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Review the ‘peer review’

Article in Reproductive biomedicine online · August 2017

DOI: 10.1016/j.rbmo.2017.08.017


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5 authors, including:

Christophe Blockeel Panagiotis Drakopoulos

University Hospital Brussels Centre Hospitalier Universitaire de Liège


Nikolaos Polyzos
Instituto Universitario USP Dexeus


Some of the authors of this publication are also working on these related projects:

Assisted reproductive technology (ART) View project

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1 bs_bs_query
Q2 Commentary
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3 bs_bs_query Review the ‘peer review’

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5 bs_bs_query
Q1 Christophe Blockeel a,b,c,*, Panagiotis Drakopoulos a,b, Nikolaos P Polyzos a,b,d,
6 bs_bs_query Herman Tournaye a,b, Juan Antonio García-Velasco e
7 bs_bs_query Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, 1090 Brussel, Belgium
8 bs_bs_query Department of Surgical and Clinical Sciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium
9 bs_bs_query Department of Obstetrics and Gynaecology, School of Medicine, University of Zagreb, Croatia
10 bs_bs_query Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark
11 bs_bs_query IVI Madrid, Madrid, Spain
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13 bs_bs_query

14 bs_bs_query A B S T R A C T
15 bs_bs_query

16 bs_bs_query Peer review has been the main form of appraisal of scientific knowledge for over a century. In essence, this process involves the evaluation of a sci-
17 bs_bs_query entific finding by independent experts prior to its dissemination to the scientific community, in an attempt to ensure that both the research and conclusions
18 bs_bs_query meet the necessary standards regarding quality, accuracy, relevance and novelty. However, although ‘peer review’ is considered the current gold stan-
19 bs_bs_query dard, it is far from perfect. A focus on the methodology of an article and reviewers’ training are key messages for the scientific community. Guidelines
20 bs_bs_query on how to review an article are needed and may help reviewers deal with this difficult process.
21 bs_bs_query © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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23 bs_bs_query

Given the absence of relevant articles regarding ‘peer review’ in 46 bs_bs_query

24 bs_bs_query Is peer review necessary? journals of reproductive medicine, the purpose of this opinion paper 47 bs_bs_query

25 bs_bs_query
is to evaluate the current status of peer review in this field of medi- 48 bs_bs_query

26 bs_bs_query Peer review has been the main form of appraisal of scientific knowl- cine per se. There is no intention to criticize potential conflicts of 49 bs_bs_query

27 bs_bs_query edge for over a century. In essence, this process involves the evaluation interest, publication biases, or evaluate other contentious aspects of 50 bs_bs_query

28 bs_bs_query of a scientific finding by independent experts (i.e. referees) prior to the process (e.g. whether the ‘peer review’ should be anonymous, or 51 bs_bs_query

29 bs_bs_query its dissemination to the scientific community, in an attempt to ensure whether authors should be blinded to reviewers and vice versa), as 52 bs_bs_query

30 bs_bs_query that both the research and conclusions meet the necessary stan- these controversial topics have been extensively debated already in 53 bs_bs_query

31 bs_bs_query dards regarding quality, accuracy, relevance and novelty (Burnham, the medical literature (Manchikanti et al., 2015; Smith, 2006). 54 bs_bs_query

32 bs_bs_query 1990).
33 bs_bs_query Scientific journals are under considerable pressure to ensure the 55 bs_bs_query

34 bs_bs_query integrity and accuracy of the scientific articles they publish, in order
56 bs_bs_query

35 bs_bs_query to maintain the continued trust placed upon them. Furthermore, as

36 bs_bs_query the number of submitted articles has increased substantially over
Tasks of the reviewer 57 bs_bs_query

37 bs_bs_query recent years (Spier, 2002), it has become routine for journals to select 58 bs_bs_query

38 bs_bs_query only the highest quality manuscripts for publication. In order to achieve Reviewing with an imposed deadline is a time-consuming and labo- 59 bs_bs_query

39 bs_bs_query this challenging goal, a number of qualified reviewers seems fun- rious task. It can take several hours over a number of days to consider 60 bs_bs_query

40 bs_bs_query damental for every scientific journal. a manuscript appropriately, reviewing previous relevant literature, 61 bs_bs_query

41 bs_bs_query

42 bs_bs_query * Corresponding author.

