Volume 21
Number 6
December
1993
Mary Castle White, RN, MPH, PhD San Francisco, California
The manuscript review process is a critical part of the dissemination of new science. This article reviews the components of the process, including editorial screening, peer review, and final author review of manuscripts, and notes the persons involved in each stage of the process. The editorial review process is an evolving science, and JOURNAL policies and procedures are revised as this science gains new insights. (AJIC AM J INFECT CONTROL 1993;2 1:279-82)
The editorial review process is a critical part of the mechanism by which new science is introduced, made available for replication, and finally refuted or accepted and translated into practice changes. The purpose of peer review, as a component of the editorial review process, is both to ensure that articles published have a high standard of quality and to help authors improve the presentation of their work. Editors and editorial boards have examined the peer review process in much the same way that ICPs have evolved in their examination of their practice: at first looking at the structure and process of the practice and more recently focusing on the quality of the product. From the landmark discussion of peer review by Locke’ in 1985, a number of editors have described the review of manuscripts and the process by which manuscripts are evaluated.*, 3 In 1989, the American Medical Association sponsored the
This Editorial represents the opinions of its author and the and should not be construed as representing the opinions Association or the publisher. Copyright Control,
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JOURNAL,
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in Infection
first international congress on editorial peer review in biomedical publications.4 In that meeting of biomedical and science editors, many issues were raised and a few research papers were presented on the peer review process. The second congress was held in September 1993, with some of the same and some new issues raised. Far more research was presented. The similarities between the evolution of thinking in this group and that among ICPs were striking: far more discussions in this second congress centered on the question of how to measure quality in a review and quality in a manuscript than on the structure and process of peer review. The purpose of this article is to describe the editorial review process of the JOURNAL, recognize those who participate in the process, and examine current thinking on peer review and the position of our JOURNAL in light of this opinion. EDITDRUL REVEW PRocess More than 100 manuscripts are submitted to the JOURNAL annually and undergo the peer review process, including research papers, brief reports (such as reports of outbreaks), review articles, commentaries, and descriptions of practice. For the purpose of this discussion, the review process 279
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can be divided into four intervals: the Editor’s initial review; the first peer review; revision, rereview and final decision; and final author review. Each interval varies in length and in the number of persons involved. Editor’s
initial
review
Each paper submitted is first read by me, or in some cases by another Editor. This initial review is done for a number of reasons. First, it serves as a screen for papers that are clearly outside the JOURNAL's scope, as published in the Information for Authors5 or that are not scholarly in nature, such as product promotions. Second, the paper is reviewed to determine the appropriate Editorial Board (EB) and external reviewers, the “peer reviewers” of the paper. I then select at least two reviewers to read each manuscript and perform a formal review. One copy of the paper is sent to a member of the EB of the JOURNAL and one is sent either to another EB member, an Associate or Staff Editor, or an external reviewer. The selection of a reviewer is based on the nature of the paper and the reviewer’s area of expertise in the topic of the paper, current JOURNAL workload, and reviewer availability. Special review of the statistical methods employed in the paper may be needed, depending on the nature of the work and the complexity of the statistical analysis presented. First peer review The first peer review represents perhaps the most critical work of the peer review process because it is the initial evaluation of the work of the author and the foundation on which all subsequent decisions about the work’s acceptability are based. The reviewers, whether editors, EB members, or external reviewers, critically read the manuscript and answer specific questions about its overall appropriateness, its originality, its importance, appropriateness of study design, methods, statistical analysis and documentation of conclusions reached, presentation, and adequacy of references. In addition, reviewers spend hours making suggested editorial revisions and providing assistance, in particular to authors whose first language is not English. In confidential comments to the Editor and in written comments to the author, they convey both overall and detailed impressions of the work under review. This review is double-blinded; that is, authors and reviewers are blinded to each other’s identities. Reviewers are encouraged to return manuscripts unreviewed if they cannot complete the
WIG 1993
review in a timely manner and are asked to state any conflict they may have in reviewing a paper, such as current competing research or financial ties to a product studied. Such a statement does not necessarily disqualify the reviewer or invalidate the review; in fact, the basis of the peer review process is review by a scholar who understands the work and who thus may well be engaged in the same kind of research. Rather, the statement makes explicit any possible ties or conflicts to consider in evaluating the review and in the event of an appeal by the author if the manuscript is rejected. This initial peer review is usually completed within 6 to 8 weeks, although there is considerable variation as a result of holidays, JOURNAL workload, and the seasonal peaks in manuscript submissions after national meetings. Using the advice and comments of the reviewers, and on completion of my own independent review of the paper, I make a decision on the initial disposition of the manuscript. Another factor that may play a part in the decision is the number of papers already published or in press on the subject, in light of the fixed number of pages per year available for original papers. The decision may be one of five: accept as is (a decision that virtually never occurs); accept with revisions suggested; accepted provided revisions are made; defer a decision with suggestions for considerable revisions with resubmission (either as the same kind o f paper or as a new paper, such as suggestions that the paper be rewritten as a Letter to the Editor); and reject. A letter is then sent to the author, indicating the decision and including comments that may be useful for her or him to understand the reasons for the decision. At the same time, a letter is sent to each reviewer, indicating the decision and including a copy of the other reviewers’ comments, which serves both as a response to the work performed and a mechanism to give confirming or contradicting information to the reviewer on the basis of the work of his or her peer. Of the manuscripts reviewed, more than half are not accepted for publication. Authors have the right to appeal the decision and to request a rereview by another set of reviewers. Although this happens rarely, it is important to note that this option is available, in an effort by the Editors and EB to offer an opportunity for authors who believe they may not have received a fair review. Feedback from authors has been uniformly positive, indicating that authors learned much from the comments and suggestions of peer reviewers, regardless of the ultimate fate of the paper.
