Peer-review of a medical journal article, pre-publication: what exactly is involved?

I recently came across a good article on the peer-review process for articles submitted for publication in research journals, including medical ones.

Since so many of the journal articles that we read about cancer, and PCa in particular, go through this process, l thought sharing the article's observations on how the process works might be instructive.

We've all heard the term, "peer review," of an article that is being submitted for publication in a journal, and we probably already have a pretty good idea as to what it means.

It means a group of especially qualified experts in the field that the article is covering, is taking a look at the article, to make sure that it "measures up" to the standards that the journal expects of its articles, such as accuracy, timeliness, and significance, and with possible publication of the article in the journal if it does.

But what are the usual specific characteristics of this review process, especially for medical-subject articles?

Here's a good article about the process:

https://www.medicalnewstoday.com/articles/281528

From it:

"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."

"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 ... (and) the Committee on Publication Ethics."

"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."

"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."

"A peer review generally addresses three common areas: quality, relevance, importance."

"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."

"The “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."

"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: (1) 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 (2) minor revision: some revisions are necessary before the editor can accept the submission for publication (3) willing rejection: the authors need to “conduct further research or collect additional data” to make the manuscript suitable for publication."

There is also a comment on imperfections that exist in the system:

"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."

Here's an Interesting detail about the peer review process (something I learned while researching for this thread):

We all probably know about single-blind and double-blind reviews:

Single-blind: "The most common type of peer review is single-blind (or single anonymized) review. Here, the names of the reviewers are not known by the author. While this gives the reviewers the ability to give feedback without the possibility of interference from the author, there has been substantial criticism of this method in the last few years. Many argue that single-blind reviewing can lead to poaching or intellectual theft or that anonymized comments cause reviewers to be too harsh."

Double-blind: "In double-blind (or double anonymized) review, both the author and the reviewers are anonymous. Arguments for double-blind review highlight that this mitigates any risk of prejudice on the side of the reviewer, while protecting the nature of the process. In theory, it also leads to manuscripts being published on merit rather than on the reputation of the author."

But it turns out there are also a few other types of peer review:

Triple-blind: "while triple-blind (or triple anonymized) review—where the identities of the author, reviewers, and editors are all anonymized—does exist, it is difficult to carry out in practice. Proponents of adopting triple-blind review for journal submissions argue that it minimizes potential conflicts of interest and biases. However, ensuring anonymity is logistically challenging, and current editing software is not always able to fully anonymize everyone involved in the process."

Collaborative review: "In collaborative review, authors and reviewers interact with each other directly throughout the process. However, the identity of the reviewer is not known to the author. This gives all parties the opportunity to resolve any inconsistencies or contradictions in real time, and provides them a rich forum for discussion. It can mitigate the need for multiple rounds of editing and minimize back-and-forth. Collaborative review can be time- and resource-intensive for the journal, however. For these collaborations to occur, there has to be a set system in place, often a technological platform, with staff monitoring and fixing any bugs or glitches."

and

open review: "Lastly, in open review, all parties know each other’s identities throughout the process. Often, open review can also include feedback from a larger audience, such as an online forum, or reviewer feedback included as part of the final published product. While many argue that greater transparency prevents plagiarism or unnecessary harshness, there is also concern about the quality of future scholarship if reviewers feel they have to censor their comments."

From:

https://www.scribbr.com/methodology/peer-review/

So that's the way the peer-review system works in general.

And here's a good, quick (3 min.) video on the peer-review process, presented animation style, and mentioning a few points not already covered in this thread:

https://libguides.libraries.wsu.edu/ebhc/peer-review

It all sort of reminds me of the process that the FDA follows when determining if a new drug is okay for release to the public, by doing trials and analyses of it first. That's kind of what the reviewers do when evaluating an article put to them. Will they approve an article for publication, the way the FDA might approve a new drug for public use?

Or maybe like a person going for job interview, and he eventually gets the job (like the article getting published) or he doesn't (the article is rejected).

