Commentary
Is A Mandatory Two-Year Follow-Up for Peer Reviewed Medical Publications Necessary in 2021?
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I am writing this commentary from the perspective of an Orthopedic Surgeon who has been involved with journal publications as a contributor, reviewer and an editorial board member for the last forty years.
Many medical journals require a minimum of two year follow up on clinical studies before accepting a manuscript for publication in a peer reviewed journal. Although two year follow ups on outcomes are ideal, it is often a very difficult requirement to fulfill.
While serving on the editorial board of Spine in the mid 1980’s, there was a lengthy discussion about the necessity for two-year period of follow-up before a manuscript would be considered for publication. A vote was taken by the editorial board to require a minimum two-year follow-up for all study participants. The decision was more emotionally based than dictated by data analysis.
Patients undergoing elective surgery are often healed and back to full function in 6 to 12 months. It is difficult even under the best of circumstances to get these patients back to the office or clinic for examination and any necessary testing or imaging. This is especially true of trauma patients that crash in on us for treatment during off hour times and then disappear after their body part is healed.
Having been involved in a number of clinical studies, it is often the case that patients don’t return after their surgeon declares them “healed and doing well”. In order to comply with the current journal requirements, the majority of these patients would need to take time from their busy lives to make a return visit and undergo follow-up studies adding to the cost and complexity of the study.
One solution in this digital age might be to conduct a virtual follow up. Another might be an email survey with a list of pertinent outcome metrics such as the Visual analog Scale (VAS), Oswestry Disability Index (ODI) and numerous other outcome formats which can easily be completed online and sent in for tabulation. Patient Reported Outcomes Measures (PROMIS) seem to be reliable and valuable method for outcomes assessment.
Journal editorial boards need to modernize their requirements for publication and need to retool their instructions to authors desiring to publish in their journals.
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