Peer review is a quality control measure for medical research. It is a process in which professionals review each other's work to make sure that it is accurate, relevant, and significant.
Scientific researchers aim to improve medical knowledge and find better ways to treat disease. By publishing their study findings in medical journals, they enable other scientists to share their developments, test the results, and take the investigation further.
Peer review is a central part of the publication process for medical journals. The medical community considers it to be the best way of ensuring that published research is trustworthy and that any medical treatments that it advocates are safe and effective for people.
In this article, we look at the reasons for peer review and how scientists carry them out, as well as the flaws of the process.
Peer review helps prevent the publication of flawed medical research papers.
Flawed research includes:
- made-up findings and hoax results that do not have a proven scientific basis.
- dangerous conclusions, recommendations, and findings that could harm people.
- plagiarized work, meaning that an author has taken ideas or results from other researchers.
Peer review also has other functions. For example, it can guide decisions about grants for medical research funding.
For medical journals, peer review means asking experts from the same field as the authors to help editors decide whether to publish or reject a manuscript by providing a critique of the work.
There is no industry standard to dictate the details of a peer review process, but most major medical journals follow guidance from the International Committee of Medical Journal Editors.
The code offers basic rules, such as, "Reviewers' comments should be constructive, honest, and polite."
The Committee on Publication Ethics (COPE) are another association that offer ethical guidelines for medical peer reviewers. COPE also have a large membership among journals.
These associations do not set out rules for individual journals to follow, and they regularly remind reviewers to consult journal editors.
The code summarizes the role of a peer reviewer as follows:
"The editor is looking to them for subject knowledge, good judgment, and an honest and fair assessment of the strengths and weaknesses of the work and the manuscript."
The peer review process is usually "blind," which means that the reviewers do not receive any information about the identity of the authors. In most cases, the authors also do not know who carries out the peer review.
Making the review anonymous can help reduce bias. The reviewer will evaluate the paper, not the author.
For the sake of transparency, some journals, including the BMJ, have an open system, but they discourage direct contact between reviewers and authors.
Peer review helps editors decide whether to reject a paper outright or to ask for various levels of revision before publication. Most medical journals ask authors for at least minor changes.
The exact tasks of a peer reviewer vary widely, depending on the journal in question.
All peer reviewers help editors decide whether or not to publish a paper, but each journal may have different criteria.
A peer review generally addresses three common areas:
- Quality: How well did the researchers conduct their study, and how reliable are its conclusions? These points test the credibility and accuracy of the science under evaluation.
- Relevance: Is the paper of interest to readers of this journal and appropriate to this field of work?
- Importance: What clinical impact could the research have? Do the findings add a new element to existing knowledge or practice?
The editor will need to decide whether a paper is relevant, whether they have space for it, and if it might be more suitable for a different journal.
If the editor decides that it is relevant, they may seek peer reviewers' opinions on the finer points of scientific interest.
The journal editors make the final decision when it comes to publishing a study. Peer-review processes exist to inform the editor's decision, but the editor is not under any obligation to accept the recommendations of peer reviewers.
Different journals have different aims, and it is possible to see individual titles as "brands."
The editorial position and best practices of the journal influence its criteria for publishing a paper.
The BMJ, for example, focus on relevant findings that are important to current disease management. They say, "nearly all of the issues we research have relevance for journal editors, authors, peer reviewers and publishers working across biomedical science."
The Lancet state that they prioritize "reports of original research that are likely to change clinical practice or thinking about a disease." However, they also place some emphasis on papers that are easy to understand for the "general reader" outside the medical specialty of the author.
The editors of medical journals may publish detailed information about the particular form of review that they use. This information usually appears in guidelines for authors. These policies are another way of setting standards for research quality.
JAMA, for example, outline the qualities that their medical editors evaluate before sending papers to peer reviewers.
This "initial pass" checks for the following points:
- timely and original material
- clear writing
- appropriate study methods
- valid data
- reasonable conclusions that the data support
The information must be important, and the topic needs to be of general medical interest.
How do journals respond?
Journals can respond to submissions in a few different ways.
The editors at the New England Journal of Medicine, for instance, either reject the paper outright or use one of three responses after using the peer review process to guide their decision.
These responses are:
- Major revision: The editor expresses interest in the manuscript, but the authors need to make a revision because the report is "not acceptable" for publication in its current form.
- Minor revision: "Some revisions" are necessary before the editor can accept the submission for publication.
- Willing rejection: The authors need to "conduct further research or collect additional data" to make the manuscript suitable for publication.
Other publications might take different actions after completing a peer review.
Although peer review can help a publication retain integrity and publish content that advances the field of science, it is by no means a perfect system.
The number of journals worldwide is increasing, which means that finding an equivalent number of experienced reviewers is difficult. Peer reviewers also rarely receive financial compensation even though the process can be time-consuming and stressful, which might reduce impartiality.
Personal bias may also filter into the process, reducing its accuracy. For example, some conservative doctors, who prefer traditional methods, might reject a more innovative report, even if it is scientifically sound.
Reviewers might also form negative or positive preconceptions depending on their age, gender, nationality, and prestige.
Despite these flaws, journals use peer review to make sure that material is accurate. The editor can always reject reviews that they feel show a form of bias.
Is peer review the most reliable method of checking a research report?
Peer review is not perfect, but it does provide the editor with the opinion of multiple experts in the field or area of focus of the review. As a result, it ensures that the topic of study is relevant, current, and useful to the reader.
Generally, reviewers are researchers or experts in their field, and they are able to gauge the accuracy and any potential bias of a research study.Deborah Weatherspoon, PhD, RN, CRNA Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.