Interview with Dr. Tar Choon Aw—Winner of the Editor of Distinction Award (Singapore)

Francis Bacon: “Reading maketh a full man; conference maketh a ready man; and writing maketh an exact man.”

Question 1: 

Congratulations on receiving the Editor of Distinction Award! To begin, could you briefly introduce yourself and share the core themes driving your research? 

Prof. Tar-Choon Aw:  I am a Clinical Professor (Pathology Academic Clinical Program) at the Duke-NUS Graduate Medical School and Director of Chemical Pathology (Dept of Laboratory Medicine) Changi General Hospital.

One enduring priority in laboratory medicine is the evaluation, validation, and verification of new diagnostic technologies and improvements to existing ones. New tests and platforms are constantly being introduced, but the key questions remain the same: How good is it? Is it equally applicable in different populations? Are reference ranges established elsewhere applicable locally? We constantly need to determine whether new tests work as well in our local population as they do elsewhere, whether they are good enough for clinical use, and which platforms or technologies we should adopt. Independent verification is essential because manufacturers will naturally present their products in the best possible light. 

Consequently, pre-clinical and exploratory research work remain key to eventually adopting these new technologies. Many important discoveries arise serendipitously. Research advances are often driven by curiosity and serendipity rather than by large, targeted programs alone. You do not begin an experiment knowing it will win a Nobel Prize. Most of the time, only afterwards do we understand the full significance of the research. Take the HIV test for example—the scientists were studying retroviral biology and were initially looking for markers to understand biological processes. Supporting innovative ideas and early-stage projects remains important for scientific progress.  

Question 2: 

What does the Editor of Distinction Award mean to you? What originally motivated you to serve as an academic editor? 

Prof. Tar-Choon Aw: Overall, my motivation for being involved in academic publishing is the same reason I do research. Of course, research is part of my professional responsibilities, but more importantly, it helps us answer practical questions. Research helps us make informed and dependable decisions. It allows us to evaluate new assays, solve clinical problems, test new ideas, and guide choices between competing technologies. During the COVID-19 pandemic, for example, speed was critical. We generated local data on vaccine responses because information specific to our population was needed urgently. Even studies with relatively small numbers provided valuable insights at the time. 

Regarding my work as an editor, I think one of the main responsibilities of editorial work is to review regularly and in a timely manner. Timeliness is a responsibility that I particularly value, both as an author and an editor. Manuscripts should be evaluated and decisions made in as timely a manner and as quickly as possible. Authors should not have to wait too long for a decision. If a paper is not suitable for the current journal, authors should at least be informed promptly so that they have the chance to submit their work elsewhere. 

Question 3: 

How do you balance academic rigor with your clinical work? 

Prof. Tar-Choon Aw: In laboratory medicine, our role differs from that of frontline clinicians. Our responsibility is to ensure that tests are performed accurately and that results are delivered efficiently. Speed is a priority. The faster reliable information becomes available, the more the uncertainty around a patient's diagnosis and treatment can be reduced. 

For us, academic rigor and clinical work are closely linked. Medicine is a knowledge-intensive profession, so we do not really have a choice but to keep up with the latest developments. When new tests become available, we evaluate them, assess their effectiveness, and determine whether they provide sufficient value for clinical adoption. The goal is not always to find the absolute best test, but to determine what is the most cost-effective option while also meeting our needs. 

To accomplish this, we must constantly read, discuss and share our ideas, as well as write about our findings. 

These are the principles we emphasize to our trainees. As Francis Bacon famously said, “Reading maketh a full man, conference maketh a ready man, and writing maketh an exact man.” Those three activities remain essential to medical practice and academic growth. 

Finding time requires developing habits and making use of small pockets of time throughout the day. I regularly review journal tables of contents, read articles, and listen to podcasts (such as Eric Topol) and webcasts from trusted experts. Continuous learning is a key part of the profession. 

Ultimately, research and editorial work both contribute to generating reliable evidence that helps clinicians, laboratories, policymakers, and patients make better decisions. 

Question 4: 

Based on your expertise, which emerging areas in lab medicine/diagnostics should the journal prioritize in the next 3–5 years to strengthen its global footprint? 

Prof. Tar-Choon Aw:   Artificial intelligence (AI) is a major area of interest, especially on how transformative it could be in diagnostics. AI has significant potential, but its value depends heavily on the quality and representativeness of the data used to train the models. One of the key challenges will be ensuring that AI tools are developed and validated using sufficiently robust datasets. 

In diagnostics, the automation of technologies such as liquid chromatography–mass spectrometry (LC-MS) is also worth watching. These technologies offer greater sensitivity and specificity, but current workflows remain complex and labor-intensive, particularly for sample preparation. Several companies are working on automating and integrating these workflows, which could significantly improve efficiency and broaden adoption. However, questions around cost-effectiveness (in particular for the patient), affordability and implementation remain important considerations for the long-term success of this area. 

Another important area is the study of emerging biomarkers, particularly in neurodegenerative diseases such as Alzheimer's disease. There is growing excitement around new biomarkers, but important questions remain regarding how applicable they are in different populations—whether they perform consistently across settings, and how they relate to patient outcomes over time. Longitudinal studies are particularly valuable, although they are often difficult to conduct because they require long-term commitment and funding. 

Overall, the journal should pay more attention to developments of technologies that improve diagnostic accuracy, support evidence-based decision-making, and demonstrate value in real-world clinical practice. These new technologies will be expensive and wealthier countries, such as the United States, Europe and China, will be leading the development.  

Question 5: 

What is your #1 piece of advice for early-career scholars taking on editorial or GE roles? 

Prof. Tar-Choon Aw: First, be diligent and complete reviews as quickly as possible. Timeliness is important because delays affect authors and slow down the dissemination of research. 

Second, if a manuscript falls outside your area of expertise, do not hesitate to pass it on to a more suitable editor. Do not attempt to review something that is beyond your expertise. 

Third, recognize that editorial responsibilities usually come with experience. It is uncommon to take on major editorial roles very early in one's career. For example, I only became more heavily involved in editorial work in the last 5–10 years. Most people start by contributing in smaller ways and gradually gain experience over time. 

I encourage early-career scholars to accept opportunities when they arise. Reviewing manuscripts, participating in editorial activities, and contributing to the publication process all help build experience and understanding. 

It is also important to submit your own papers and experience the publication process from the author's perspective. Understanding what authors go through enables editors to make better decisions and approach their work with greater empathy and perspective.  

Question 6: 

What is the one improvement you would most hope to see in the journal's editorial workflow or experience moving forward? 

Prof. Tar-Choon Aw: In the past, one source of frustration was receiving manuscripts with poor grammar and weak English. At the time, I often felt that considerable corrections were needed before I could properly evaluate the scientific content. However, in fairness to editorial assistants, they do not know whether a paper will ultimately be accepted or rejected, so it may not be worthwhile to invest significant time in language editing at an early stage. 

However, the overall language quality has improved considerably with the availability of AI-assisted writing tools. While the writing style may not always be perfect, the grammar is generally much better and the content is readable. 

Personally, I do not mind suggesting improvements to wording or sentence structure while reviewing a paper. Since I am already reading the manuscript, making a few suggestions to help the authors does not take up too much time. Unfortunately, not everyone takes this approach. Some reviewers recommend rejection. However, when language issues result in repeated rounds of revision, the editorial process can become unnecessarily prolonged.  

Ultimately, the most important consideration is the quality of the science. As long as the scientific content is sound and clearly communicated, that should remain the primary focus of the review process.