Dr. Hoppin has performed a great service to the scientific community by writing his article (1). He makes the point that a good review cannot be completed in 3 hours – especially when there are significant issues to address. I wonder if this problem could be helped in part by more prescreening by journal editors. For example, the “n = 10” studies that merit publication only in abstract form, the obvious “fishing expeditions,” and those written in poor English could be sent back for revision prior to submission to reviewers for detailed technical review. Also, if more reviewers were selected per submission, guidance could be provided as to which specific areas each reviewer should pay closer attention. Speaking personally, time constraints are the major reason for which I decline a reviewing opportunity.
| 1. | Hoppin F. How I review an original scientific article. Am J Respir Crit Care Med 2002;166:1019–1023. |
Peer review sets standards for publication, and can substantially improve the science and clarity of submitted articles (1). These goals are compromised when scientists refuse invitations or conduct hasty reviews because of the attendant time. Dr. Druce's letter, above, offers two suggestions that might ease that burden. Each has merits, but must be balanced against other considerations.
| 1. | Triage. The prevalence of poorly prepared submissions reporting weak studies is frustrating and discouraging to reviewers. Triage of such articles would presumably reduce that problem, and prestigious journals could presumably afford to miss a few worthy articles without substantially compromising their quality. The practice, however, of rejecting a paper that represents a man-year's work without giving it a serious, broadly informed examination, and without giving careful feedback seems both unfair and unwise. Judging a study as a “fishing expedition,” for example, can be glib, a judgment of scientific style rather than of merit. Accountability demands participation by more than one scientist and responsible communication with the authors. | ||||
| 2. | Guidance to specific areas for each reviewer's attention already occurs to some extent through the Associate Editor's selection of reviewers. Further narrowing of each reviewer's focus, however, would walk away from a comprehensive assessment of a submission's science and its appeal to a reasonably broad audience. | ||||
Other possible approaches fall logically into two categories–although I do not find them particularly promising:
| 1. | Increase the tangible benefits of reviewing. These are indeed limited (2, 3). Editors might consider sending letters of thanks to their best reviewers with copies to their Chairs. They might also push the idea that good reviewing leads to invitations to submit editorials. But that's about it! Meaningful reimbursement is probably impractical. | ||||
| 2. | Better submissions. For any journal, there is opportunity in enhancing its image; e.g., through the powerful positive feedback of good reviews. More generally, promoting good science runs into a variety of problems – structural (strong pressures within a system that does not reward quality very well), cultural (local practices of limited consulting and debate, particularly across disciplines), even topical (e.g., less rigorous research training for clinicians than for basic scientists). There may be more practical approaches to improving the preparation of manuscripts by persuading authors that it is distinctly in their best interests either to apply the necessary discipline (2–5) or to corral help with the writing. Tobin's recent editorial (6) may be a useful model. | ||||
| 1. | Goodman SN, Berlin J. Fletcher SW, Fletcher RH. Manuscript quality before and after peer review and editing at Annals of Internal Medicine. Ann Intern Med 1994;121:11–21. |
| 2. | Hoppin FG Jr. How I review an original scientific article. Am J Respir Crit Care Med 2002;166:1019–1023. |
| 3. | Godlee F. Making reviewers visible: openness, accountability, and credit. JAMA 2002;287:2762–2765. |
| 4. | Day RA. How to write and publish a scientific paper, 4th ed. Phoenix, Arizona: The Oryx Press, 1994 |
| 5. | Huth E. How to write and publish papers in the medical sciences, 2nd ed. Baltimore: Williams and Wilkins, 1990 |
| 6. | Tobin MJ. Compliance (COMmunicate PLease wIth Less Abbreviations, Noun Clusters, and Exclusiveness). Am J Respir Crit Care Med 2002;166:1534–1536. |
Dr. Druce agrees with Dr. Hoppin (1) that a worthwhile review of a manuscript requires a considerable expenditure of time. Dr. Druce asks whether journals might not improve the efficiency of peer-review by declining a greater fraction of manuscripts without sending them out to experts for assessment.
At AJRCCM, we believe that a scientific journal represents a great deal more than the articles published within its covers (2, 3). We try to provide a service to authors even when we do not accept their manuscript for publication; we hope that feedback on rejected manuscripts influences the quality of research in pulmonary and critical care medicine. Since September 1999, when the current editorial team began its term, we have received over 6,500 manuscripts and more than 98% were entered into peer review.
It is true that many journals reject a considerable fraction of manuscript without peer review. For example, The Lancet rejects about 70% of manuscripts without external review (4). The Journal of Clinical Investigation rejects 25% or more of manuscripts without formal assessment (5). Editors who reject a high fraction of manuscripts without peer review give two justifications for their action. One, a rapid rejection enables authors to rapidly submit their manuscript to another journal. Two, the editors wish to expedite the processing of manuscripts that appear more meritorious (4). Rapid rejection certainly shortens the time for submission to another journal. Nevertheless, all manuscripts submitted to AJRCCM undergo complete peer review within 30.3 days (median), and accepted manuscripts are published on our website within one week of acceptance.
AJRCCM interprets the term “peer-reviewed journal” to mean that decisions on submitted manuscripts are almost invariably based on assessments by fellow experts in a research field. I recall several instances where I judged a manuscript to have minimal merit on an initial superficial reading. After receiving favorable critiques from the reviewers, however, I changed my mind and a revised version of the manuscript was published in the Journal.
It is possible for AJRCCM to provide detailed critiques on virtually all submissions only because more than 6,000 individuals in our Web-based database express willingness to selflessly donate time and expertise to this task.
| 1. | Hoppin FG Jr. How I review an original scientific article. Am J Respir Crit Care Med 2002;166:1019–1023. |
| 2. | Tobin MJ. Rigor of peer review and the standing of a journal. Am J Respir Crit Care Med 2002;166:1013–1014. |
| 3. | Tobin MJ. The Journal in 2002. Am J Respir Crit Care Med 2002;166:1153–1156. |
| 4. | James A, Horton R. The Lancet's policy on conflict of interest. Lancet 2003;361:8–9. |
| 5. | Weiss SJ, Ginsburg D, Lowe J. An unvarnished truth. J Clin Invest 1999;104:1642–1644. |
