
cardioversion correlates with national and international formativeness and quality of multicenter trials as formu-
guidelines pertaining this matter. lated by the Trial Innovation Network. Bourin78 described
Reviews published in ACEM in 2021 covered a wide range specific requirements regarding multicenter trials, while
of medical topics, including, among others: hematological Chung et al.79 focused on stipulations of state agencies
manifestations and complications of COVID-19 (Erdinc in this context; basic principles in this regard were also
et al.68) and machine learning in orthodontics (Liu et al.69). summarized by Aisen and Schafer.80
The thematic scope of reviews published in ACEM A cross-sectional study assessing multicenter clini-
in 2022 was more diverse and can be categorized as follows: cal trial protocols was published by Zhang et al.,81 while
Medical conditions and their management: Many ar- Seifirad and Alquran82 pointed out several shortcomings
ticles focused on various medical conditions and their of MSs with large samples. A chapter in Handbook for
diagnosis and management, e.g., chronic kidney disease.70 Clinical Research: Design, Statistics, and Implementation
Transitional care and adolescents: Some articles dis- by Hammond et al. is also devoted to this issue.83 Finally,
cussed the transition of care, particularly in adolescents there are 3 checklists which can be used for preparing MSs:
with specific urological conditions. This indicates a focus 1) Consolidated Standards of Reporting Trials (CON-
on the healthcare journey and needs of this specific age SORT),84 designed for reporting randomized controlled
group.71 trials, with several specialized versions;
Biomarkers and diagnostics: Some articles focused on 2) Standard Protocol Items: Recommendations for In-
new biochemical, immune, and molecular markers for terventional Trials (SPIRIT), 85 a guideline for the mini-
diagnostic and prognostic purposes in various medical mum content of a clinical trial protocol; 33-item SPIRIT
conditions, including lung cancer.72 checklist applies to protocols for all clinical trials and fo-
It should be emphasized that the most-cited article cuses on content rather than format;
published in ACEM in the discussed period is a review. 3) Transparent Reporting of Evaluations with Nonran-
An article titled “Cerebral small vessel disease: A review” domized Designs (TREND)86 for reporting intervention
by Chojdak-Łukasiewicz et al.73 has been cited 22 times, evaluation studies using nonrandomized designs.
while the SR by Czubak et al.66 gained 7 citations and Two MSs were published in ACEM in the period 2021–
achieved the 6th position in the citation ranking for 2022, both in 2021 and both pertained to the COVID-19
the years 2021–2022 (as of September 30, 2023). pandemic. The study by Arnabat-Dominguez et al.87 con-
cerned laser dentistry in daily practice during the CO-
VID-19 pandemic, while a paper by Kusztal et al.88 inquired
Multicenter studies whether home-based therapy in Fabry disease is the an-
swer to compelling patients’ needs during the COVID-19
In contrast to other types of articles discussed further pandemic. Both articles explored the benefits, risks,
in this editorial, there is no ambiguity in defining a multi- and recommendations for safe treatment in the context
center study (MS), that is, a clinical trial conducted at more of the pandemic, and how patient needs are addressed.
1338 M. Misiak, D. Kurpas. Types of articles in Adv Clin Exp Med

Research-in-progress discuss an innovative concept before its full demonstration

in the following publications. There are even entire scien-
Although research-in-progress (RiP) type of article is tific journals devoted only to RLs understood as above,
widely used in scientific publishing, it lacks clear defini- e.g., Nanoletters. In ACEM, a RL is defined as a brief, but
tion. Only Heinrich et al. published an editorial summing scientifically important study which is basically a shorter
up a debate among members of the editors of Advanc- form of an original paper. The text structure (Background
ing Scholarship and Research in Higher Education.89 Four – Objectives – Materials and methods – Discussion – Lim-
participants did not offer a definition per se, but proposed itations – Conclusions) remains the same as in an origi-
4 characteristics of RiP: nal work. Research letters are peer reviewed and subject
1) It cannot only present the research question and to a stringent editorial review. Moreover, RL are in-
methodology, but must at least give some insights to answer dexed in all databases, including PubMed and Scopus,
the question, or at least to start answering the question; and the number of points assigned for such publication
2) It identifies opportunities to collaborate and indi- is identical as for original papers. However, a RL contains
rectly or directly invites other researchers to join the pre- a maximum of 1,500 words, as opposed to 3,500 words
sented research project, or at least to offer their suggestions in an original article, and may contain at most 2 tables
regarding how to proceed; and 2 figures. The number of references is not limited.
