What Are Supplements?
Supplements are scholarly monographs on specific subjects that scientific journals usually publish quite regularly. They always appear as separate issues of the "mother journal" and each issue is independently financed. They are an ideal medium to disseminate the contents of symposia, provide a vehicle for continuing education or updates on specific topics, for the Societies' Working Group or Scientific Section consensus documents, and for clinical practice guidelines, too.
As supplements always have special financial support, the International Committee of Medical Journal Editors1 recommends the following guidelines: the editor should ensure the independence of the scientific content and that good editorial practices are maintained in relation with the source of finance; the editor should approve the subject index and collaborate with the guest editor of each supplement; it is reasonable to set up external peer review for each supplement; final supplement content cannot be changed at the request of the sponsor; the type of financial support should be clearly stated in each supplement and advertising should follow the same norms that apply to scientific journals; supplement pages should be numbered independently to distinguish them from the journal.
Revista Española de Cardiología Suplementos. A Brief History
Revista Española de Cardiología Suplementos (REC Supl) is a scholarly journal that is independent of Revista Española de Cardiología (REC) although the editorial team is the same. The REC Supl first appeared some years ago but the number of articles and frequency of publication varied tremendously until 2006. From 2001 through 2005, REC Supl published monographs dedicated to reviews of specific subjects, often associated with a pharmaceutical product, in response to companies connected with the sector. A guest editor structured the index and proposed the authors who would write articles under his or her supervision. Both guest editor and authors were recognized, prestigious members of the Spanish cardiology community, proposed by the sponsoring company, although always approved of by the REC editor-in-chief.
Details of annual issues and numbers of articles are available on the Editor's Pages of REC in the respective annual reviews2-7 and appear in Figure 1.
Figure 1. History of the number of supplements and number of articles in Revista Española de Cardiología Suplementos.
The REC editorial committee decided to publish 3 special monographs as annual supplements: Summaries of the Congress of the Spanish Society of Cardiology, Current topics in Cardiology and Relevant Problems in Cardiology. The first publishes presentations from the Spanish Society of Cardiology (SEC) National Congress; Current topics in Cardiology, published since 2004, is written by the SEC Scientific Sections and surveys new issues arising in the previous year. This supplement is currently indexed. Relevant Problems in Cardiology publishes a summary of the joint meeting of the American Heart Association (AHA), SEC and the Interamerican Society of Cardiology, coordinated by Dr Valentín Fuster and held annually during the AHA congress in November.
REC Supl is an economically solvent editorial product and its profits benefit REC.
From January 2006, the REC editor-in-chief decided to incorporate a supplements editor to give REC Supl a new boost. Below, we present the objectives achieved in 2006-2007 and the challenges for the future.
Objectives Achieved
The objectives we have worked towards in the last 24 months have been: a) to improve the quality and scientific content of the articles published in order to increase their value in continuing education; b) to fix the number of supplements per year and their frequency; c) to open up REC Supl to SEC scientific sections and working groups for them to publish updates and consensus documents, among other things; d) to publish a selection of the continuing education courses held in the Casa del Corazón; e) to improve accessibility; and f) to improve the design.
Improving Quality and Scientific Content
This has been our fundamental objective and, among our achievements, we would like to mention the following: we have paid special attention to ensuring that each issue presents an inclusive index and that topics are therefore handled globally, while avoiding the publication of redundant issues on specific conditions. We have taken care to ensure the uniformity of recommendations in each issue. We have also proposed the inclusion of appendices with practical summaries on applying recommendations (eg, blood pressure in the patient with diabetes). When reviewing imaging techniques, we have tried to offer a comparison between them to guide cardiologists about benefits and potential problems in diagnosing cardiac illnesses. In reviews of drugs or therapeutic procedures we always mention the scientific societies' clinical practice guidelines. Some monographs include a first chapter about the epidemiology of the illness under discussion, with previously unpublished data on the Spanish population.
Number of Supplements and Frequency
We have decided to publish a minimum of 6 bimonthly supplements per year in addition to the special issues of REC Supl (Summaries of the Congress of the Spanish Society of Cardiology, Relevant Problems in Cardiology and Current topics in Cardiology). In 2006 and 2007, we published 8 supplements, which represents a good balance between the commercial commitment and our ability to handle the editorial work generated. The supplements editor has tried to ensure each issue is published no more than 6 months after receiving the original articles, in deference to the guest editor and authors, and to guarantee the relevance of the texts in a field as changeable as cardiology.
Supplements and SEC Scientific Sections/Working Groups
The Editorial Committee is convinced that REC Supl can be the ideal medium for the publication of many documents generated by SEC sections and Working Groups. These documents may range from updates on specific topics, consensus documents and publications of epidemiologic data drawn from registries to other subjects of interest that simply do not fit into REC.
