1. Mason, Diana J. PhD, RN, FAAN, AJN Editor-in-Chief

Article Content

One of the most important concepts in journalism is what the International Committee of Medical Journal Editors (ICMJE) calls "editorial freedom and integrity." "This concept of editorial freedom should be resolutely defended by editors," the committee's Web site says, "even to the extent of their placing their positions at stake." I've never had to risk my job in that way, but I would if necessary. That's how seriously I take my obligation to produce a publication nurses can have confidence in.


Our staff strives to disclose to readers any possible conflicts of interest in what we publish. For example, while AJN is the official publication of the American Nurses Association, the ANA does not control what we publish, except in its own advertisements and on editorial pages that bear the ANA logo. The ANA has the right to review all editorial pages that refer to it, but we're not obligated to make the changes it requests. The ANA respects editorial independence and only occasionally requests a change. When we make one, it is to ensure accuracy.


Similarly, advertisers have no influence on the editorial content of the journal. Our Job Focus sections are now marked "Special Advertising Section" to alert readers that those pages have not undergone our usual editorial review. Many publications are financed solely through advertising, and nurses receive them for free. Their editorial integrity may be compromised by the obligation to produce articles that won't rankle the advertisers. AJN has no such obligation. We have published and will continue to publish news and other material critical of advertisers, if warranted.


Can the author of an article on a new drug be unbiased if she is a paid consultant to the company that makes it? We now require all authors to disclose conflicts of interest involving their relationships with organizations or manufacturers of products their articles discuss-for example, holding stock in a company or being paid by one as a consultant or speaker. If there is such a relationship, we ask the author to describe how the organization or company may have influenced the article. And we now print disclosures of conflicts of interest in author biographies on the first page of each article.


Why is all this important to you?


First, you should be able to trust that what you're reading has not been tainted by outside interests and that it doesn't present them in the light of favoritism.


Second, schools of nursing must recognize that AJN adheres to the editorial standards established by the ICMJE ( and employs a double-blind peer review process. I continue to hear from faculty members that because schools of nursing don't believe AJN is peer reviewed, being published in AJN does not count toward tenure and promotion. Many nursing publications claim they're peer reviewed, but their processes don't adhere to the standards of double-blind review.


AJN 's process does. Manuscripts submitted to AJN are reviewed here first, usually by me. Each one that I deem relevant to our readers is assigned to at least three experts who aren't told the authors' names (submissions of original research are also reviewed by a statistician or a research methodologist). Other AJN editors and I evaluate the experts' reviews, and no manuscript is published if all reviewers recommend rejection. When there are differences of reviewers' opinions, we usually send the reviews (without reviewers' names) to the author for use in revision of the article.


We receive about 700 manuscripts each year; we publish about 15% of them, and nearly 95% of those are revised before acceptance. Although some have questioned whether double-blind peer review ensures unbiased evaluation of manuscripts (see the Cochrane Library's recent assessment:, AJN will continue to adhere to this process as one of many ways in which we attempt to ensure the quality of what it publishes.


The nursing profession and our readers deserve that. We may misstep, and I encourage you to tell us when you think we do.