Evolutionary change is always welcome but it brings with it, its own set of complexities. The issue of open access as discussed in the last editorial1 opens the "Pandora's box" of unregulated papers. In today's "Publish or Perish" world, the editorial board is often inundated with a surfeit of verbiage, irrelevant material and ever-growing manuscripts that weigh a lot, yet say very little. The only check that remains is the peer-review process. The purpose of the peer- review process is to pick out the publishable manuscript and prune it prior to the print run. A paper becomes publishable if it makes a sufficient contribution, proves useful in furthering knowledge and science and helps in the better care of the patients. Much has been written about it and many of us serve as reviewers in various journals. Yet the entire process is more than often shrouded in a cloak of mystery (by editors?).This communication aims to clear the air, dispel doubts and provide an overview of the peer- review process as it applies to the Indian Journal of Ophthalmology (IJO).
The peer-review process has traditionally been considered as a "quality control exercise" which involves assessment of material submitted to the journal with respect to its pertinence to a given subgroup of readership; with regard to its scientific originality and credibility, appropriateness of methodology used to answer a research question, interpretation of results in view of existing evidences in literature and the validity of its conclusion; so as to maintain the standards of science and scholarship. The peer-review process forms an integral and indispensable component of the publication process of most scientific journals.
The peer-review process is by no means a modern phenomenon. The credit goes to Ishap Bin Ali of Raha, Syria, who recorded the process in his book titled Ethics of the Physician, (854-931 Common Era).2 Since then much water has flown under the bridge (across the Tigris and elsewhere too!). The peer-review process has evolved over the years to the present universally acceptable format of sending manuscripts that have been submitted, to one or more impartial, independent and external experts for evaluation and review.
From an "informal opinion seeking" it's importance has reached such proportions that to be "indexed" a journal needs to have a formal review process. In fact, a journal's standing in the medical fraternity depends largely upon the quality of its reviewers.
There are essentially two models of the review process3- the "open" review system where both the author and the reviewer are aware of each others identity (the author sometimes recommending the reviewer) or the Editorial Board approved double blind reviewer, where neither the author nor the reviewer know the identity of each other. Like most medical journals, the IJO follows the latter. It is a well documented fact4 that author recommended reviewers tend to give more favourable reviews while editor-selected reviewers, being more critical in their remarks, are more helpful to the editors in their decision making process. Surprisingly, blinding of the author's name to the reviewers does not increase the detection of errors,5 or affect the time taken for the review process,5 or improve the quality of review.67 In a study, where the reviewers were asked to sign the review reports, the chances of the reviewers declining the review increased significantly. However, it had no effect on the quality of work of the reviewers who did sign their reviews as compared to that of those reviewers who were asked not to sign their reviews.8 Another study found that the reviewers who were asked to sign their reviews were more cautious, took more time to review and were more likely to recommend the acceptance of the manuscript.9 A "double blinding" allows the reviewer to bring fraud and plagiarism to the notice of the editor without feeling intimidated by the perpetrator of the offence.
Each of the two basic systems of "blinded" review system and the "open" review system, has its pros and cons. We, in the IJO, strive to maintain the transparency in relationship to the review process and yet retain the advantages of a "blinded" review process. The peer-review process depends heavily on the "peer" reviewer.
A "peer" is "one that is of equal standing with another" and a peer reviewer may be considered the "expert helper" to the editor who may be considered "quality control manager" in the process of scientific publication.The role of the reviewer is to assist the editor in selecting the appropriate article by concentrating on the following key-questions:
- What is the purpose of the paper?
- Is the goal of the paper significant?
- Is the paper appropriate for the particular journal?
- Is the study design valid?
- Is the actual execution (the methodology) of the research correct?
- Are the correct conclusions being drawn from the results?
- Is the presentation satisfactory?
- What will the readers learn?
While all the above mentioned criteria are important, the ultimate test of acceptability lies in the fulfillment of the last criterion, for if the reader were to gain nothing from the paper, it is really not worth publishing. The veryraison d'κtreof the IJO is to disseminate gainful information so that we, the readers, are richer by the exercise of reading it.
The parts of a review include a brief recommendation with reasons, summary of the points of the paper, statement of the goal of the work and its relevance to readership. The evaluation should assess the completeness of literature search and research question in introduction, soundness of methodology and appropriateness of the discussion.The three major remarks received from the reviewer are- accept, reject or accept with minor or major revision. A good reviewer is expected to provide enough discussion and information to justify his recommendation. If the recommendation is favourable a list of necessary changes should be suggested in each part of the paper. If the recommendation is not favourable then the suggestions for improvement should be given and the recommendation should carry enough evidence with references. Essentially a reviewer is a good writer and so some journals expect that a reviewer has at least five articles published in "indexed" journals.