3) It needs to have a meticulously prepared Discussion Authors of original papers considered by the editors too
section – the readers have to learn why the incomplete brief for publication will be asked to change the category
research presented is actually important; of the manuscript into a RL.
4) It has to include a Limitations section clearly stating This concept has one element in common with the idea
that the main limitation of the presented research is that of Rutkowski and Dohan Ehrenfest92 – the speed of pub-
it is still in progress. lication (RLs are published ahead of print online faster
In ACEM, the second characteristic is not considered than original papers – but it is important to note that they
as a requirement. The other 3 characteristics outline how are peer-reviewed like any other paper). A definition more
RiP paper is understood in this journal, especially re- similar to this from ACEM’s was provided by Kukafka
garding the first characteristic. If a RiP submission lacks et al. when RLs were introduced in the Journal of Medi-
adequate data, there is no sufficient evidence to warrant cal Internet Research in 2022 – in their view, they should
any judgments about the next steps that might be taken convey “[…] new, early, or sometimes preliminary research
to conduct further research. findings, including interesting observations from ongoing
Two RiP articles were published in ACEM in 2021, and research with significant implications that justify concise
none in 2022. The paper by Dejnek et al.90 was an analysis and rapid communication”.93 Conversely, the Canadian
and compari­son of autologous platelet-rich plasma prepa- Journal of Kidney Health and Disease defines a RL not only
ration systems used in the treatment of enthesopathies, regarding its size (500–1,500 words, up to 10 references and
while the study by Rudno-Rudzińska et al. analyzed effects 1 figure or 1 table) but also its scope – RL in this journal
of calci­um electroporation, electrochemotherapy, and irre- is a “ […] publication of results which deserve dissemina-
versible electro­poration on quality of life and progression- tion, usually because they may be useful to others, but do
free survival in patients with pancreatic cancer.91 not advance the field to the same extent as a full original
clinical research paper”.94 Finally, the editors of the Chest
point out that RLs should be “of high quality, be novel,
Research letters or have potential clinical impact, but should not be ad-
vanced or large enough to warrant publication of a complete
Research letters (RLs) were introduced in ACEM in April original research manuscript”, limit the article parameters
2021. Although editorials and RiP papers also lack a clear to 1,000 words, 10 references and 2 tables and/or figures,
definition, it is essential to note that RLs should never be and stipulate a structure with Introduction, Methods, Dis-
mistaken for a “letter to the editor.” While the former one cussion and Conclusions, which is, at least in broad terms,
is a concise rendition of an original academic paper, re- in concert with the definition adopted in ACEM.95
flecting original research findings, the latter one is a brief There were 5 RLs published in ACEM in 2021 and 14
commentary on previously published academic papers in 2022 – this type of papers has been introduced in this
in scholarly journals. journal in April 2021, but nevertheless these numbers show
This view is neither universally accepted nor obvious. its growing popularity. The RLs released in 2021 dealt with
For example, Rutkowski and Dohan Ehrenfest mentioned diverse research problems: 27-gauge sutureless vitrectomy
a concept of RL as an autonomous format for the rapid under topical anesthesia,96 the influence of comorbidities
publication of data, with a three-part structure (intro- on mortality in bronchiectasis,97 and ST-segment depres-