We have worked hard to achieve this objective in recent months and have already seen the fruits of our efforts in the publication in 2006 of "Current application of magnetic resonance,"8 under the auspices of the Cardiac MR and Cardiac CT Working Group and the Echocardiography and other Imaging Techniques Section (now called Cardiac Image). In 2007, we have already published 3 new issues: "Consensus Conference of the Spanish Heart Transplantation Groups" (also available in English in electronic format),9 which summarizes the results of the conference; "The cardiovascular clinic in the 21st century,"10 sponsored by the Clinical and Out-patient Cardiology Section; and "Cardiac stimulation with pacemakers: physiopathology, clinical use, follow-up, and complications," under the auspices of the Cardiac Stimulation Section.11 In 2008 we will publish another 2 supplements about defibrillators and nuclear cardiology, under the auspices of the respective sections/Working Groups.
Although we are fully satisfied with the objectives attained in these 2 years, we hope to continue to consolidate our achievements in the future.
Supplements and Courses Held in the Casa del Corazón
This is another of the new activities we are actively working on and which has received a boost since 2007. With this initiative, REC Supl has become another platform for continuing education within SEC, together with REC itself and the SEC Editorial Agency's educational products. Obviously, REC Supl does not intend to publish a monograph on each course but, rather, to select the most topical and therefore most changeable subjects for which our readers need updates. One advantage of this initiative is that the Course Director can be the guest editor and, usually, the content index can be drawn up by adapting material discussed during the course to meet editorial requirements. In 2007, we published "Diabetes for cardiologists,"12 the first supplement produced in this way, which covers the topics taught on the 2006-2007 course of the same name. In addition, "Diabetes for cardiologists" incorporates another novelty in the award of 3.66 SEC continuing education credits and 1.8 Spanish Ministry of Health and Consumer Affairs credits, which should prove attractive to doctors in training and others with professional careers which require periodic re-accreditation. In fact, this amounts to the implementation of a new quality criterion.
Accessibility
Since 2006, REC Supl has for the first time been available via the REC webpage (http:// www.revespcardiol.org). This URL address gives access to the REC home page where 1 of the 5 tabs links directly to REC Supl. Currently all issues of REC Supl from 2005-2007 are available (although there is a delay between publication in paper and availability on the Internet, sometimes due to commercial agreements); special issues of Relevant Problems in Cardiology and Current topics in Cardiology are also available online, from 2000 and 2004, respectively. All articles are in PDF format and can be downloaded free of charge. Table 1 shows data on REC Supl webpage visits and the number of pages visited in two 9-month periods in 2006 and 2007. Both the number of visits and the number of pages visited have practically doubled.
Design
During 2006 we decided REC Supl should use the same graphic design as REC. Since mid-2006, figures and schema, headings, subheadings, and frames around Tables appear in color in all supplements. Although design may seem a superficial aspect, we believe it is important as it makes issues more visually attractive and improves the appearance of figures and schema, making them more user-friendly, and easier to understand.
Challenges for the Future
In our efforts to make this journal more and more interesting for authors and readers, the challenges for the future are:
a) To Improve Visibility
In collaboration with the publishers, we are striving to have REC Supl included in international bibliographic databases (eg, Science Direct). One of the attractions of publishing in this journal will, without a doubt, be the greatest possible dissemination of articles. Today, the more databases that reference our articles, the more attractive REC Supl will be for authors. In this context, the lack of full text English translations of articles (currently it is only obligatory to publish an English abstract) may be a limitation, although in 2007 we have already published a full English translation of the "Consensus Conference of the Spanish Heart Transplantation Groups"9 with another pending for 2008.
In the short term, we cannot expect REC Supl to be admitted to MEDLINE or to receive an impact factor due to the way in which the Science Citation Index functions and the restrictions inherent in the system.
b) To Introduce a Peer-Review System
Through inviting an external, subject expert referee for each supplement. Currently, articles are reviewed by the guest editor and the REC Supl editor but we believe that adding an subject matter expert would provide a third, independent point of view that will undoubtedly help improve the quality of REC Supl.
c) Fulfillment of the ICMJE Norms
The ICMJE norms13 draw together several recommendations on supplement editorial policy that the editor wishes to meet and specify clearly in each issue of REC Supl. In this context, independent peer-review (above) is important. Moreover, in each issue the sponsors' role should be described as should any possible conflicts of interests on the part of the authors. MEDLINE has recently insisted on the need to specify these, particularly in supplements.
d) Implementation of Electronic Manuscript Management
From January 2008, all manuscripts will be electronically managed, as currently happens with REC manuscripts. This will really be an important change as it will speed up the review process and permit coordinated, simultaneous work on the part of the different people involved in the editorial process.
To summarize, we are pleased to be able to share with our readers the changes that have occurred in REC Supl in recent months and our plans for the future. We hope the opportunities REC Supl offers can be taken up by cardiologists and other professionals interested in the field of cardiology and that it can go on transforming itself in the coming years into a product of reference in continuing education in cardiovascular disease.
Correspondence: Revista Española de Cardiología.
Sociedad Española de Cardiología.
Nuestra Señora de Guadalupe, 5-7. 28028 Madrid. España.
E-mail: recsuplementos@revespcardiol.org