Report from the Editorial Office
Tilman B. Drüeke and
Norbert Lameire
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Introduction
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In July 2004, we began our last year of a 6 year tenure as Editor-in-Chief and Deputy Editor of Nephrology Dialysis Transplantation (NDT). The time has come to look back on what we have achieved, to describe the present status and to take a look at the future.
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Past achievements
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Readership of NDT has increased steadily over the years, as shown by progressively increasing subscription rates and also by the progressive increase in hit rates since NDT became accessible on the Internet (High Wire Press).
We have become the leading European journal in the field of nephrology in terms of Impact Factor. This is issued once yearly by the International Science Institute (ISI) in the USA. It is based on the number of times articles from a given journal are cited in the two years preceding the year of estimation. When we took over, the Impact Factor for NDT was comparable to that for Nephron and Clinical Nephrology, in the range between 1.5 and 1.8. The most recent estimation of the Impact Factor for NDT was 2.6.
The number of submitted manuscripts has also been on the rise. This increase can be explained, at least in part, by our switch from paper submission to electronic submission, starting in June 2001, before other nephrology journals, such as the Journal of the American Society of Nephrology or Kidney International, which joined the same website, Manuscript Central, after NDT. Despite some initial difficulties in this transfer of data management, the system has worked relatively smoothly. Manuscript Central has enabled us to considerably increase the speed of manuscript handling. The majority of our Subject Editors rapidly adapted to the switch, although there were major individual differences from one editor to another. This system also enables us to increase the number of reviewers, to keep their addresses regularly updated and to assess their performance more easily than in the past.
There was an overall increase of 20% in manuscript submission between 2002 and 2003. Compared with 2003, so far in 2004 there has again been an overall increase of
12% in submissions (+9% for Original Articles and +27% for Case Reports).
The number of NDT supplements has varied over the years, with a maximum of 12 per year. In response to critical comments received by some of our Editorial Board members as to a supplement inflation, we decided to be more demanding and limit the number of supplements, if possible, to no more than eight per year.
An important innovation in 2003 was the creation of an online-only sister journal by the ERAEDTA, named NDTEducational for Kidney & Blood Pressure Related Disorders (NDTE), under the stimulating leadership of Carmine Zoccali. This website journal (www.ndt-educational.org) has become a superb complementary instrument of continuous medical education in nephrology.
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Present status
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Manuscript flow and evaluation
In the year 2003 the Editorial Office handled 1271 manuscripts, including 773 Original Articles and 271 Case Reports, compared with 1059 manuscripts including 640 Original Articles and 211 Case Reports in 2002 (Figure 1).
The Editor-in-Chief directly handled 728 manuscripts in 2002 and 894 in 2003 and the Deputy Editor 83 in 2002 and 128 in 2003. Each Subject Editor handled between 5 and 20 original articles per year, with some variation from one editor to another. The ratio of acceptance vs rejection per Editor appears to vary more according to the area covered by each Editor than by his/her degree of severity.
As in previous years, we enjoyed working with motivated colleagues from all over the world and thank them warmly for their superb work. Their expert assistance is of utmost importance for our common goal: a steady increase in the scientific value of original work published in NDT and the continuing high standards of our educational features. A total of 1528 reviewers assisted us in manuscript reviewing for the past 12 months (November 2003 to October 2004), of whom 305 reviewed 10 manuscripts and more, 400 five to nine manuscripts and the remaining 823 one to four manuscripts.
Each year, the Editorial Board of NDT changes. Certain members complete their service and rotate off this board. New transitions will take place in February 2005.
Manuscript turnover time in 2002 and 2003 was, on average,
40 days between submission and first decision, an average of
50 days between submission and rejection and an average of
130 days between submission and final acceptance. The average time from acceptance to online publication is now 56 weeks. Unfortunately, the average time from acceptance to publication is still 5 months.
In addition to the 12 regular monthly issues, eight NDT supplement issues were published in 2003 in various domains of clinical nephrology and six have been published so far in 2004. The Deputy Editor personally handles all supplement issues.
Acceptance rate
Articles were most frequently accepted in the category chosen by the authors and less frequently after transformation to another category. For example, we often ask authors to transform Case Reports to the format of a Letter-to-the-Editor.
Figure 2 shows the number of accepted papers per manuscript category for the years 2002 and 2003; the respective percentage values of acceptance and rejection rates per manuscript category are presented in Table 1. The acceptance rate of Original Articles increased from 32% to 35% and that of Case Reports from 19% to 24%, in parallel with the increase in total submission rate.
