Do We Really Need Another Journal?

Abstract

A new Journal sees dawn – but didn't we already have too many journals and too many articles published to go to oblivion rapidly? Publishers take advantage of the move towards open access. The need to attract an audience and select papers for high-quality decreases with the move towards business models where journals charge article processing fees to cover expenses and create margins. The Journal of Global Neurosurgery (JGNS) is not a business project: it is far more altruistic and intends to fill a real need. The long-term prospects will not depend on revenue but on the sustainability of the publication model, which by necessity must be low cost and non-profit – other ways, the new journal will not be able to fill the need.

"Global Neurosurgery" is becoming increasingly vogue. Individual neurosurgeons and the World Federation of Neurosurgical Societies have fostered projects to develop our specialty in low- and middle-income countries (LMIC), where single neurosurgeons have catered to many millions of patients. We see a worldwide quiet revolution of expanding surgical infrastructure and dissemination of knowledge in countries previously deprived. The stakeholders of this revolution have soon identified a veritable glass ceiling when it comes to publication. Submissions have frequently been seen as relevant or generalizable for the audiences of existing journals. Clinical neuroscience in LMICs is, much to the surprise of many practitioners and editors in previously established structures, different. Fundamental issues such as study population and external validity were rediscovered when population data, research findings, and practice guidelines from affluent, relatively elderly western people with access to smooth infrastructure and exquisitely equipped hospitals were applied with little meaning in LMICs with different demographics and epidemiology. Yet, many clinical studies from LMICs were adapted to previous literature's format and style, without detecting the unique qualities, "the cracks in the wall" of existing paradigms, that would bring the progress of knowledge and change. I believe that a research community with a thorough understanding of the specific qualities of infrastructure and epidemiology in LMICs is being established, and it needs dedicated platforms. A journal is one such platform that can serve to define and direct the subspecialty.