In 2021, ATM reviewers continue to make outstanding contributions to the peer review process. The following reviewers are highlighted and commended for their professional effort and enthusiasm in reviews. Let us take this chance to express our heartfelt gratitude for their tremendous effort and valuable contributions to the journal and to the scientific process!
Mohammed Osman, West Virginia University Hospitals
Arnaud Thille, University Hospital of Poitiers, France
Anna Moles, Spanish National Research Council, Spain
Saraschandra Vallabhajosyula, Mayo Clinic, USA
Noriaki Sakakura, Aichi Cancer Center Hospital, Japan
Takashi Uebanso, Tokushima University, Japan
In-Ho Jeon, University of Ulsan, Korea
Stergios Boussios, King’s College London, UK
Seong Hwan Kim, Chung-Ang Univ. Hospital, Korea
Amos Lal, Mayo Clinic, USA
Adrià Arboix, University of Barcelona, Spain
Cynthia H. McCollough, Mayo Clinic, USA
Pi-Shan Sung, National Cheng Kung University, Taiwan
Darshan Gandhi, UT Regional One Physician, USA
Wang-Xia Wang, University of Kentucky, USA
Menno Pruijm, University Hospital of Lausanne, Switzerland
Romain Jouffroy, University Paris Saclay, France
Sebastian Clauss, LMU Hospital Munich, Germany
Heather Stevenson-Lerner, University of Texas, USA
Daichi Sone, Jikei University, Japan
Mitsuhisa Takatsuki, , University of the Ryukyus, Japan
Susanna S. Park, University of California Davis, USA
Ming Han Lincoln Liow, Singapore General Hospital, Singapore
Michael D. Maile, University of Michigan, USA
Yojiro Yutaka, Kyoto University, Japan
Tomohiro Yazawa, Gunma University Hospital, Japan
Masayuki Nakao, Cancer Institute Hospital, Japan
Raúl J Gazmuri, Rosalind Franklin University of Medicine and Science, USA
Jitka Virag, East Carolina University, USA
Takashi Matsushima, Nippon Medical School Musashi Kosugi Hospital, Japan
Natalia Reglero-Real, Queen Mary University of London, UK
Dr. Mohammed Osman is the Chief Cardiology Fellow at West Virginia University Hospitals. His research areas of interest include racial and gender disparities in interventional & structural cardiology procedures, cardiogenic shock, mechanical circulatory support devices, invasive hemodynamics, and coronary artery disease. For more details, you may follow Dr. Osman on Twitter @MoOsmanMD or here.
Dr. Osman sees peer review as one of the significant roles that he serves in the academic field, “It helps ensure that published materials have gone through the scrutiny of several experts in the area. Our job as reviewers is to provide constructive feedback and offer the authors ideas and feedback to improve their work. This is why for every criticism a reviewer provides, they should always present a way to move forward because the goal is to improve every manuscript collectively. On the other hand, peer review is also a crucial step in the development of any academic. To be a good author, you need to be a good reviewer. I always try to find time to review at least one paper per week as this keeps me on track and ensures that I keep myself updated about the new research in my field of interest.”
To Dr. Osman, reviewers have to keep in mind that they are among the final defense lines to ensure the paper contents’ accuracy, “Authors always rely on the peer review process to pinpoint any holes or mistakes in their manuscripts. Hence, reviewers must spend enough time on each peer review assignment and make sure that they review every detail and give their honest and unbiased feedback.”
Lastly, Dr. Osman make the following suggestion to his peers, “My advice for authors is to be familiar with the guidelines of reporting research projects. It is important that the authors stick to these guidelines (like PRISMA, STROBE, etc.) when reporting their findings.”
Arnaud W. Thille
Arnaud W. Thille is the Head of Intensive Care Unit at the University Hospital of Poitiers (more than 1000 beds in the west of France). He was a student in Medicine in Paris and did his residency, Master 2 and PhD with Professor Laurent Brochard at the University of Paris-East. His topic of research focuses exclusively on mechanical ventilation and acute respiratory failure, including ARDS, patient-ventilator interactions, weaning, and noninvasive ventilation. Then, he spent one year in Madrid (Spain) for a post-doctoral research with Professor Andres Esteban on the theme of diffuse alveolar damage in patients with ARDS. He joined the University of Poitiers in 2013 and conducted several large randomized clinical trials on mechanical ventilation. Two large trials have been completed, one comparing noninvasive ventilation vs. high-flow nasal oxygen in more than 300 immunocompromised patients with acute respiratory failure, and another one comparing T-piece vs. low levels of pressure-support for spontaneous breathing trials before extubation in nearly 1000 patients at high-risk of reintubation. He now leads a research group on respiratory physiology and they welcome any students to join them with pleasure.
