What’s new? addressing novelty in manuscripts

      Hardly a day goes by without us reading a review that indicates that a submitted manuscript lacks novelty. We have carefully considered this criticism and pondered the disconnect between what the authors must think they presented versus what the reviewer opines. Surely, the authors believed they were writing from a new perspective or could present a new angle to the topic. The reviewers, however, did not appreciate the new twist or their imagination was not captured by the authors. There are certainly a fair number of manuscripts that present data from an institutional series which lacks novelty. A reasonable number of works, however, present data that indeed fills an incremental knowledge gap and may be worthy of publication. How can we satisfactorily address this dilemma?
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