43 bs_bs_query E-mail address: (C Blockeel).
44 bs_bs_query
45 bs_bs_query 1472-6483/© 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Please cite this article in press as: Christophe Blockeel, Panagiotis Drakopoulos, Nikolaos P. Polyzos, Herman Tournaye, Juan Antonio García-Velasco, Review the ‘peer
review’, Reproductive BioMedicine Online (2017), doi: 10.1016/j.rbmo.2017.08.017

62 bs_bs_query evaluating the methodology, formulating comments and a conclu- homogeneous reviewing, which may standardize and improve the 119 bs_bs_query

63 bs_bs_query sion. The report of the reviewer, which itself is an intellectual quality of the review process. 120 bs_bs_query

64 bs_bs_query document, should be clear and concise, to help the associate/ 121 bs_bs_query

65 bs_bs_query section editor and the editor decide whether to proceed or not with 122 bs_bs_query

66 bs_bs_query the manuscript. Therefore, it should be written in a clear, succinct Focus on methodology 123 bs_bs_query

67 bs_bs_query and neutral but decisive tone.

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One of the most crucial skills is the meticulous evaluation of the meth- 125 bs_bs_query

69 bs_bs_query odology of a research paper. We consider that the Methods section 126 bs_bs_query

70 bs_bs_query Standardization of peer review of a manuscript is the most vital part, because a poor methodology 127 bs_bs_query

may lead to biased results, limiting the clinical extrapolation of an 128



article. Although scientific interest and innovation remain key com- 129 bs_bs_query

72 bs_bs_query Although ‘peer review’ is considered the gold standard for the ap-
ponents of medical research, the lack of proper methodology 130 bs_bs_query

73 bs_bs_query praisal of scientific knowledge, it remains far from perfect (Godlee

undermines the value of any novel idea. On the other hand, even less 131 bs_bs_query

74 bs_bs_query et al., 1998). Furthermore, the process itself seems to have re-
interesting clinical results may have merit when the research is based 132 bs_bs_query

75 bs_bs_query mained largely unchanged over the years, which is in stark contrast
on a robust methodological approach. In this regard, reviewers should 133 bs_bs_query

76 bs_bs_query to the evolution in evidence-based medicine following the establish-

be encouraged to prioritize manuscripts using the correct method- 134 bs_bs_query

77 bs_bs_query ment of uniform criteria for reporting of randomized trials

ology instead of those that are fluently written or present statistically 135 bs_bs_query

78 bs_bs_query [Consolidated Standards of Reporting Trials (CONSORT) statement]

significant results (Garmel, 2010), only showing P-values for data in- 136 bs_bs_query

79 bs_bs_query (Schulz et al., 2010) and meta-analyses [Preferred Reporting Items

terpretation (Farland et al., 2016). Nevertheless, given that several 137 bs_bs_query

80 bs_bs_query for Systematic Reviews and Meta-Analyses (PRISMA statement)]

reviewers have no or limited statistical knowledge, a panel of per- 138 bs_bs_query

81 bs_bs_query (Moher et al., 2009).

manent statistical reviewers with expertise in the field would be a 139 bs_bs_query

82 bs_bs_query
valuable option, because it is the only way to safeguard high-quality 140 bs_bs_query

83 bs_bs_query
assessment before publication. 141 bs_bs_query

84 bs_bs_query Lack of training in peer reviewing 142 bs_bs_query



86 bs_bs_query Most reviewers learn how to evaluate the research of their peers by
Should the impact factor matter? 144 bs_bs_query

87 bs_bs_query practice rather than by instruction or training (Benos et al., 2003). Al- 145 bs_bs_query

88 bs_bs_query though most journals do have instructions to guide the reviewers Another crucial question that should be asked is whether reviewers 146 bs_bs_query