AJIC Volume 21, Number 6
Revision,
rereview,
White and ffnal decision
For those manuscripts that are not rejected, the review process becomes more or less complicated depending on the extent of revisions and whether the revisions are suggested or required. It is the job of authors to answer the questions raised, and if they are in disagreement with the reviewer to make a case for their point of view on a suggested revision. Although the changes suggested or expected are evident in the revised manuscript, most of the discussion about each point of the review is done in a cover letter accompanying the revision. In some cases this letter resembles another paper, including references to justify positions on the reviewers’ comments. If the revisions suggested are minor, and the authors have answered each comment in either a revision or an explanation (commonly in both the cover letter and the revised draft), the manuscript may not go out for rereview. If questions seem to remain, I will send the manuscript back out to the same reviewers, with a (blinded) copy of the author’s letter of response. This cycle of review may repeat, leading to final acceptance or to a final rejection if revisions are not or cannot be made; the latter occurring, for example, in a case where data thought to be critical to the analysis were not collected during the study. Although reviewers may only receive one or two new manuscripts from me in a given month, they may also be asked to comment on revisions of previously reviewed papers-occasionally in more than one cycle of review, revision and rereview-and I have been told of the feelings that a large envelope with the JOURNAL'S return address engenders. Flnal author
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rewards, except perhaps the knowledge that they have helped improve the papers published in the JOURNAL. The roster of manuscript reviewers, listed at the end of this article, includes the entire EB, the external reviewers, and some Editors who serve as reviewers in addition to conducting other specific activities as Editors. This list will expand and contract with time as our field, scientific interests, and needs for scholarly work change. The second congress on editorial peer review in biomedical publications reaffirmed the importance of peer review in the screening, selection, and improvement of papers accepted into the literature. As more research results on the nature and impact of peer review become available, I will share the ideas and findings with those who serve the JOURNAL in this capacity. It is imperative that we keep abreast of the best methods and measures to ensure high quality in the manuscripts published in the JOURNAL while protecting and educating authors and reviewers and serving readers. The work of the many persons involved in the review of papers is much appreciated, and their continued enthusiasm is my reward. References 1. Locke S. A difficult balance: editorial peer review in medicine. London: Nuffield Provincial Hospital Trust, 1985. 2. The journal’s peer review process. N Engl J Med 1989;32 1: 837-9. 3. Reidenberg JW, Reidenberg MM. Report of a survey of some aspects of editorial board peer review at Clinical Pharmacology & Therapeutics. Clin Pharmacol Ther 1991;50:1-3. 4. Rennie D. Editorial peer review in biomedical publication: the first international congress. JAMA 1990;263: 13 17-441. 5. Information for authors. AJIC AM J INFECT CONTROL 1993; 21(4):13A-14A.
