Novelty in research: A common reason for manuscript rejection!

We often hear back from reviewers and editors of scientific journals that a particular manuscript (original research, case report, series or letter to the editor) has not been accepted because it lacks novelty. Though disheartening, the reason for such a response from said reviewers needs proper elucidation, as a moral obligation from the editorial board towards the authors of the manuscripts. Research, as defined by the Cambridge Dictionary is ‘a detailed study of a subject, especially in order to discover (new) information or reach a (new) understanding’.[1] Novelty on the other hand is defined as ‘the quality of being new, original, or unusual’ or a ‘new or unfamiliar thing or experience’. Therefore, adding the adjective novel along with research is actually one of the most common redundancies that is similar to ‘return back’ or ‘revert back’ and denotes one and the same thing![1] Without delving into the nitty-gritty of the English language, novel research can be best described as one or more elements of research that are unique, such as a new methodology or a new observation that leads to the acquisition of new knowledge. It is this novelty that contributes to scientific progress. Since the main aim of research is to unravel what is unknown or to challenge views or ideas that may or may not be based on sound scientific principles, this exclusivity of novel research therefore allows us to expand our horizon beyond the realms of known domains.[2] Having defined novelty in research, one of the most common mistakes that researchers commit is confusing novelty with originality. These terms are often used interchangeably. Originality implies the genuineness of the work and signifying that the said work has not been copied from any other source. Originality can always be examined by plagiarism checkers, and data is often analysed for duplication or fabrication only if there exists a certain doubt regarding its factuality. A study, therefore, can be mutually exclusive i.e. novel, but not original, or it can be original but not novel. It is the latter that reviewers and editors encounter most often. The most common scenario encountered in anaesthesia related manuscripts that lacks novelty is the substitution of the same anaesthetic technique to different surgical procedures or patient populations (based on gender or age), with no expected change in the result. Here, the hypothesis and study designs are almost identical; however, the agents are replaced with different ones. A classic example is the comparison of the duration of analgesia with a longer acting analgesic or that of a local anaesthetic with a shorter one. The intrinsic properties of a drug are already well known, and, irrespective of it being an abdominal surgery or a limb surgery, the drugs are going to behave according to their pharmacological properties. Similarly, modern airway devices, such as video laryngoscopes, have conclusively been proven to be better aids than the conventional ones. A comparison of any new laryngoscope would definitely be a novel idea, in terms of whether it outperforms the existing device. If a certain number of studies, systematic reviews, or metanalyses have already been published on that particular device or drug, the study undertaken cannot be considered novel unless the results of the aforementioned study, utilising sound scientific principles, actually challenge or contradict the existing ideas. Another common scenario faced by the reviewers or editors is the anaesthetic management of common or uncommon syndromes or diseases. They are often well described in literature, but when managed as per the existing guidelines and expected challenges they do not constitute novelty. A case report is novel and worth publishing if an unforeseen or unanticipated event has occurred or the case has been managed in a unique or unconventional manner or significant innovative skills or equipment have been employed. However, due caution has to be exercised as this should not lead the researcher to be overtly adventurous or show undue bravado by going against the principles of patient safety. Now here lies the contradiction. We have been harping on novelty, introducing new ideas, and challenging old fixed ideas when conducting research and reporting cases. However, at the same time, due caution must be exercised, and one must not to be adventurous, unconventional, or bold. There is a fine line of distinction between these two. Herein comes the role of ethics, a separate topic of discussion altogether. Research or advancement may not always be novel just by intervention or experimentation. Theoretical or hypothesis testing may also contribute paradigm-changing findings. Some of these may include thought-based experiments, rectifying or logical rearrangement of existing knowledge, re-evaluating space and time, utilising principles of philosophy, and analysing already existing data from a new and different perspective.[3] A thorough literature search is pivotal for designing a novel research project as it helps to understand known facts and gaps. An attempt at bridging identified research gaps adds to the novelty of the study.[2] Another aspect of novel research is technological advancement. Most research starts from an idea, a thought, or an observation that further leads to hypothesis building, experimentation, data collection, analysis, and, finally, principle building. Technological advancement may stem from any of these phases. Novelty in research propels the industry to excel and outdo itself.[4] Can novelty in research be measured? The answer is a resounding yes. Traditionally, it has been measured through peer reviews and by applying bibliometric measures such as citation or text data, keeping in mind their inherent limitations. However, word embedding is a new technique that can reliably measure novelty and even predict future citations. However, this is currently limited by publicly available word-embedding libraries and its high costs.[5] To the average author and reader, novelty adds to their knowledge and makes them aware of complications that they may encounter. It offers a way out by conventional or different measures, within the realm of scientific, ethical and principles of social justice, should they get stuck, keeping in mind the quote of Hippocrates: ‘Primum non nocere’ (First, do no harm).