duction, description of the methods and results, and dis- sion in atrioventricular nodal reentrant tachycardia.98 They
cussion), with a word limit of 1,500 and 25 references.92 included a pilot study,96 a prospective observational study,97
Research letters written in this way can disclose and and a presentation of preliminary results.98
Adv Clin Exp Med. 2023;32(12):1333–1346 1339

In 2022, RLs in ACEM covered a much broader field are not cited or very scarcely cited increase the denomi-
– the following 3 categories dominated: nator (number of papers) but not the numerator (number
The health impact of COVID-19: Several articles ad- of citations) in the calculation of IF. This issue was also
dressed concerns like ocular complaints in students analyzed by Nabil and Samman in oral and maxillofacial
during the pandemic,99 and differences in the inci- surgery journals.105 They revealed that CRs had a low ci-
dence of symptoms among medical staff working with tation rate with an average of less than 1. There were 38
COVID-19 patients.100 (7.2%) CRs with more than 5 citations and 30% of the citing
Women’s health: Some articles focused on women’s articles were also CRs. The publication of CRs negatively
health issues, e.g., changes in the stomatognathic system affected journal’s impact factor, which correlated directly
in women working with COVID-19 patients.100 with the percentage of CRs published in a journal.
Orthopedic and musculoskeletal studies: There have In the opinion of the ACEM editorial staff, the research
been studies related to orthopedic and musculoskeletal discussed above cannot serve as an argument supporting
conditions, such as distal radius fractures in the elderly.101 the decision of excluding CRs from papers considered for
It is important to note that these RLs fulfilled the role publication in a given journal. The key mission of every
of rapid research dissemination – findings regarding CO- scientific journal is to disseminate research results. All bib-
VID-19 pandemic are a good example. liometric measures such as IF, Scopus CiteScore or others
were created to assess the efficiency of such dissemination,
and not to become an objective in themselves. Therefore,
Case reports: Why are they excluding specific types of papers from a journal to artifi-
cially boost citation statistics could be considered ethically
not published in ACEM? questionable.
In January 2021, ACEM implemented a policy preclud- However, there are other reasons for repudiating CRs.
ing publication of case reports (CRs) of any type, while The debate whether CRs should still be an important part
case series are considered for publication only very rarely of scientific medical publishing is still ongoing and no
– in situations when choosing this type of scientific article consensus has been reached so far. They are certainly not
is the sole way to tackle, e.g., an issue related to an orphan without scientific merit, as argued, among others, by Firat
disease or a very rare tumor. Of note, in the 2 discussed et al.,106 Bhattacharrya et al.,107 Nieder et al.,108 Yitschaky
years (2021–2022), no case series has been published. Such et al.,109 Carey,110 Carey,111 Albrecht et al.,112 and Edelmayer
tendency is observed in several other scientific medical et al.103 It is important to note that the above studies dis-
journals, e.g., PLoS One, Anesthesiology, Anesthesia and cussed this issue regarding several different fields of medi-
Analgesia, and Journal of Stomatology do not accept CRs cal research and not only in general terms. However,
at all. Although Dikensoy et al.102 stated that the major- as stated by Greenhalgh,113 CRs are placed at the bottom
ity of high-impact journals adopted such policy, there are of the hierarchy of clinical evidence, along with case se-
no data to support this claim. There are also examples ries, because of their inherent methodological limitations,
of a more nuanced stance: For example, the New England including lack of statistical sampling.
