Neil Smart, profile photoJust four months into the new role, Editor-in-Chief of Colorectal Disease, Neil Smart talks to ESCP’s communication chair Richard Brady on the challenges of academic publishing in the current coronavirus crisis.

Neil, thank you for taking time to speak to me and congratulations to the role of Editor of Colorectal Disease. The society has a long history with the journal, can you tell me how important the relationship is for the journal?

Thanks Richard. I think the relationship between ESCP and Colorectal Disease is very important and mutually beneficial. As well as being EIC of Colorectal Disease, I’m an ESCP member as well and have benefited personally from that membership through the pre-congress placement fellowships (2010 to visit Mario Trompetto in Vercelli), participation in collaborative research, attending and presenting at the annual congress and so on.

Both the founding EIC of Colorectal Disease John Nicholls and my predecessor Neil Mortensen were passionate about the relationship with European (and global) colleagues. I hope to continue with that vision and work collaboratively with ESCP. Isolationism does nobody any favours, least of all those within clinical research. Scientific truth is not confined to artificial, man-made geopolitical boundaries. We are one community trying to do the best for our patients.

What has been your strategy in the first few months of the role, and are encouraging new blood into the journal?

I had three key aims when I was appointed:

  1. Improve impact factor (rightly or wrongly still the most valued currency)
  2. Improve services to authors (because as an author myself I share the frustrations that the peer review process can bring)
  3. Provide for our core readership (members of affiliated societies want to read about the studies they have participated in, those that are relevant to their patients and those that help with doing their everyday job.)

To achieve these aims I had three strategies:

  1. Improving the quality of submissions
  2. Improve the quality of our processes
  3. Innovation in publishing

The focus had been on improving our processes first of all. This has been achieved by bringing in a lot of new talent, predominantly from around Europe, but also from around the globe. We have new Editors in Sue Clark and Dieter Hahnloser, new Associate Editors - Eva Angenete, Elaine Burns, Matteo Frasson, Cherry Koh, Yasuko Maeda, Gabrielle van Ramshorst and a new team specifically for videos - Salomone de Saverio and Valerio Celentano. I’m also delighted to welcome Dr Sarah Nevitt as our Junior Editor for Statistics.

In addition, the Editorial Advisory Board has been refreshed and a new Junior Editorial Advisory Board created. We now have a diverse and inclusive team, more representative of our community than ever before, of experts with extensive research portfolios in their own right who can act as a pool of high-quality peer reviewers.

Clearly the journal has published a large number of collaborative audit studies from the society - what do you see is the future of collaborative research studies generally?

I think we are beginning to see the benefits of high quality, prospectively collected data with the research questions and analysis stated a priori in detailed protocols. ESCP and EuroSurg have been instrumental in taking the models developed by the West Midlands Research Collaborative in the 2000s and promulgating them around the globe. Dion Morton, Tom Pinkney, Aneel Bhangu and many others have changed the face of research within the field of colorectal surgery.

The same team in collaboration with others have expanded the model and developed it further to deliver observational studies & RCTs across the world – generating data and yielding findings that are widely applicable and can benefit even more patients. The latest incarnation of the model is COVIDSurg and should rapidly generate findings useful for saving the lives of thousands – more relevant now than perhaps at any time in recent history.

Collaboration is now en vogue and the days of the spiteful and unproductive competition I witnessed in my early years as a surgeon are thankfully numbered. Social Media has brought such collaboration to the masses and into the palms of their hands, where anyone can contribute and feel valued in an open source manner akin to what those in computer science have been doing for decades. I can’t see the clock turning back.

How are you dealing with the changes in the publishing environment and what is your view on open access and are there plans at the journal to transform?