Reviewers are expected to be impartial and follow ethical principles of the review process. They should not approve or disapprove an article simply because it matches or opposes the reviewer's area of interest and research. It is also unethical to plagiarise from an article or copy an idea or concept during the review process. Courteous language and timeliness can be added qualities which considerably improve the ratings of a reviewer. Refusal to review a paper outside one's expertise and maintaining honesty and confidentiality are qualities that are usually presumed to be internalised by the reviewer. Referring the paper to a junior, student or a fellow beats the whole purpose of an expert being carefully selected for the review of a paper. To check whether an article is contributing something new to scientific literature as well as to detect plagiarism and fraud it is essential that reviewers do a MEDLINE search (PubMed). Our website (www.journalonweb.com/ijo) now provides a user friendly literature search to the reviewer (at the reviewers site) which helps them in the proper review of the manuscript. Yet many reviewers seldom utilise the facility.
The peer-review process is not without disadvantages. Some of the reviewers find it difficult to be impartial and include their own personal opinion/bias in their critical remarks. Reviewers can make factually incorrect judgements; sometimes, different reviewers may disagree on the merits or demerits of a paper. In such a situation, the author has no recourse due to the anonymity of the reviewers. The major bone of contention for the authors is the delay in publication due to the peer-review process. It is not uncommon to find editors writing to the authors asking them to revise the manuscript many times before accepting it for publication. Other perceived flaws are ignorance of the reviewer with regard to the review process or the topic, bias by the reviewer especially institutional and failure to detect statistical flaws. These can be addressed by a training programme. The problem of lack of enthusiasm can be addressed by another solution -publishing the reviewers' comments whenever the article is published
Be that as it may, the peer-review process has stood the test of time. It offers many potential benefits. It validates the authors work, assures quality and authenticity, guards against plagiarism, and may support a job or funding application. Most important of all, the work receives value addition by the process of revision. On the flip side it does increase the cost and more importantly the time taken to publish, raising doubts in minds of authors about the relevance of their research being maintained considering the rate at which science changes today. Often, it fails to detect conflict of interest, fabrication of evidence and duplication of publication.
The IJO follows a blinded peer-review process which can be followed by the authors on the journals website. The number of submissions is on the rise each year, necessitating the need for more reviewers. Any author/researcher can help IJO improve its standard by offering his services as a reviewer. There is as yet, no formal training for the job of reviewers in medical schools. This skill is usually acquired by experience and self-study. The IJO is planning to hold a reviewers' training programme so that potential reviewers can be trained to become full-fledged competent reviewers. It is pertinent to note that those reviewers who spent longer time on a review (up to three hours) produced better quality of review.10 Interestingly, when the double blinded reviewer was younger or affiliated with a good academic institution, or known to the editor, a better quality of review was the outcome.1112
The important issue that warrants attention here is the improvement of a manuscript that usually takes place from the time it is submitted to the time it gets published because of the innumerable revisions based on the expert "peer" opinion.
Considering this benefit of value addition to the manuscript and its related implications, the peer-review process is the most important aspect in the processing of a manuscript. Any resultant delay in publication is a small price to pay for the overall improvement in the quality of our journal, the IJO. The online submission and manuscript management does reduce the time taken for processing but the time taken by a reviewer to review an article does continue to be a rate limiting step. Some authors who do not understand this add to the workload of the editorial offices by demanding that schedules are stuck to whereas honorary reviewers do need the time they take. In order to reduce the delays we would appeal to all reviewers and potential reviewers to come forward and help in the timely publication of research so that its relevance is not lost because of the time taken for the review process. At the same time let us not be just critical but be constructive in our evaluation of the work of someone who has burnt the mid night oil preparing it. "Value addition" is the key word. Lets "do unto others as we would have them do unto us" In the event of more articles becoming acceptable due to "value addition" by reviewers the journal always has scope for progress by increasing its frequency. Rejection of any article is painful to any author as well as the editor. Humility at all levels is an expectation that is not unjustified.
An attempt to revive any article before giving up on it, is the policy of the present editorial board. At the same time maintaining and improving the standards of the IJO is a promise the board vows to keep. The board heavily depends on its team of reviewers for the fulfillment of this promise as well as the maintenance of its policy. Though the editor can overrule the reviewers comment the present editorial committee would like to desist from the same. So it becomes imperative for the reviewer to tread the narrow path between being excessively permissive and ending up drowning good research in a flood of repetitive research and being excessively strict and blocking good research and leaving the journal with not enough articles to publish.
In conclusion it would be prudent to say that, with a vibrant international reviewer base that the IJO has been blessed with and the rigorous review process and reviewer training that has been planned, the readers can rest assured that the articles that are published will be scientifically as correct as they can be. But in all humility we agree that we continue to evolve and any further suggestions on the matter are welcome.
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