Figure 3 shows the number of manuscripts submitted from various regions of the world for the years 2002 and 2003 (all articles combined). Not surprisingly, manuscripts from Europe represented >50% of all manuscript submissions and they increased by 38% from 2002 to 2003. The number of papers from the Near/Middle East, North America, Japan and Asia other than Japan were in roughly equal numbers: around 100 manuscripts per region in 2002 and between 120 and 159 per region in 2003. Whereas submissions from Japan increased by <10% from one year to the next, those from the other three world regions increased by 4060%.

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Fig. 3. Number of manuscripts submitted from various world regions for the years 2002 and 2003 (all articles combined).
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Figure 4A and B show the number of manuscripts submitted from various countries in Europe, for the years 2003 and 2004.

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Fig. 4. Number of manuscripts submitted from various countries in Europe, shown separately for the years 2003 (A) and 2004 (B) (extrapolation for the latter, based on submissions between 1 January and 31 October 2004).
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Impact Factor
As mentioned above, the Impact Factor of NDT has increased steadily over the years. Table 2 shows a comparison of Impact Factors for the major nephrology journals, as issued by ISI for 2003 and 2004. When excluding journals that publish solely review articles (shown in square brackets), NDT occupies fifth place.
E-toc registrations, online access and hit rates
We appreciate that a large readership enjoys NDT not only within but also, increasingly, outside Europe and we are pleased to see that NDT occupies an honourable place amongst the large number of journals devoted to the field of nephrology. The growing interest in NDT is demonstrated by steadily increasing e-toc registrations, from 1500 at the end of 1999 to more than 4500 at the end of 2003. It is also shown by the progressive increase in hit rates. The assessment of online hit rates on recently published articles allows (i) an estimation of the interest of readers for a given journal in general and (ii) an estimation of those topics which generate the highest interest among readers. This latter evaluation gives an estimate of readers access to articles, which is different from that of the Impact Factor. NDT online access began in January 1999. Since then, the number of home page hits per month has been approximately 10 000 in January 2001, 20 000 in September 2002, 40 000 in September 2003 and 50 000 in May 2004. More importantly, the number of monthly HTML full-text downloads increased from 7000 to 85 000 and that of PDF full-text downloads from 8000 to 90 000 in the same time period. The four top NDT articles with the highest HTML download rates in the year 2003 are shown in Table 3. Not surprisingly, they are all Editorial Comments. The ten top NDT articles with, respectively, the highest HTML and PDF download rates in the last 12 months (from November 2003 to October 2004) are shown in Tables 4 and 5. Again, review and guideline articles are the manuscripts with the highest hit numbers.
Size of the journal
In 2003, NDT published a total of 284 Original Articles; 98 articles were devoted to editorial features, 46 were clinical reports and 37 articles covered educational features. The total number of pages published per volume increased from 2294 pages in 2002 to 2684 pages in 2003. The projected page number for 2004 is likely to be 3187.
Support by industry
We also wish to thank the Industry, whose continued support has allowed us to expand our activities progressively.
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Outlook
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Starting in July 2005, a new team will run the journal. It will be facing a number of new challenges in common with the majority of medical science journals. These include the increasing use of the Internet for article access and the concomitant trend towards decreased subscription rates, the possible advent of widespread free access to journals with the inherent problem this creates for journal financing, competition with online-only journals and, last but not least, the importance of the Impact Factor, which influences both a journal's reputation and the quality of submitted manuscripts.
Another challenge is that raised by the creation of new journals in the field of clinical nephrology. On one hand, the two journals Nephron and Experimental Nephrology have merged to make three out of two, namely NephronClinical Practice, NephronPhysiology and NephronExperimental Nephrology. In addition, two new journals in clinical nephrology will be created in the near future, one by the American Society of Nephrology and the other by the International Society of Nephrology. In this context, it is also worth mentioning that the new editorial team of the American Journal of Kidney Diseases decided, >2 years ago, to accept only those manuscripts that are entirely devoted to clinical aspects of nephrology. On the other hand, Kidney & Blood Pressure Research, the official journal of the German-speaking Society of Nephrology, may cease its monthly publication definitively by the end of the year 2004.
Taking into consideration these challenges, it may become more difficult to attract good clinical nephrology-oriented manuscripts to NDT. It will also be important to see whether the present decision of keeping basic research-orientated manuscripts in NDT was the right one or not, both in terms of authors needs and readers interest. It may become necessary to transfer the educational features of the Journal entirely to NDTE in order to increase the Impact Factor and to decrease costs.
Finally, we hope that the recent increase in the NDT's international reputation continues and that more and more nephrologists and other physicians and scientists enjoy reading NDT articles.