From Dr. Thille’s point of view, peer review theoretically allows to take a critical look by several experts with experience who have previously been confronted to this issue. At the end of the writing of an article, the author is often no longer able to detect errors, missing messages or simply explain his work. Peer review then makes it possible to gather several opinions and to take a step back with a fresh look. Reviewers are from any country on the planet, which also makes to have different opinions and points of view on a same theme. The reviewer has to ensure that there are no errors and that the message is actually valid. In all cases, the main objective is to improve the quality and readability of the article. The reviewer also has to help the editor’s decision and must not hesitate to reject an article which provides no new information or without a clear message.
To Dr. Thille, a constructive review helps to improve the quality of the article, “In my opinion, the most important thing is to deliver a simple message. The authors have often lots of results and would like to explain all their findings in detail, whereas the most important is to simplify, to have one or two messages to hook the reader and easily remember the main message. My main objective as reviewer is to help deliver a simple message and to facilitate readability by avoiding subanalysis, by facilitating readability of tables and messages, deleting decimals after digits often unnecessary, etc…”
“Curiosity!” says Dr. Thille when being asked what drives him to keep doing peer review, “It is always interesting to read the most recent articles and last update on our favorite topic of research with the aim at improving ourselves. And sometimes, the journal may offer us the opportunity to write an editorial to debate and express our opinion.”
Obtaining ethical statement for a research is of utmost importance in Dr. Thille’s opinion, even for retrospective studies. “Laws are different from one country to another, and in France for example, we have to respect law on ‘computer and freedom’ in order to not use nominative data. This means that for retrospective studies, the authors must declare their research and must commit to anonymizing their patient database. The process is simple but helps to protect patients’ data and guarantee an information on research ongoing.”
Anna Moles Fernández is a Tenured Scientist (Científico Titular) from the Spanish National Research Council. She works at the Institute of Biomedical Research of Barcelona. She obtained her degree in Biology and her PhD in Biomedical Sciences at the University of Barcelona. After spending more than 7 years working at Newcastle University, UK, first as Research Associate and afterwards as junior PI, she relocated to the Institute of Biomedical Research of Barcelona with a prestigious Ramon y Cajal contract in 2018. In 2020, she was awarded with a highly competitive position as Tenured Scientist. As an expert in her field of research she is often asked to review grants and papers for different funding bodies and editorials. Her current research focuses on investigating the proteolytic pathways driving fibrosis and cancer, to unravel new therapeutic candidates for drug development. Please visit Dr. Moles’ LinkedIn for more information.
On peer review, Dr. Moles says, “As scientists, critical appraisal from our peers is essential to produce high-quality science. Peer-revision is one of the ways scientists can receive feedback from its peers and raise the quality of their manuscripts at different levels, from data collection and interpretation to comprehensive communication and discussion of the results presented.”
To Dr. Moles, a robust peer review system requires the participation of several reviewers in the process, at least one of them an expert in the particular topic of the paper. The process must be overseen by an Editor. The reviewers should check among other things for novelty, appropriateness of the methodology and soundness of the experimental results, “One of the main limitations we face during peer revision are the biases inadvertently experienced by both reviewers and editors. To avoid this, all the materials handled to reviewers should be blinded, so authors names and affiliations should not be displayed. The inclusion of a professional reviewer hired by the editorial would also be a good addition to guarantee a fairness and homogeneous treatment of the different submissions received by the journal. Finally, and in some particular cases, open communication between reviewers and authors would help manage the revision process.”
In Dr. Moles’ opinion, the qualities to look for in a good reviewer are knowledge on the topic to review, impartiality, attention to details, and willingness to provide insightful comments to peers to help them improve their own work.
From a reviewer’s point of review, Dr. Moles believes that data sharing is essential to provide access to the primary results of our studies to our peers but also to wider communities. Access to data not only reassures the scientific community about the soundness of our own studies, but it also helps others to reproduce and validate our own findings. Only by sharing and working together we will be able to build up on previous knowledge and make break-through discoveries that will have a real impact on people’s lives.