89 bs_bs_query through the process, these vary significantly from one to another and are influenced by the impact factor of the journal to which the article 147 bs_bs_query

90 bs_bs_query fail to specify which prerequisites are to be expected from a quali- has been submitted. That is, reviewers may be more rigorous with 148 bs_bs_query

91 bs_bs_query fied reviewer. Consequently, the lack of coherent training and manuscripts submitted to high-indexed journals and less so with ar- 149 bs_bs_query

92 bs_bs_query specialization of peer reviewers could jeopardize the scientific quality ticles submitted to journals with a lower impact factor. Although we 150 bs_bs_query

93 bs_bs_query of published manuscripts and little is currently being done to raise believe that the criteria for the evaluation of a submitted article should 151 bs_bs_query

94 bs_bs_query awareness of the necessity of formal teaching in this essential skill be uniform, regardless of the journal’s impact factor, it may be stated 152 bs_bs_query

95 bs_bs_query (Schroter et al., 2004). As the current availability of training oppor- that the above-mentioned discrepancy may be part of human nature, 153 bs_bs_query

96 bs_bs_query tunities on how to perform a review is lacking, initiatives such as those not only observed in the peer review process. 154 bs_bs_query

97 bs_bs_query promoted by the American Society for Reproductive Medicine (ASRM), Nevertheless, even if the reviewer judges that the submitted manu- 155 bs_bs_query

98 bs_bs_query the European Society of Human Reproduction and Embryology (ESHRE) script is not suitable for publication in a journal with high impact factor, 156 bs_bs_query

99 bs_bs_query and the World Congress on Controversies in Obstetrics, Gynecology one of his/her fundamental tasks would be to provide comments that 157 bs_bs_query

100 bs_bs_query and Infertility (COGI), in organizing regular courses for reviewers, as- could help authors to improve the overall quality of a rejected paper, 158 bs_bs_query

101 bs_bs_query sociate and section editors should be further encouraged; however, and therefore make it appropriate for eventual publication in another 159 bs_bs_query

102 bs_bs_query it is notable that topics covered by ESHRE and ASRM at courses in journal. As every study has its limitations, one must bear in mind that 160 bs_bs_query

103 bs_bs_query 2017 were clearly oriented more to authors than to reviewers (Table 1). manuscripts should be judged on the study that was conducted rather 161 bs_bs_query

104 bs_bs_query Appropriate training of reviewers could be the first step towards more than the study the reviewer thinks the authors should have performed. 162 bs_bs_query

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The role of predatory journals 165 bs_bs_query

107 bs_bs_query Table 1 – Topics covered by ESHRE and ASRM at courses in

108 2017.


Finally, this opinion paper would be incomplete if we did not comment 167


on the constant generation of predatory medical journals. In fact, there 168 bs_bs_query

110 bs_bs_query Principles of study design Types of studies

is an increasing appearance of online journals publishing articles with 169 bs_bs_query

111 bs_bs_query Ethics of performing and publishing How to design a study

a questionable (if not clearly exclusively business-oriented) motiva- 170

bs_bs_query research
113 bs_bs_query Writing a study How to read a paper tion, without tribute to scientific evidence and the need for excellence 171 bs_bs_query

114 bs_bs_query How does the review process work? How to evaluate a manuscript in research. Emails congratulating authors for their research and im- 172 bs_bs_query

115 bs_bs_query Engaging readers and achieving impact Media resources available to portant contributions to the field, inviting them to submit any type of 173 bs_bs_query

116 bs_bs_query interact in the communication manuscript which will be published in a short timescale due to a ‘fast’ 174 bs_bs_query

117 bs_bs_query A good oral presentation How the journal is organized review process, have become a daily phenomenon. Provocatively 175 bs_bs_query

118 Post-publication care Ethics in publishing

speaking, many of these journals with a very low or frequently 176


Please cite this article in press as: Christophe Blockeel, Panagiotis Drakopoulos, Nikolaos P. Polyzos, Herman Tournaye, Juan Antonio García-Velasco, Review the ‘peer
review’, Reproductive BioMedicine Online (2017), doi: 10.1016/j.rbmo.2017.08.017