Journal of Medicine (NEJM) does not accept stand-alone In 2021, the Institutional Review Board of the Johns
CRs; however, articles of other types in this journal may Hopkins University School of Medicine stated that “[a] case
include CRs. report is a medical/educational activity that does not meet
In the literature, it is contented (but not proven) that the Department of Health and Human Services (DHHS)
the vast majority of CRs are very rarely cited or not cited definition of «research», which is a «systematic investiga-
at all (Edelmayer et al. introduced the term “case report tion, including research development, testing and evalu-
classics” to denote the relatively small minority of fre- ation, designed to develop or contribute to generalizable
quently cited CRs, but noted that most of them were pub- knowledge»”.114 Case reports are not based on controlled,
lished before 1990s).103 This has been shown, i.a., by Erivan experimental research and present only an individual clini-
et al., who performed a retrospective bibliometric analysis cal picture of a given patient, while results of RCTs or MAs
of all articles affecting the impact factor (IF) calculated for are considered more reliable and influential in the field
the year 2017 published in 77 journals covering the field of medicine they belong to.
of orthopedics.104 Individually, in 2017, each CR was cited Given the controversial perception of CRs in the medical
0.86 times ±1.4 (0–13) on average. Case reports published literature, the Editorial Board of ACEM on the one hand
in 2015 had a mean of 0.96 ±1.49 (0–13) citations, while is not interested in publishing them, but on the other hand
those published in 2016 had a mean of 0.76 ±1.29 (0–13) has no intention of discouraging authors from utilizing
citations (p = 0.002). Of all the CRs, 571 (30%) were not this form of scholar contribution. In the last 30 years, with
cited at all in 2017. After a statistical analysis, Erivan et al. the emergence of digital publishing, a considerable number
concluded that in 69 instances, the IF would have increased of journals have appeared that are dedicated solely to dis-
if the journal had not published any CR. Conversely, the IF seminating valuable CRs (e.g., BMJ Case Reports, Journal
improved in 8 instances by publishing CR. Papers which of Medical Case Reports, and American Journal of Case
1340 M. Misiak, D. Kurpas. Types of articles in Adv Clin Exp Med

Reports). Several authors offered valuable advice on where in clinical and experimental medicine. However, one argu-
to direct studies of such type for publication. Rison et al.115 ment can be based on the checklists introduced as man-
provided detailed criteria for informed choice (there are datory for all authors submitting manuscripts to ACEM
journals of debatable value operating in this field), while since January 2021. These tools have been proposed during
Akers116 compiled an exhaustive list of journals with such the last 30 years by various collective bodies within the sci-
a profile, and the library of the George Washington Univer- entific community and pooled together in the EQUATOR
sity (Washington, D.C., USA) established a detailed website (Enhancing the QUAlity and Transparency Of health Re-
on this topic, including an up-to-date list of journals that search) network website (https://www.equator-network.
peer-review and publish CRs.117 org). The most commonly used checklists are:
– Consolidated Standards for Reporting Trials (CON-
SORT) checklist for clinical trials;
Effectiveness of the article – STrengthening the Reporting of OBservational stud-
ies in Epidemiology (STROBE) checklist for observational
categorization in ACEM and studies;
standardization of papers in ACEM – Critical Appraisal Skills Programme (CASP) checklist
for qualitative studies;
The types of papers distinguished in ACEM have proved – Animal Research: Reporting of In Vivo Experiments
to be a useful tool, since they are deliberately broadly de- (ARRIVE) checklist be followed in the preparation of stud-
fined and therefore relatively capacious – among them, ies involving live animals, from mammals to fish and
only the MS, MS and SR types have strict definitions invertebrates.
that entail specific stipulations. The presented classifica- – Preferred Reporting Items for Systematic Reviews
tion encompasses most of the scientific medical papers and Meta-Analyses (PRISMA) checklist for all MAs and
of value met in other journals, even if the categorization reviews.