review
Manuscripts that have successfully completed peer review are sent to the publisher for copy editing to conform to the JOURNAL style5 and for typesetting. The skills and experience of the staff at Mosby are without equal, but in both the copy editing and the typesetting of a manuscript, errors can occur or meanings may be changed. Responsibility for the fkaI review of a manuscript rests with the author (or the person designated by the authors), and this occurs when the typeset pages are sent for approval. AJIC PEER REVIEWERS
Persons selected as reviewers have experience in publishing and understand the seriousness of the charge given them and the implications of their review for the JOURNAL, the field, and the individual author. They are hard workers with few
OUR THANKS TO AJIC PEER REVlfiWERS Editors
Richard Garibaldi, MD, Farmington, Connecticut Eddie R. Hedrick, BS, MT(ASCP), Columbus, Missouri Joseph J. Klimek, MD, Hartford, Connecticut Patricia Lynch, RN, MBA, CIC, Seattle, Washington Gina Pugliese, RN, MS, CIC, Chicago, Illinois Barbara M. Soule, RN, MPA, CIC, Olympia, Washington William M. Valenti, MD, Rochester, New York Editorial
Board members
Michael T. Brady, MD, Columbus, Ohio Jerri K. Bryant, RN, MPH, CIC, Cleveland, Ohio Janet Kjestene Bundy, RN, MS, Houston, Texas
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John P. Burke, MD, Salt Lake City, Utah Brian W. Cooper, MD, Hartford, Connecticut George W. Counts, MD, Bethesda, Maryland Theodore C. Eickhoff, MD, Denver, Colorado Angella Goetz, RN, MNEd, Pittsburgh, Pennsylvania Donald A. Goldmann, MD, Boston, Massachusetts Barbara Goldrick, RN, PhD, Washington, D.C. Bruce H. Hamory, MD, Hershey, Pennsylvania Sharon L. Hansen, PhD, Baltimore, Maryland Kenneth L. Harkavy, MD, Washington, D.C. Marguerite M. Jackson, RN, MS, CIC, San Diego, California Julie T. Jacobson, MT(ASCP), CIC, Salt Lake City, Utah Helen Rosen Kotilainen, MA, MT(ASCP), CIC, Worcester, Massachusetts Elaine Larson, RN, PhD, FAAN, Washington, D.C. Jane Lipscomb, RN, PhD, San Francisco, California John E. McGowan, Jr., MD, Atlanta, Georgia Ronald Lee Nichols, MD, New Orleans, Louisiana William A. Rutala, PhD, Chapel Hill, North Carolina Jay P. Sanford, MD, Bethesda, Maryland Steve Selvin, PhD, Berkeley, California Robert J. Sharbaugh, PhD, Charleston, South Carolina Jerry D. Smilack, MD, Scottsdale, Arizona Philip Smith, MD, Omaha, Nebraska Walter E. Stamm, MD, Seattle, Washington Marjorie J. Stenberg, MA, MS, RN, CIC, Providence, Rhode Island Beth H. Stover, RN, CIC, Louisville, Kentucky Melvin P. Weinstein, MD, New Brunswick, New Jersey Terry Yamauchi, MD, Little Rock, Arkansas
Bound
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aallc 1993
revkwers
Carla J. Alvarado, MS, Madison, Wisconsin Bonnie M. Barnard, BS, MPH, Houston, Texas Elizabeth A. Bolyard, RN, MPH, Atlanta, Georgia Mary Ann Bordner, MS, CIC, Hershey, Pennsylvania Patricia J. Checko, MPH, Berlin, Connecticut John C. Christenson, MD, Salt Lake City, Utah Helen M. Crowe, MD, Hartford, Connecticut Candace Friedman, MT(ASCP), MPH, CIC, Ann Arbor, Michigan Julie L. Gerberding, MD, San Francisco, California Richard Harris, MD, Houston, Texas Jane Kosolcharoen, RN, MS, CIC, Madison, Wisconsin Robert H. Latham, MD, Nashville, Tennessee Robert E. Levi& MD, Hartford, Connecticut Dennis G. Maki, MD, Madison, Wisconsin Pamela S. Newsome, RN, MS, CIC, Lilbum, Georgia Mark Nicas, PhD, MS, MPH, Berkeley, California Charles John Palenik, BA, MS, PhD, Indianapolis, Indiana Russell N. Olmsted, MPH, CIC, Ann Arbor, Michigan Stephen Paulker, MD, Boston, Massachusetts Dwight A. Powell, MD, Columbus, Ohio Larry Reimer, MD, Salt Lake City, Utah Jane S. Roccaforte, MD, Omaha, Nebraska Barbara Russell, RN, MPH, CIC, Miami, Florida Jeffrey W. Smith, MS, MPH, New Orleans, Louisiana Steven J. Sperber, MD, Hackensack, New Jersey Larry James Strausbaugh, MD, Portland, Oregon Dorothy J. Thomas, BSN, CIC, Miami, Florida Carolee M. Wende, BS, MS, Washington, D.C.
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