Scientific research aims to improve medical knowledge and find better ways to treat disease. Publishing findings in medical journals enables other scientists to share developments, to test the results, and to take the investigation further.
Peer review is a central part of the publication process for medical journals. It is considered the best available way to ensure that research submitted by scientists is trustworthy and that the medical treatments they advocate are safe and effective for patients.
Here are some key points about peer review. More detail is in the main article.
- A peer-reviewed article has been checked by another professional who was not involved in the project. If research is about a new drug, for example, this is important for patient safety.
- The process helps journals maximize the quality of research in their publications.
- Different publications have different ways of conducting peer review, and this can match their editorial vision.
- Sometimes an author will be advised to do more research before their work can be published.
Why is peer review necessary?
Researchers have to have their work reviewed before publication, to ensure it is accurate and relevant.
Peer review helps prevent flawed medical research papers from being published.
Flawed research includes:
- Made-up findings and hoax results that are not supported by proper scientific research
- Dangerous conclusions, recommendations, and findings that could harm patients
- Plagiarized work, when an author takes ideas or results from other researchers.
Peer review has other functions, too. For example, it can guide decisions about grants for medical research funding.
What does it involve?
For medical journals, peer review means asking experts from the same field as the paper's 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) is another association that offers ethical guidelines for medical peer reviewers. COPE also has a large membership among journals.
These associations do not set out rules for individual journals to follow. They regularly remind reviewers to consult journal editors.
The code summarizes of the role of a peer reviewer as follows:
"The editor is looking to them for subject knowledge, good judgement, and an honest and fair assessment of the strengths and weaknesses of the work and the manuscript."
The peer review process is usually "blinded." This means the reviewers have not been told the identity of the authors, and usually the authors 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 is discouraged.
Peer review helps editors to 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 revisions.
Quality, relevance, and importance
The exact tasks of a peer reviewer for a medical journal vary widely, depending on the journal they are working for.
All peer reviewers help editors decide whether a paper should be published, but different journals have different criteria.
Three common areas are addressed, with similar example questions:
- Quality: How well was the research done, and how reliable are its conclusions? This tests the credibility and accuracy of the science being assessed.
- Relevance: Is the paper of interest to readers of this journal, and is it appropriate to this field of work?
- Importance: What clinical impact could the research have? Do the findings add something new?
The editor may decide whether a paper is relevant, whether they have space for it, or if it would be better in another journal.
If editors decide it is relevant, they may seek peer reviewers' opinions on the finer points of scientific interest.
The editors make the final decision. Peer-review processes are there to inform the editor's decision. The recommendations of peer reviewers do not have to be accepted by the journal.
Different ways of doing peer review
Different journals have different aims and individual titles can be seen as "brands." The editorial position of the journal influences the criteria used to make decisions on whether to publish a paper.
The BMJ, for example, focuses on findings that are relevant and important to current disease management. They say, "The BMJ peer reviews all the material it receives. We give priority to articles that will help doctors to make better decisions."
The Lancet states that it "Prioritizes reports of original research that are likely to change clinical practice or thinking about a disease." However, it also places some priority on papers that can be understood by the "general reader" outside the medical specialty of the author.
A medical journal may publish in some detail the particular form of review that it uses. This usually appears in guidelines for authors. These policies are another way of setting standards for the quality of research reports.
What do reviewers look for?
The Journal of the American Medical Association (JAMA) outlines what its 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 are supported by the data.
The information must be important, and the topic must be of general medical interest.
How do journals respond?
Journals can respond to submissions in a number of ways.
The editors at the New England Journal of Medicine (NEJM), for example, use three responses, apart from outright rejection, after making decisions based on peer review.
- Major revision: The journal is "interested" in the manuscript, but a revision is needed because it is "not acceptable" for publication in its current form.
- Minor revision: "Some revisions" are needed before the submission can be accepted for publication.
- Willing rejection: The authors need to "conduct further research or collect additional data" to make the manuscript suitable for publication.