So when consulting an article on prostate cancer in a medical journal, we might bear in mind that it likely went through a "peer-review approval process" such as described above, before it got to the pages (or screens) we are now looking at.

mattam -

You make some good points in your post, and I agree with them.

Specifically,

"I got to see what goes on behind the scenes in a high powered lab. In the 5 years I was hanging around, he reviewed lots of papers, and grant applications. Seems like they don't like doing it but it's part of building stature. They become locked in their offices writing grants, papers, or they're traveling the world going to meetings and giving talks. It seemed overwhelming to me."

Based on what I saw during my own 35-year career as an Associate Librarian at the University of Florida, this is pretty much spot on. There are at least two professions in the world where the amount of paperwork needing to be done is daunting, and more so than people probably realize: medical doctor and university faculty member (such as professor, or, as in my case, academic librarian).

Grant applications were especially onerous (I was involved in a few). They were a great way to get funding for a university, or library, project, especially for one-time things, but the paperwork could be really overwhelming. Grant applications to private sources usually weren't so bad, nor were applications for state grants, but anything submitted to a federal government agency, such as the Department of Education, was usually, as noted, daunting. I remember being on a team once completing a grant application form for the Department of Education, filling out page after page, and thinking "Why do they want to know THAT???" But the usual acceptance rate at the Department of Education was pretty good, so maybe that made up for it a bit.

"But as far as doing blinded reviews, they immediately know whose paper or grant application they're looking at by the research."

That's going to be true a good bit of the time. For example, if Professor Smith goes to a conference, and learns that Professor Jones is working on the effect of X on Y, and then later Smith is asked to peer-review a paper on the effect of X on Y, then, yes, he'll likely know that this is Jones' work. Professors "in the know" in a field are likely to already be aware of who's working on what.

"As you can imagine the politics and competition are intense."

They can be. I once thought that a good analogy to the "need to succeed" in academia was that of such need in a major league sport, say baseball. In MLB, one's performance level must be STELLAR, since there are so many other almost equally qualified players just a step below in the minor leagues, just waiting for a chance to move up and replace someone at the higher level. I thought this was especially true at the most prominent universities, like the Harvards and Yales. Like in the sports pros, only the best make it to the top, and have to work to stay there.

(Which reminds me of something rather interesting, and something that some may find even amusing, the situation for academic librarians who become employed in the Harvard Libraries system. They make pretty good salaries there, right? No, actually it's just the opposite. Their salaries are actually below the national average for academic librarians. Or so I heard when I was working. The reason for this is that working in the Harvard Libraries system is so prestigious, that it's a buyer's market, and Harvard is the buyer, knowing that with so many qualified people applying for its positions, it can save money by paying low salaries, but still getting good people. Those people would then work there for a couple of years or so, and then, with a stint at Harvard now in their resumes, be in a position to negotiate a much better salary in a similar position at another university).

"Back then I remember they were disgusted by a colleague they suspected of lifting experiments from grant proposals he was reviewing to use in his own research. It's a cutthroat business."

Of course this happens. My own view is that the vast majority of faculty members are honest, ethical guys, willing to play by the rules, and put in an honest day's work. But can it happen? Well, the situation with the now former president of Harvard is a case in point that academic scandal in its various forms is not unknown.

(BTW, committing plagiarism is one of the WORST offenses that a college professor can commit. It's a breach of the trust that the university has had in the professor to create original, useful knowledge, and is usually treated with the harshness that it deserves when it does occur.

But, again, most professors are in fact hard-working joes who fulfill their job requirements appropriately, often with distinction.

With respect to mattam's post, a paper in one of the most prestigious science journals (Nature, Science and a few others) probably counts for ten papers in the Journal of Obscure Results. In the medical sciences, the New England Journal of Medicine is still tops, AFAIK.
Top journals will also ask a 'real' statistician to review a manuscript if there are significant statistical issues.
Top medical and science journals are also on the lookout for 'image manipulation' in submitted manuscripts these days because there have been a few 'incidents' along those lines.

Post Edited (Sr Sailor) : 1/3/2024 4:13:25 PM (GMT-8)