Running title: Efficiency factor

Devender Bhalla*1-4, Laurent Cleenewerck1

  1. Iran Epilepsy Association, Tehran, Iran
  2. Nepal Interest Group of epilepsy and Neurology (NiGEN), Kathmandu, Nepal
  3. Sudan League of epilepsy and Neurology (SLeN), Khartoum, Sudan
  4. Pôle Universitaire Euclide (EUCLID), Bangui, Central African Republic.

Name and address of the corresponding author:

*Prof HDR Devender BHALLA

Pôle Universitaire Euclide, An intergovernmental organization under UN Treaty 49006/49007

Bangui, Central African Republic.



Type of article: opinion piece

Keywords: Impact Factor, Cite Score, Efficiency Factor


According to the English definition, “efficiency” is the state or the quality of being able to accomplish something with the least waste of time and effort. With respect to the Journals, that would mean to provide the submitting authors a peer-review decision with the least loss of time and delays in academic return for the submitting authors. In other words, efficiency is the measurable ability of the Journals, whether paid or unpaid, to do their duties well, successfully, and without waste and avoidable loss to the submitting authors. The efficiency of the Journals is critical because that may ensure timely disbursal of new scientific information, and preventive and therapeutic solutions for use by the health agencies. Here, the efficiency should not be confused with effectiveness, since efficiency is doing things right, while the effectiveness is getting things done. Similarly, the argument of supposed rigor, which perhaps is not there [1] should also be not confused with efficiency, which is “doing things right in a time-bound convenient manner”.

Thus, with our vision to make the entire publication process coherent and convenient, while also to protect the right of submitting authors to have a time-bound, convenient, and efficient service from their service providers, i.e., the Journals, whether paid or unpaid, we propose “Bhalla-Cleenewerck Efficiency Factor ©” as a parameter for assessing the functional efficiency of the Journals. This Efficiency Factor© would help the submitting authors in making an informed decision about possible submission of their manuscript for publication to a particular Journal, and would also help the Journals in their healthy commercial competition.

Why do we need to speak about efficiency?

At present, there are no reliable tests of journal quality and operational efficiency, which is unfortunate since the “state of medical journals is terrible” and quality remains a problem.

There are as many as 16,000-40,000 medical journals in the world, and this number could still be an under-estimate since many for-profit Journals continue to emerge [2]. One common problem among both the new and established medical Journals is that they operate their services, to the submitting authors, without apparently adequate arrangements for ensuring efficient peer-review and decision-making process.

Individuals may get added in the peer-review/editorial board solely to fill the vacant space, who may, in the absence of any monetary gains or formal peer-review training, may not be able or available to provide a peer-review that is committed, direct, quality-based, careful, without personal bias and opinions, and without the sole vision to find faults alone. Thus, there are chances that the majority of current peer-review processes remain careless to the loss of timely scientific progress and disbursal of vital scientific work being done by the authors worldwide.

No doubt, a manuscript submitted in North Africa took one and half years to get reviewed, or, a manuscript submitted to a Journal in Latin America, and East and North Europe took nearly seven months to provide a review, or, well-established Journals in India may brutally change their submission system during the ongoing peer-review process  or may prioritize personal opinions over professional coherence. There are possibly numerous other examples of inefficiency. So, where may we draw the line to help the Journals in their duties and obligations towards their authors, based on whom they thrive?

How does Efficiency Factor© differ from Impact Factor and Cite Scores?

Both Impact Factor and Cite Score are commercial constructs run by profit-making agencies. These are possibly an attempt to lure authors in a dishonest way. Both systems have apparent issues, for instance, CiteScore includes all document types indexed by Scopus alone, and not all Journals are indexed in Scopus. Moreover, many Journals who are handled at high operational levels may not reflect in their Impact Factor. For instance, the Impact Factor of  World Health Organisation’s Revista Panamericana de Salud Pública is operational “since 1922” and has an Impact Factor of solely 0.53, although it is a “flagship scientific and technical publication for disseminating information of international significance to strengthen national and local health systems within the continent”.

In addition, there are no ways to objectively determine which Impact Factor can be considered as good and which may not. Moreover, Impact factors are based on citation numbers, and others have also shown that there would always be a small group of core journals that may account for a substantial percentage of citations in a subject or a discipline, leaving most other Journals aside [3].

The Efficiency Factor ©  (EF©) can be quantitatively determined, as below (Table 1), and the assessment could be organized at two separate levels, firstly, for the first submitted version, and secondly, for the revised submitted version. Here, we address the first scenario alone, for the moment, since first Peer-review of a manuscript is the most troubling in terms of efficiency. The scores are in Likert Scale in the range of zero to three, with zero as the minimal efficiency and three as the maximum efficiency. The overall Efficiency Factor© of a Journal, therefore, ranges from 0 to 21.

Table 1: The parameters for estimating Bhalla-Cleenewerck Efficiency Factor© (B-CLEF©)

Level of inconvenience for submission Email submission 3
Submission with minimal data entry 2
Submission with considerable data entry 1
Submission with enormous data entry and/or with reqt. of allied documents and/or broad copy-editing or formatting 0
Time to acknowledge the submission Same day 3
First two days 2
First week 1
Never 0
Editorial in-house review First one week 3
First two weeks 2
First three weeks 1
First four weeks or never 0
Time to selection of peer-reviewers Subsequent one week 3
Subsequent two weeks 2
Subsequent three weeks 1
Subsequent four weeks or later 0
Time to primary peer-review Subsequent one week 3
Subsequent two weeks 2
Subsequent three weeks 1
Subsequent four weeks or later 0
Time to decision after Peer-review Subsequent one week 3
Subsequent two weeks 2
Subsequent three weeks 1
Subsequent four weeks or later 0
Time to publish after accept Subsequent one week, or, AOP 3
Subsequent two weeks 2
Subsequent three weeks 1
Subsequent four weeks or later 0
Footnotes: The allied documents include those documents that are not necessary for the peer-review stage, such as publishing contracts, hand-signatures of all authors, Ethics Board letters, and similar. The duration is in calendar days. AOP is the Ahead of Print or online publication of title, or, abstract, or, full manuscript


To conclude, we put forth our Efficiency Factor©, a non-profit innovative measure for the sole purpose of “greater good” of all concerned. We hope that this measure would help the Journals recognize their duties towards efficient service and to also help them make their publication process more fulfilling and coherent for everyone’s benefit and ease, particularly for the authors, based on which the journals thrive. The Efficiency Factor should become an important aspect of an author’s informed decision to make a submission to a particular journal.















Not applicable.


DB receives research funds from entities that does not directly deal with PB, and attend and give talks in meetings that may have been funded directly or indirectly by commercial entities. The author is under public International Law. All other authors have no conflicts of interest.


Not applicable.


All authors made similar contribution.
















  1. Rennie D. The present state of medical journals. The Lancet. 1998;352:18-22.
  2. Dickersin K, Scherer R, Lefebvre C. Identifying relevant studies for systematic reviews. In: Chalmers I, Altman D, editors. Systematic reviews. London: BMJ Publishing Company; 1997. p. 17-36.
  3. Garfield G. Bradford’s law and related statistical patterns. Essays of an Information Scientist. 1980;4:476-83.


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