References Are Important – Part 1


What we do is called scholarly publishing. Scholarly publishing—in all fields, but particularly in medicine—builds on work that has already been done. That prior work is acknowledged through references.

References are arguably just as important as the text of a paper. And yet every day, authors submit papers to scholarly journals with incomplete and inaccurate reference lists, with callouts in the text that point to the wrong references in the reference list, and with incorrectly and inconsistently formatted references.

Nothing makes a point better than actual examples.

Here is an unedited entry from a reference list in a paper we reviewed this week:

Gaspar MP, Md † ‡, Motto MA, et al. Platelet-Rich Plasma Injection With Percutaneous Needling for Recalcitrant Lateral Epicondylitis Comparison of Tenotomy and Fenestration Techniques. doi:10.1177/2325967117742077

Notice the symbols and the degree after the first author’s name. They don’t belong there. Notice that this reference includes ZERO publication information: there’s no journal name, there’s no publication date, and there’s no volume/issue/page number. In addition, not all the authors are listed and only the first word of the title should be capitalized. This citation cannot be published in its current form.

Another common problem—and far more insidious than sloppy reference formatting—is citing the WRONG reference. Here is a real example from a paper we reviewed this week:

Statement in the text: “An estimated 80% of heroin-users admit to first abusing a prescribed pain medication2.”

Reference #2 in the reference list: Scully RE, Schoenfeld AJ, Jiang W, et al. Defining Optimal Length of Opioid Pain Medication Prescription After Common Surgical Procedures. JAMA Surg. 2018; 153(1):37-437.

The Scully et al paper does not contain the word “heroin” or the 80% statistic. The author cited the wrong paper.

Here’s another example from the same paper:

Substance Abuse and Mental Health Services Administration. Results from the 2013 Nation Survey on Drug Use and Health: Summary of National Findings. Rockville, MD. Substance Abuse and Mental Health Services Administration; 2013.  https://www.editorialmanager.com/otohns/accounts/AuthorPg.htm. August 2nd, 2019.

The URL provided for this government report is a URL for the online submission portal for the journal Otolaryngology—Head and Neck Surgery. Let the enormity of that error sink in for a moment.

Further, the name of the report is not accurate in this citation and the agency name is given twice.

This lack of attention to references is not OK.

Not only does treating references as an unimportant component of a paper reflect poor scholarship and shoddy work, not only does this lack of attention fail to credit the researchers and scholars and practitioners who came before you, but submissions like this also reflect a lack of respect for the editorial staff. The editors at scholarly journals are not administrative assistants responsible for fixing your reference lists.

The reference problem is so widespread that some of the larger journals, you know them—the ones with the very high rejection rates—reject papers before peer review if the staff in the editorial office finds problems with the references. Good for them! Poor references often reflect poor overall work, so using the reference list as a quality benchmark to judge a paper is a good and justifiable practice.

References are important.