The editorial process: Peer review

Peer review continues to be the fundamental mechanism for determining which original research is published in today’s medical literature and thus is a gate-keeper of the accepted body of scientific knowledge. Despite a fair amount of ambivalence regarding the evidence of effectiveness,1 peer reviewers remain the foundation of biomedical journals for filtering manuscripts and ensuring quality control. Journal readers, as well as authors who offer their intellectual work, depend on a detailed critique but one that is also constructive and timely. A good and timely review has become progressively more challenging given the growth of sub-specialty journals, the sheer number of submitted articles and the un-remunerated service provided. This year, CUAJ instituted an online manuscript submission and review system, and began publishing monthly, in order to facilitate a speedier review process and enhance the turn-around for accepted articles.

At CUA’s Annual Meeting in Niagara Falls this year, we hosted the second annual CUAJ reviewer workshop. The feedback we received was so positive that we wanted to share our experience with you — our readers, authors, and regular reviewers — as well as any of you who might be interested in joining the reviewing team at CUAJ! The role of the reviewer is to critique a manuscript and identify its strengths and weaknesses. Reviewers are not the final arbiters on what gets published; however, they recommend a course of action that is highly respected and accepted by editors.¹ Journals depend on reviewers to be objective and constructive in their feedback and to understand and maintain their ethical mandate of confidentiality. This understanding of ethical reviewing and, by extension, of ethical publishing, is increasingly a hot-button issue, and reviewers and authors alike are encouraged to read the COPE Ethical Guidelines for Peer Reviewers, which has been endorsed by the CUAJ editorial board.²

So what makes a good review, and who is a good reviewer, for CUAJ? Unfortunately, there is little evidence that can help us pinpoint the pedigree of the penultimate reviewer. In fact, significant research training and post-graduate qualifications do not necessarily ensure a high-quality review. Some research suggests that, other than the reviewer being younger, and spending a limited amount of time on a review (up to, but no more than, 3–4 hours), no one formula defines a good reviewer.³

At CUAJ we are always looking for new reviewers, especially younger enthusiastic members of CUA, so that we can assess their performance in order to decide whether we can continue to use them. Many have questioned this assessment process: if it is ubiquitous, how will new reviewers learn the ropes? The skill set required to be an excellent reviewer is not part of the training requirements in medical school or residency, and is likely only an occasional assigned task during fellowship. Hence, journals must heed the call to become more proactive, and to approach and mentor new reviewers — a call that we at CUAJ have taken to heart!

Reviewers must have a passion for their area of research or clinical sub-specialty and therefore have a desire to help advance research in their field. Many participants in our workshop stated that the greatest motivation for reviewing was that the process was fabulous continuing medical education and that it kept them abreast of developments in the field. Our best reviewers also know the journal and its mandate. They know the ingredients that make for a good CUAJ paper and that its readership would consider valuable: novel, succinct, insightful research in a Canadian context and, of course, a strong relevance to human urological disease. A good reviewer will also suggest rejecting manuscripts that do not adequately describe study design or statistical methods used, or that over-interpret borderline results, to ensure that its propagation to our collective knowledge base does not occur. At the CUAJ Editorial Office, we do receive many papers from authors whose first language is not English. While we encourage international authors to submit to CUAJ and recommend they go through an English editor before submission, a reviewer does not need to focus on grammar or reference formatting – that is the copyeditor’s job.

Before agreeing to review a paper, a potential reviewer must be transparent with the editors regarding any conflicts of interest. If a reviewer feels unable to provide a fair and unbiased opinion, then he or she should decline the review. Moreover, a reviewer must have both the time and the expertise needed to complete the task. When reviewing a paper, the Golden Rule applies: Reviewers should treat all manuscripts in the same manner as they would want their papers to be treated, especially specifically with respect to timelines.

We learned a great deal from our first CUAJ reviewer workshops with respect to what motivates our members to review articles and what we can do to ensure that our experts continue to review for us. We are committed to enhancing this relationship and, in particular, helping to train young investigators to become expert reviewers. If you have any comments or suggestions, we would welcome your thoughts. Send them to the Editorial Director at josephine.sciortino@cua.org.