used in the most respected ones is more detailed. We pur- There are several other tools of this kind, not presented
posefully avoid formulating subcategories, e.g., regarding here, which can be accessed through the EQUATOR
different types of reviews – only a SR is discerned be- website. The authors assume that these checklists reflect
cause of clear delimitations of this type of paper, while the aforementioned breadth and depth of research in clini-
every other type of review article is simply a review in light cal and experimental medicine – and because the authors
of the ACEM rules, and no specific stipulations are made of papers published in ACEM choose various checklists, this
for specific subtypes of reviews. Every paper which includes broadness of scope translates also to the contents of each
original experimental or clinical research can be submitted category in the employed classification. The checklists
as an original paper; should it be too brief for a full-fledged also allow for the standardization of the papers’ structure
article; it will be reclassified as a RL – if the authors con- and other features – to a reasonable extent – to facilitate
sent. This is to avoid bias and to minimize the possibility better conformity with established standards in scientific
that authors will abstain from submitting a manuscript medical publishing. These checklists have been extensively
to ACEM because their paper does not fit into any category. discussed in a paper by Misiak and Kurpas.118
The only limitation observed concerns RLs. Authors
of short papers receive a proposal to reclassify them
as RLs – before or after the initial acceptance for publi- Comparison to other journals
cation. Since the introduction of RLs in ACEM, several
authors (we are unable to provide an exact figure) decided A comparative study of the classification strategy em-
to withdraw their papers in response to such proposal, ployed in different journals could be useful in assessing
citing either stipulations made by granting or evaluating the efficacy and reliability of such categorization. However,
institutions (which may only recognize original papers differences in scope and editorial and marketing strategy
as fulfilling their assessment criteria), or the lower prestige between different journals could make such comparison
that RLs would, in their opinion, have in their resumes. biased or otherwise unreliable. A large number of dif-
Such cases are evaluated individually – while the former ferent types of papers can usually be found in journals
argument is often a basis for reconsidering the matter, published by enormous transnational entities like, e.g.,
the latter still poses a challenge since – while holding pro- Taylor & Francis, Springer Nature or Elsevier, which
fessional opinion of a researcher in high regard – we have aim to standardize such classification across several ti-
not yet been able to find any research results that would tles owned by a respective publisher (at least concerning
substantiate claims of lower prestige of RLs compared the most prestigious journals in the portfolio of a given
to original papers. publisher). Even the nomenclature used varies significantly
Within the scope of this paper, it is impossible to au- between journals – Editor Resources by Taylor & Francis
thoritatively state whether the described classification state that there are more than 1,400 (sic!) different article
is optimal to reflect the breadth and depth of research type headings in use in that publisher’s journals alone.119
Adv Clin Exp Med. 2023;32(12):1333–1346 1341

The same publisher provided a glossary of article types for Access Initiative (https://www.budapestopenaccessinitia-
early career researchers, which, while relatively concise, tive.org). Dissemination of science understood as the main
provides a classification that: 1) is more detailed than that goal of scientific journal should also encompass registered
used in ACEM (it includes, e.g., method articles); 2) is not preprints; therefore, encourages the publication of pre-
compatible with categorization used in several journals prints on preprint servers such as BioRxiv, MedRxiv
owned by this publisher (e.g., Scandinavian Journal of Gas- or ResearchSquare, as well as on authors’ or institutional
troenterology); and 3) uses nomenclature different from websites. During submission of a manuscript to ACEM,
ACEM (e.g., an original paper is called a research paper).120 the authors must disclose that the paper has already been
In a single journal, such a detailed categorization could released as a preprint and provide a link to the preprint.
lead to confusion among authors regarding which type Our journal endorsed this practice in January 2022; since
of paper their manuscript should be assigned to during then, there have been 6 papers published in 2022 and 3
submission. Therefore, we reasoned that the categories by the September 2023 issue that were previously pub-
used in ACEM should be as broad as possible to reflect lished as registered preprints. This issue will be addressed
only the general types of manuscripts – based on the meth- in another editorial by the same authors.
odological approach (original papers, reviews, MAs that Ensuring the public availability of raw data facilitates
need to be discerned from reviews, RiP papers and MSs), the transparency of research and enables its replicability.
to emphasize papers written by invitation and providing Several papers published in ACEM include a disclaimer
an opinion (editorials), and to set aside articles shorter in which authors offer to share raw data upon request.