Dr. Saraschandra Vallabhajosyula, MD MSc FACP FCCP FCCM is a Fellow in Interventional Cardiology at Emory University School of Medicine in Atlanta, Georgia and an Assistant Professor of Medicine at the Mayo Clinic College of Medicine and Science in Rochester, Minnesota. He attended medical school at Manipal University in India, trained in Internal Medicine at Creighton University School of Medicine in Omaha Nebraska, Critical Care Medicine at Mayo Clinic in Rochester Minnesota, Cardiovascular Diseases at Mayo Clinic in Rochester Minnesota, and Interventional Cardiology at Emory University School of Medicine in Atlanta Georgia. He also received his Master of Science in Clinical and Translational Science from the Mayo Clinic Graduate School of Biomedical Sciences in Rochester Minnesota. He is a clinician and outcomes researcher whose work encompasses the fields of cardiogenic shock, acute myocardial infarction, cardiac arrest, high-risk percutaneous coronary intervention, percutaneous mechanical circulatory support, non-cardiac organ failure, septic shock, septic cardiomyopathy, and circulatory shock.
Dr. Vallabhajosyula is a Fellow of the American College of Physicians, American College of Chest Physicians and the American College of Critical Care Medicine. He serves as the current chair of the In-Training Section of the SCCM. He also serves on the ACC Interventional Cardiology Council, AHA Acute Cardiac Care Committee, AHA FIT Programming Committee, AHA EPI Statistics Committee, ACC FITs on the Go Editorial Committee, SCCM Program Committee, SCCM Mentorship Task Force and has been invited as faculty to multiple ACC, AHA and SCCM Congress meetings. He has mentored over 30 medical students, residents and fellows during the last nine years and taught many more in over 100 lectures in this period. He is a highly published clinical researcher with over 200 peer-reviewed publications in high impact journals, 120 peer reviewed abstracts, and over 200 regional, national and international presentations. His work has been cited more than 1800 times. He has received multiple awards from the ACC, AHA, SCCM, ACCP and ATS. He has secured multiple research grants from local and national bodies to further his work in acute cardiovascular care. He is one among only 100 physicians in this country trained in cardiovascular medicine, critical care medicine and interventional cardiology. You may follow Dr. Vallabhajosyula on Twitter @SarasVallabhMD.
To Dr. Vallabhajosyula, peer review is crucial for the advancement of science in the community. Strong peer review is crucial to ensure high-quality science reaches the consumers. For example, in the COVID-19 era, scientific publications have increased multiple fold. Physicians are working overtime to report early results that will benefit the scientific community. However, unfortunately, we have seen multiple reports that were poorly presented, and caused confusion with the management of this disease process. Peer review is thus essential to prevent such developments and ensure science is both accurate and high-quality.
In Dr. Vallabhajosyula’s opinion, it is important for reviewers to focus on the science independent of the reputation of the authors, personal viewpoints of the reviewer, or any other biases that one might hold, “As an author myself, nothing gives me greater joy than a balanced review that is fair, rigorous and helpful. It is important reviewers treat authors the way they would like their manuscripts handled.”
Despite the heavy workload in daily work, Dr. Vallabhajosyula never douses his enthusiasm in peer review, “Peer review gives me an opportunity to learn about the latest developments in my field faster than many colleagues who read once the paper is in print. It further sharpens my abilities as an author, since I often evaluate my manuscript dispassionately (akin to a reviewer). It is crucial to pay forward the benevolence that I have received from other editors/reviewers, so that as a scientific community, we all make progress together.”
Last but not least, Dr. Vallabhajosyula stresses that Data Sharing Statement is a remarkable measure for researchers and physicians to share their research data with others, “In the current information era, there is no substitute for raw data and it truly reflects confidence in the reported manuscript and the ability to develop strong collaborations with independent researchers.”
Dr. Noriaki Sakakura is a specialist in the surgical treatment of thoracic diseases, especially malignant thoracic tumors, including lung cancer, mediastinal neoplasms, and metastatic thoracic tumors. He currently serves as the Chief Physician of the Department of Thoracic Surgery at the Aichi Cancer Center Hospital, Japan. He graduated from the Nagoya University School of Medicine in 2000 and received his Ph.D. degree in 2010 for his research on the subcategorization of resectable non-small cell lung cancer involving neighboring structures.
Currently, his main responsibilities include performing extensive invasive surgeries in patients with highly advanced thoracic tumors, salvage operations following chemoradiation therapy, and re-do surgeries. He also performs robot-assisted minimally invasive surgeries. An “open-thoracotomy-view approach” using vertical port placement and confronting upside-down monitor setting has been introduced in the Aichi Cancer Center Hospital for robotic lung resections. Dr. Sakakura constantly strives to arrive at the most effective surgical treatment strategies for patients with serious conditions using a patient-specific, tailored approach.
