Page 1 ... your comments and make sure they are written clearly, succinctly, and precisely ... ask the authors to simply replace their bias with your own. Write as if ...
THE FELLOWS’ CORNER
How to review As trainees and future academicians, we aspire to publish in peer-reviewed journals. But at the same time, we may have the opportunity to review submissions for these very same journals and determine the fate of other people’s hard work. As a reviewer, it is often easy to be blindly sympathetic or overly critical—when we probably should be somewhere in between. In this month’s Fellows’ Corner, Drs Amnon Sonnenberg and Charles Boardman from the Oregon Health & Science University provide helpful tips and rules on how to review. Stephen Kim, MD The Fellows’ Corner Editor Gastroenterology Fellow University of California Los Angeles Los Angeles, California, USA As part of their training, gastroenterology fellows occasionally are asked to review scholarly manuscripts submitted to scientific journals or even participate in the reviews of grant proposals. They may be given some general guidance, but there is little formal training on how to review. In what follows, we have tried to briefly summarize the dos and don’ts of reviewing.
Take your time Authors spend years accumulating their data and months writing their manuscripts. At least 1 day should pass between reading the manuscript and writing its review.
Be specific, and write clearly The same standards of scientific writing apply to the reviewer’s comments as to the article itself. Spell-check your comments and make sure they are written clearly, succinctly, and precisely, and try to avoid any sweeping statements. The reviewer needs to provide specific citations from the literature in all instances when the authors’ own line of argument is being questioned or when the reviewer endorses a different point of view. You must not ask the authors to simply replace their bias with your own.
Write as if your identity were known The review system is not always as anonymous as advertised. Reviewers are selected from a handful of ex-
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perts known to or specifically recommended by the authors. The reviewers’ identities may be revealed by their idiosyncratic writing style, unique knowledge, or characteristic opinions. Editorial managers make mistakes and incidentally reveal the reviewers’ identities. As editorships change, a new crew may feel less restricted by previous commitments of confidentiality. Investigators gossip among themselves and often disclose seemingly confidential information. Therefore, you should always write your comments as if your identity were already unveiled. Write your comments in a balanced and detached fashion and abstain from making any derogatory, ironic, or cynical comments about the manuscript or its contents. They may reflect more on your own level of ignorance than the authors’ incompetence.
Avoid paradoxical demands Although most authors are very intelligent and resourceful, few—if any—are up to the challenge of rigorously addressing each of the 10 reviewers’ recommendations while simultaneously shortening the manuscript by half.
Number your comments In your review, you should number all your comments consecutively. Otherwise, it becomes difficult for the authors to respond to your comments when resubmitting their manuscript. Occasionally, reviewers like to make variations of the same comment multiple times and list them as separate points in their review. This practice just inflates the length of the review and does not truly add to the process.
Stratify by major and minor comments Break down your comments into major and minor issues, and focus your review on the relevant major issues. Major points of criticism relate, for instance, to missing control groups, underpowered case or control subjects, or clear-cut systematic bias that threatens to invalidate the study outcome. Minor issues include anything else that can be corrected within a matter of hours. Minor issues relate, for instance, to errors in spelling and grammar, errors in calculation and statistics, erroneous citations of figures or tables within the text, missing references, or your own disagreement with statements of the discussion. If there are one or two major issues that invalidate the entire study approach, there is no need to belabor 10 other minor issues. In your comments to the editor, clearly identify Volume 78, No. 2 : 2013 GASTROINTESTINAL ENDOSCOPY 343
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Table 1. Summary of rules on how to review No.
Rule
Explanation
1
Take your time
Take at least 2 days to review a manuscript.
2
Be specific and write clearly
Spell-check your review, provide citations for your comments.
3
Write as if your identity were known
Write in a balanced, detached fashion and abstain from making derogatory, ironic, or cynical comments.
4
Avoid paradoxical demands
Authors cannot simultaneously follow 10 recommendations and shorten a manuscript by half.
5
Number your comments
So simple and self-evident a rule, yet so frequently disregarded!
6
Stratify by major and minor comments
Focus your review on the relevant major issues.
7
It is not about you
The review does not serve to show how smart or critical you are.
8
Respect the authors’ independence
Do not impose your opinion on the authors, do not censor them.
9
Abstain from making prohibitive requests
It is unfair to demand from authors a “perfect” manuscript according to the reviewer’s own fantasy design.
10
Do not invoke the mythical “general reader”
If the reviewer can understand the manuscript, usually others will be able to do so as well.
11
Be ethical
It is unethical to reject a manuscript because of dislike of its authors or potential compromise of one’s own work.
12
Try to rise above your own bias
Would you accept such study with the same type of evidence but opposite outcome?
13
Expand your horizon
New ideas outside the box are only appreciated by knowledgeable and open-minded reviewers.
which of your requests to the authors are really crucial and need to be met for the manuscript to become acceptable for publication.