than others, but nonetheless important (RLs). Our point Papers published online as ahead of print since No-
is that any subdivision within these broad categories would vember 2023 include a mandatory disclaimer at the end
not serve any purpose worth the effort in a single journal of the main body of the article as follows: “The datasets
of broad scope (all clinical and experimental medicine). generated and/or analyzed during the current study are
The policy of each journal regarding 1) what classifica- available from the corresponding author upon reasonable
tion of papers is used, and 2) which categories from this request”. Supplementary material is a peer-reviewed mate-
classification are considered for review and which are rial directly relevant to the conclusion of a paper that can-
excluded and desk-rejected from a given journal, stems not be included in the printed version for reasons of space
from the scope of a journal and the strategy of journal or medium limitations (e.g., movie clips or sound files).
development adopted by its Editorial Board. The stipula- If a paper accepted for publication in ACEM is accompa-
tions of institutions that evaluate the work of researchers nied by supplementary data of any kind (in many cases,
heavily influences both policies of editors and authors’ these are statistical data), the Editorial Office requires that
choices of specific article types (e.g., multiple evaluating all such files be deposited in the Zenodo repository (https://
bodies require scientists to publish full-text original pa- zenodo.org) and that a single DOI be obtained for the en-
pers in the first place). Therefore, differences in the em- tire package. Each file should be numbered (Supplementary
ployed categorizations may result from strictly scientific, Table 1, Supplementary Fig. 1, etc.) and a one-sentence
editorial, or external factors, which are not always possible description of its contents should be provided. Both the de-
to identify. scription and the DOI are placed in a separate subsection
To sum up: Such a comparison would provide valuable titled “Supplementary data” at the end of the manuscript.
arguments for shaping journal’s policy in this respect, but Neither ACEM nor the journal’s publisher (Wroclaw Medi-
performing it with due diligence and adequately broad cal University) are in any way associated with the Zenodo
scope would require a separate study of comparable, repository, either financially or organizationally. We are
if not larger, size; otherwise, superficial conclusions based simply recommending this entity as a reliable and cost-
on a skewed selection of the materials might be misleading. free third-party data storage opportunity. This policy was
introduced in January 2022 and so far, 17 papers published
in 2022 and 25 until the September 2023 issue have had
Promoting open science the supplementary materials made available as described
above. This issue will be covered in another editorial
Advances in Clinical and Experimental Medicine by the same authors.
is an Open Access journal employing the Gold Open Ac-
cess model, which means that articles can be accessed
at no cost on the journal’s website immediately following Limitations
publication. There are no embargos, paywalls, subscrip-
tions, or other modes of payment of any kind. All articles First and foremost, we provided no description of practi-
are published in Open Access model and distributed un- cal application of the discussed theoretical concepts, i.e.,
der the terms of the Creative Commons Attribution 3.0 case studies showing how the presented article types trans-
Unported (CC BY 3.0) License. The publisher and editors late into concrete papers published in ACEM. As men-
of ACEM support the principles of the Budapest Open tioned above, the categories used in ACEM are deliberately
1342 M. Misiak, D. Kurpas. Types of articles in Adv Clin Exp Med

broad and presented on the journal’s website121 only in gen- submitted to the journal, and 14 of these submissions
eral terms (RiP) or only by their names, because ACEM were published – 2 in 2021 (both from call No. 4) and 12
editors assume that the understanding of an original paper in 2022 (from 3 other calls – 6 from No. 3, 3 from No,
or a MA is rather obvious for a professional researcher. 2 and 3 from No. 1). This topic will be covered in another
The only types referred to more extensively are RLs (be- editorial by the same authors.