Open access (OA) is here to stay. Colorectal Disease is a hybrid journal and has some OA content. If anything, the current global crisis with COVID-19 will likely accelerate calls for transformation to full OA across all fields. The principles behind Coalition S/Plan S will not go away. For me the question is "when?" not "If?" this transformation will occur. No one wishes to be King Canute, trying to resist the inevitability of the rising tide, least of all Colorectal Disease. There remains, however, a delicate balance to be struck surrounding the timing of adopting full OA. We are monitoring the situation very closely.

Up until the current COVID-19 era, what were the trends you were seeing in the colorectal surgical literature and are there major gaps that need focus?

Continuing from the theme on collaboration above, we were starting to see the demise of the single institution retrospective case series, particularly for well established surgical approaches/techniques. There is still a place for single institution manuscripts, especially if the technique is novel and development/reporting adheres to the principles of the IDEAL collaboration ( The quality of the manuscripts of this type we accept now is very much higher than a decade ago, largely thanks to standardised reporting frameworks as laid out by the Equator Network (

The major gaps in the literature remain in terms of choosing outcomes that are relevant to patients. I hope to see more articles that have patient reported outcome measures (PROMs) and Quality of Life (QOL) as primary outcomes rather than those that are of predominantly academic interest to surgeons (and which can too easily be manipulated to give sample sizes that are specious).

Those studies that focus on process measures (e.g. length of stay, duration of operation etc) as primary endpoints should be confined to the research dustbin. As a secondary endpoint, especially to aid health economic analyses, I’m still very supportive of them.

Clearly these are extraordinary times, on a personal note, how is the journal responding to the crisis?

We continue to receive submissions as usual for the moment. We are cognisant that many of our reviewers will be tied up with the COVID response in their hospitals and so we expect review times to elongate a little. Wiley has signed up to the World Health Organization (WHO) and Wellcome Trust commitment to share research data and findings relevant to the novel coronavirus outbreak.

For more information please see:

Can you tell me what you are seeing coming through in relation to submissions from surgeons in relation to COVID-19?

We have had correspondence detailing mechanisms for remote consultations with patients that has been very well received, especially by surgeons in the UK NHS. More manuscripts to come on Italian experiences of colorectal surgery in the COVID era. We expect more guidance documents from affiliated societies in due course.

As a journal, what kind of papers do you want members to send to you, specifically also during the current crisis?

We are keen to receive papers relating to COVID 19 that are specific to colorectal patients and we will endeavour to process them as a priority. Novel solutions to minimise exposure to smoke and particulate matter during laparoscopic surgery are particularly welcome as Technical notes or correspondence. Video vignettes demonstrating how to set up such equipment would also be welcome. Longer term, we’d welcome outcome data on COVID 19 positive patients undergoing both benign and cancer related colorectal surgery, both as emergency and urgent (time critical cancer) elective situations.

Globally, what have been the most important papers to pay attention to in regard to COVID-19?

Personally, I found Repici et al 'Coronavirus (COVID-19) outbreak: what the department of endoscopy should know' in Gastrointestinal Endoscopy, doi: very useful.

The debate around the role of laparoscopy and viruses in this COVID 19 remains important. I note the guidance from SAGES and others. The following may be useful: Kwak HD, et al. Occup Environ Med 2016;73:857–863. doi:10.1136/oemed-2016-103724

You are the lead for the CIPHER study – will the crisis effect the study and how have you responded to the crisis in terms of recruitment?

Many of the sites within the NHS have suspended recruitment across all NIHR studies during the COVID period and approximately a third of our sites have suspended recruitment - more may yet follow suit. We therefore expect recruitment to fall during this time. However, we are cognisant that some activity regarding elective cancer surgery may continue in some sites, especially with the UK Government’s announcement relating to capacity in private hospitals. We are also aware that surgeons may take lower risk options surgically due to lack of critical care bed availability and as a consequence may have a lower threshold for stoma formation. NIHR have not ordered suspension of all studies so far, and so we have continued to allow recruitment during this period if the site has capacity and personnel to capture the data required.

ESCP Affiliates