In Dr. Sakakura’s opinion, the multi-review process is an essential step in the production of high-quality scientific manuscripts. The different viewpoints of several reviewers refine a manuscript and make it more logical, scientific, and readable. However, the opinions of reviewers are not absolutely definitive. Since reviewers may make unnecessary or unfocused comments, the Editor-in-Chief and members of the Editorial Board must objectively evaluate these comments in order to avoid misjudging the true value of a manuscript.
Dr. Sakakura believes that reviewers should practice constructive, unbiased criticism. Even high-quality manuscripts with a valuable message may be negatively reviewed if the message of the manuscript differs from the reviewer’s viewpoint. In general, authors put a lot of effort into writing a manuscript, so in order to refine their manuscripts, reviewers should provide constructive suggestions for all manuscripts, including well-written manuscripts. In addition, they should constructively suggest and provide ideas for improving the quality of unacceptable manuscripts.
To Dr. Sakakura, peer review is a demanding but an enjoyable task, as long as the manuscripts are not too voluminous. He feels that the editorial board should provide feedback on the selection process regarding the acceptance or rejection of the articles that he reviewed.
Lastly, from a reviewer’s perspective, Dr. Sakakura indicates that even if a study is retrospective, approval from the institutional review board is desirable. It is also important for authors to show that their study does not contradict any ethical principles.
Takashi Uebanso, PhD is a scientist in Nutrition at Tokushima University, Japan. His research focuses on the relationship between diet and gut microbiota and its impact on metabolic diseases such as obesity and diabetes, and the development of allergic diseases as well as impact of maternal diet and gut microbiota targeting preconception health.
To Dr. Uebanso, peer-reviewed papers are a means of “making good scientific knowledge known to the world”. For this purpose, reviewers are cooperators to improve the papers. A peer-review system is also important to prove that we agree that there is a “place” to promote a science.
Speaking of the key qualities a reviewer should possess, Dr. Uebanso says, “When reviewing papers, we need to pay attention to whether the necessary control experiments have been conducted, whether there are any possible artifacts, and whether there are any suspicions of research misconduct. Reviewers need the qualities to consider: Is the purpose, methods, data, statistical analysis, and interpretation of paper technically sound?”
The rapid increase in the number of open access journals has led to an increase in the number of papers submitted and the corresponding number of reviewers. The burden on reviewers is increasing. In order to reduce the burden on reviewers, Dr. Uebanso advocates that scientists should write good papers first. In addition, the cooperation of reviewers should be rewarded, so together we should raise our voices to improve their treatment.
Dr. Uebanso concluded by encouraging authors to follow reporting guidelines while writing papers, “Reporting guidelines are in general very helpful in writing papers. Also, for individual papers, I think it is important to write papers that you want to read (that you think would have been helped by having this paper).”
In-Ho Jeon, MD, PhD, is a professor in the Department of Orthopedic Surgery, College of Medicine, University of Ulsan in Seoul, Korea. He is actively involved in clinical appointments majoring elbow and upper extremity surgeries in Asan Medical Center, University Hospital of Ulsan Medical School. He serves as a chairperson of shoulder elbow subspecialty committee in SICOT, an associated editor of Journal of Shoulder Elbow Surgery, and a president elect of APOA hand & upper limb society.
Dr. Jeon obtained his medical degree from Kyungpook National University in Daegu and finished his orthopedic resident training in the same university hospital. He had a Shoulder and Elbow Research Fellowship in the University of Nottingham supervised by Prof. Angus Wallace for two years and became assistant professor in the Kyungpook National University. Dr. Jeon worked in Mayo Clinic for clinical and research on elbow with Prof. Bernard Morrey. He published over 100 scientific papers in peer-reviewed journals as a main author.
Dr. Jeon’s clinical research work covers elbow anatomy, biomechanics and elbow trauma. His research team collaborates with researchers in robotics and IT companies to establish next generation robotic surgery in orthopedic surgery and a new digital surgical suite. His team has several grants supported by the Ministry of Health & Welfare, and Ministry of Trade, Industry and Energy of Korean Government.
To Dr. Joen, peer review is of utmost importance in improving the quality of research. It ensures only high-quality research is disseminated and available as a body of scientific evidence.
