Most journals use acceptance or rejection rates to analyse whether the number of papers that they are rejecting or accepting is too high and to monitor any unusual trends. The rates depend on the quality of papers submitted to a journal. These rates are an internal quality control benchmark, whereas the impact factor is an external benchmark. Journals do not necessarily decide at the beginning of a year that they will reject 80% or 90% of articles; the rates naturally fall into a range. Some journals decide a target, but only as an internal benchmark to monitor whether the rate has spiked unusually, and the target varies from month to month.
The other factor that affects acceptance or rejection rates is the number of papers in the system, which most managing editors and editors monitor very closely: the fact that the system has enough papers for a whole issue could influence the number of accepted papers. This is of particular concern to specialty journals that could publish 19-24 papers a month in one issue. Therefore, a general medical journal that publishes say 3 articles weekly and gets around 10,000 submissions a year will have a higher rejection rate than a specialty journal that gets 1500-3000 submissions a year, although it is not the number of papers submitted that is taken into consideration when calculating the acceptance rates but the number of papers handled or considered. However, the number of submissions and their quality directly affect the number of papers handled.
Most journals refrain from publishing acceptance rates on their website as they feel authors might be put off by a low acceptance rate. More importantly, editors of journals reject papers for a variety of reasons and often provide helpful comments to authors as feedback. A few specialty journals do reject papers on the basis of priority, but this simply means that the research is not novel enough for the journal or the standard of research is very poor. Most editors will often overlook language problems initially and review papers only on the basis of scientific content, but if the paper goes through a revise-and-resubmit cycle, editors expect and advise authors to seek professional help regarding language. The few journals that do publish their acceptance rates do so on their pages about the journal. Hence, authors should not use acceptance/rejection rates as a basis for selecting a journal, although mathematically speaking, the higher the acceptance rate, the higher the probability of a paper being accepted.
Despite smaller specialty journals having a higher acceptance rate, most randomized trials are submitted to the general medical journals with higher rejections rates- purely because general medical journals have higher impact factors and visibility. So do not let mere rejection rates dissuade you from submitting to a journal. At the same time, be aware that a specialty journal, which may not compare favourably with a journal that has a broader scope in terms of the impact factor or visibility, may reach the target audience you seek.
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