177 bs_bs_query unexciting impact factor may tend to accept a lower threshold of peer REFERENCES 203 bs_bs_query

178 bs_bs_query review quality and publish research of controversial value. 204 bs_bs_query

205 bs_bs_query

179 bs_bs_query
Benos, D.J., Kirk, K.L., Hall, J.E., 2003. How to review a paper. Adv. 206 bs_bs_query

Physiol. Educ. 27, 47–52. 207 bs_bs_query

180 bs_bs_query Burnham, J.C., 1990. The evolution of editorial peer review. JAMA 263, 208 bs_bs_query

181 bs_bs_query Suggestions 1323–1329. 209 bs_bs_query

Farland, L.V., Correia, K.F., Wise, L.A., Williams, P.L., Ginsburg, E.S., 210 bs_bs_query

182 bs_bs_query

Missmer, S.A., 2016. P-values and reproductive health: what can 211 bs_bs_query

183 bs_bs_query In conclusion, peer review, the current arbiter of scientific quality, clinical researchers learn from the American Statistical 212 bs_bs_query

184 bs_bs_query requires further improvement. Incentives for reviewers in order to Association? Hum. Reprod. 31, 2406–2410. 213 bs_bs_query

185 bs_bs_query enhance their motivation, such as free access to a publisher’s jour- Garmel, G.M., 2010. Reviewing manuscripts for biomedical journals. 214 bs_bs_query

Perm J 14, 32–40. 215

186 nals, could be an interesting option, especially for younger scientists.


Godlee, F., Gale, C.R., Martyn, C.N., 1998. Effect on the quality of peer 216 bs_bs_query

187 bs_bs_query A larger focus on the methodology of an article and guidance and train- review of blinding reviewers and asking them to sign their reports: 217 bs_bs_query

188 bs_bs_query ing for reviewers would also be paramount for the broader scientific a randomized controlled trial. JAMA 280, 237–240. 218 bs_bs_query

189 bs_bs_query community. Manchikanti, L., Kaye, A.D., Boswell, M.V., Hirsch, J.A., 2015. Medical 219 bs_bs_query

190 bs_bs_query Received 16 March 2017 journal peer review: process and bias. Pain Physician 18, E1–E14. 220 bs_bs_query

191 bs_bs_query Received in revised form 8 August 2017 Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., Group, P., 2009. 221 bs_bs_query

192 bs_bs_query Accepted 8 August 2017 Preferred reporting items for systematic reviews and meta- 222 bs_bs_query

analyses: the PRISMA Statement. Open Med 3, e123–e130. 223


bs_bs_query Declaration: The authors report no

Schroter, S., Black, N., Evans, S., Carpenter, J., Godlee, F., Smith, R., 224 bs_bs_query

194 bs_bs_query financial or commercial conflicts of 2004. Effects of training on quality of peer review: randomized 225 bs_bs_query

195 interest. controlled trial. BMJ 328, 673. 226




197 bs_bs_query
Schulz, K.F., Altman, D.G., Moher, D., Group, C., 2010. CONSORT 2010 227 bs_bs_query

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statement: updated guidelines for reporting parallel group 228 bs_bs_query

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199 Evidence-based

Smith, R., 2006. Peer review: a flawed process at the heart of science bs_bs_query

200 bs_bs_query Peer review and journals. J. R. Soc. Med. 99, 178–182. 231 bs_bs_query

201 bs_bs_query Review Spier, R., 2002. The history of the peer-review process. Trends 232 bs_bs_query

202 bs_bs_query Scientific quality Biotechnol. 20, 357–358. 233 bs_bs_query

Please cite this article in press as: Christophe Blockeel, Panagiotis Drakopoulos, Nikolaos P. Polyzos, Herman Tournaye, Juan Antonio García-Velasco, Review the ‘peer
review’, Reproductive BioMedicine Online (2017), doi: 10.1016/j.rbmo.2017.08.017
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