It is not about you The goal of a review is to help the authors write a better manuscript and help the editors make a balanced decision against or in favor of a manuscript submission. In your review, you do not need to show how smart you are by listing as many comments as possible or coming up with at least 3 different critiques. It is a cheap shot to copy from the authors’ own discussion of potential limitation arguments against their study. Most manuscripts have undergone extensive inside review by their multiple coauthors or through previous submissions to other journals. Most authors think about the contents of their manuscript for months and take great pains to write up their results and discussion. If there are no adverse comments to be made, then have the courage to say so and write a short review.
Respect the authors’ independence Your job is not to save the world (from a seemingly bad manuscript). The ultimate responsibility for the manuscript rests with the authors, not the reviewer. Because it is their, and not your, manuscript, you should not impose your opinion, outlook, or writing style on the authors. 344 GASTROINTESTINAL ENDOSCOPY Volume 78, No. 2 : 2013
Respect their independence and freedom of speech; do not censor them. Be generous in accepting novel unusual thoughts, concepts, or experimental approaches. Be benign in your critique and modest in your requests for revision.
Abstain from making prohibitive requests The mere possibility of bias does not make it real. The hypothetical influence of confounding variables does not necessarily invalidate the associations shown by the authors. Most confounding risk factors, such as sex, smoking, alcohol consumption, or socioeconomic status, exert only a moderate influence on the outcome and may change the odds ratios by few decimal points. Generally, authors have not included additional variables in their analysis because the pertinent information was not available to them. It is unfair for a reviewer to develop a long list of potential risk factors and then ask for their inclusion in the revised manuscript. It is unfair for a reviewer to demand from authors a “perfect” manuscript according to the reviewer’s own fantasy design. Such demands are easily made (at no cost to the reviewer) but are often impossible or enormously difficult to meet and only at extreme costs to the investigators. Clean, perfect data are generally trivial or untrue. By their very nature, all new findings at first rely on imperfect data that, according to later standards, appear www.giejournal.org
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generated by sifting through muddy waters, using crude instruments, and squinting one’s eyes. No study can be innovative, profound, easy to understand, and of general interest and assured relevance at the same time.
Do not invoke the mythical “general reader” Occasionally, reviewers suggest that a manuscript should be simplified or its scientific content toned down in order to accommodate the putatively lesser intellectual prowess of the “general reader.” Who is the general reader? Our papers are not usually read by workaday morning commuters on the train or lay retirees on the beach. Our journals do not sit side-by-side with US Weekly and Mademoiselle on the supermarket shelf. Although we all would like to flatter ourselves that our contributions have some general usefulness for society, our actual papers are very specific, technical, and targeted contributions to a highly specialized facet of science and, as such, are not usually amenable to easy, labor-free digestion. If you, as reviewer, can understand the authors’ figures and lines of reasoning, it would be silly to ask them to simplify their text for the sake of a future, hypothetical, less enlightened “general reader.” If every manuscript is to be understood by everyone immediately, there can be no progress in science.
Be ethical It is unethical to reject a manuscript because you hold a grudge against its authors. Similarly, it is unethical to reject a manuscript that could compromise your own submission or to raise inordinate objections to delay publication by your scientific competitors. Last, you may be asked to review a manuscript similar to, but of lesser quality than your own previously rejected submission. As an ethical reviewer, again, you should be able to take yourself completely out of the equation and review the new manuscript based solely on its own merits.
Try to rise above your own bias If a study confirms a reviewer’s own belief system, all caution and critical attitude tend to be thrown overboard.
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How to review
Irrespective of poor methods and results, a reviewer will frequently accept a paper because its message confirms a long-held belief. Ask yourself: would you accept such a study with the same type of evidence but the opposite outcome? It is difficult to reject a paper that cites or supports your own previous publication. Do not engage in nepotism toward your own set of ideas. If we loosen our standards, we may soon find ourselves having lost them altogether.
Expand your horizon There is an inherent paradox underlying the entire review process: We see only what we already know, and we can judge only up to our own level of understanding. New facts can be accepted at face value or be judged based on existing knowledge, but it is nearly impossible to learn new facts and criticize them at the same time. The review system is geared toward recognizing the best representation of the mean, but it functions poorly at accepting novel concepts that flourish far outside the box. The only partial resolution to the paradox comes from knowledgeable and open-minded reviewers who constantly strive to expand their horizons. Ultimately, the merits of any manuscript cannot be reliably predicted even by the best reviewer but become determined solely by the combined “market force” of its future readers who will find it useful or worthless according to its durable capacity to relate to the truths of the world. Table 1. DISCLOSURE The authors disclosed no financial relationships relevant to this publication. Amnon Sonnenberg, MD, MSc Charles R. Boardman, DNP, MS The Portland VA Medical Center and The Division of Gastroenterology/Hepatology Oregon Health & Science University Portland, Oregon, USA
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