cause of the terminological confusion discussed above)
and reviews (due to several types of reviews discussed
in the literature, a link to a paper by Grant and Booth122 Recommendations for the ACEM
presenting a typology of reviews – 14 review types and
associated methodologies – is provided as a reference and
Editorial Board
guide). Therefore, there are no strict definitions per se Although, as stated above, we think that the catego-
stated as stipulations for the authors that can later be trans- rization we use covers the scope of ACEM, even a brief
lated into practice. However, one can observe such transla- comparison with other journals (as in the “Comparison
tion regarding checklists discussed above, which predefine with other journals” section) shows that there may be
especially the structure of the paper, and within in – par- paper categories/types that could prove useful in achiev-
ticularly the Materials and methods section. Moreover, ing an even broader diversification of content. Exploring
the choice of the papers considered for publication from a wider range of medical topics and specialties would allow
all submitted manuscripts and the final form of the cho- to cater to a more diverse readership. Such broadening
sen papers (following all revisions) are to a greater extent should mean incorporating types of articles as for now
the result of the professional experience, journal’s policy, explicitly (CR) or implicitly (book reviews) excluded from
and the decision of Section Editors than the employed ACEM. A change in this respect could facilitate the in-
paper classification. The stipulations stemming from clusion of multidisciplinary perspectives by encouraging
this categorization and those found in the checklists play submissions that integrate insights from various medical
more a gatekeeping than shaping role. Manuscripts that disciplines to provide a more holistic view of healthcare.
do not conform to these rules, or that do not fit into any Therefore, we propose to prepare a report on the chosen
of the categories used, are desk-rejected during the ini- article categories employed in different scientific medical
tial verification by the Managing Editor or the prelimi- of comparable (i.e., more general) scope to identify prom-
nary review by the Section Editor before they can be sent ising new types of articles to be introduced in ACEM and
to peer-review. assess them in the light of ACEM’s to-date policies and
Second, no suggestions were formulated for an even- needs as defined by the Editorial Board. Such a report
tual modification of the article type classification utilized would not necessarily be a full-fledged comparative study
in ACEM in the future. We only became more aware that as discussed in the “Comparison with other journals” sec-
we should conduct a study on this issue in the future. tion, nor should it pretend to be a complete view of the is-
Third, meaningful comparisons with paper category sue of paper classification in medical literature as a whole.
policies in other scientific medical journals were deemed However, even a partial view could provide valuable sug-
to be outside the scope of the present study and should be gestions. We will never achieve an ideal classification, but
the subject of future studies. we should not refrain from modifications – ACEM must
Fourth, original papers were not reflected upon for evolve along with all other scientific medical journals.
the reasons stated in objectives, which renders the picture
of paper categorization in ACEM more cohesive, but also
incomplete. This issue will be addressed in further papers Conclusions
by the same authors.
Finally, the potential influence of publications in ACEM The article type classification used in ACEM in only one
on medical research or policy changes has not been dis- of many possible solutions and may be modified in the fu-
cussed. The Editorial Office of ACEM does not have any ture – it should be both clear for the authors and allow
tools that would allow for tracking such influence. How- easy orientation in the journal’s content for the readers.
ever, the section editors of our journal attempt to shape The motivation for choosing the employed categories
the distribution of topics in the journal through calls stems from 3 reasons: 1) their position on the accepted
for submissions. In 2021 and 2022, there were 4 calls for levels of evidence in EBM and their potential to be cited;
submissions: 1) Heart failure: recent advances and future 2) the usefulness and comprehensibility of the chosen
perspectives in diagnosing, prognosticating and manage- categorization for authors, who should be able to assign
ment; 2) Gastroenterology in the face of local and global their paper to an appropriate category without delving into
challenges; 3) Nephrology in the face of local and global theoretical considerations. It is also obvious that the pre-
challenges; and 4) Metabolic pathways in carcinogene- sented classification of papers is to some extent arbitrary
sis: Mechanism, diagnosis and treatment. The response – the important thing is not to exclude any types of papers
to each call was clearly visible in the stream of manuscripts from consideration based on arbitrary decisions.
Adv Clin Exp Med. 2023;32(12):1333–1346 1343

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