Speaking of the key qualities a reviewer should possess, Dr. Joen thinks that the skill of performing critical appraisal is very important, yet not easy to achieve. Reviewers should provide constructive and positive comments (rather than destructive), which can be helpful for the authors to improve their study. Moreover, they should understand the originality and significance of any manuscript meriting in publication in the journal. In addition, they should scrutinize the scientific correctness of the study and evaluate the substantiated conclusions. In the end, they are expected to provide detailed basis of recommendations to the editor in chief.
“This is not easy to always prioritize work to take on extra review tasks,” says Dr. Joen, “Physicians who act as heavy volume clinician and active academician are prone to have burn out syndrome. Balancing is always an important concept rather than juggling. One of the solutions is to allocate time for each task to avoid any imbalance or loss of control.”
In most cases, Dr. Joen believes it is important for retrospective studies to apply for institutional review board (IRB) approval, “Assuming that the data may be sensitive (and therefore may have risk for compromising the identity or safety of the individuals), or relevant to the disease, disorder, or problem you are investigating, we should apply for IRB approval considering that it is impossible to obtain patients’ consent for using retrospective data. All in all, ethical clearance is mandatory to ensure the research is conducted in a responsible and ethically accountable way. We have to minimise the risk of harm to humans (and animals). And most importantly, ensure that the research leads to beneficial outcomes.”
Prof. Stergios Boussios, MD, MSc, PhD, MRCP(London), currently serves in (1) King’s College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, London, UK; (2) Medway NHS Foundation Trust, Kent, UK and (3) AELIA Organization, Thessaloniki, Greece. He trained in Medical Oncology at the University Hospital of Ioannina, Greece (2010–2013). He was awarded European School of Oncology (ESO) and Hellenic Society of Medical Oncology (HeSMO) fellowships for clinical and laboratory research at the Royal Marsden Hospital, London, UK (2014–2015). Prof. Boussios holds a PhD (2016). His thesis examined the role of circulating cancer cells and cancer cells with blastic phenotype and epithelial mesenchymal transition in peripheral blood of patients with Carcinomas of Unknown Primary site (CUP). In 2017, he was selected by the European Society of Medical Oncology (ESMO) Fellowship and Award Committee to be part of the ESMO Leaders Generation Programme. Since April 2018, he has served as consultant at the Medway NHS Foundation Trust, Kent, UK. Prof. Boussios’ research interests include individualization of patient treatment and targeted therapies in gynecological cancers, CUP, urological cancers, colorectal cancer, cancer diagnosed in pregnancy and new drug development. He is actively involved in translational research in cancer and is principal investigator in phase I-III studies. In October 2020, Prof. Boussios offered an honorary academic appointment at the King’s College London (School of Cancer and Pharmaceutical Sciences). For more information about Prof. Boussios, please visit here.
“The benefits of peer review are real,” says Prof. Boussios, “It actually acts as a quality-control system and applies checks and balances for ideas and scientific discoveries, before they are widely accepted by the scientific community. Novel findings or ideas might not move into the mainstream of our understanding of biological processes if they are viewed as simple statements from the discoverers. It should be ensured that peer reviewing remains an important element in the whole process that transfers experiment into shared information.”
To Prof. Boussios, apart from being polite, honest and clear, reviewers should also try to be objective and constructive. Reviewers should give constructive criticism even if they make conclusions suggestive of rejection of the submitted manuscript. This potentially helps researchers to improve their work and explains to the editor why reviewers feel that the manuscript does not meet the criteria to be accepted for publication. It is strongly recommended for the reviewer to keep in mind the argument’s construction, the clarity of the language and content. With regard to the argument’s construction, there should be identified any places where the meaning is unclear or ambiguous, along with potential factual errors or invalid arguments. Usually, authors welcome constructive criticism and applicable advice on all aspects of their papers offered by reviewers. Apart from the manuscripts, the reviewers and their reviews should also be evaluated. This could be facilitated by the publication of the reviewers and their reviews.
Speaking of the importance of research data sharing, Prof. Boussios explains that sharing the full data sets underlying the results brings many benefits. It enables reuse, reduces research waste, and promotes collaboration. Greater transparency increases trust in research results by allowing results to be independently verified. Many journals encourage authors to share the data and other artefacts supporting the results in the paper by archiving it in an appropriate public repository. Authors may provide a data availability statement, whilst shared data should be cited. Moreover, sharing clinical trial data is one step in the process articulated by several organizations as best practice for clinical trials. Although universal compliance with the requirement to prospectively register clinical trials has not yet been achieved, we must work toward fulfilling the other steps of best practice as well-including data sharing. As we move forward into this new norm, we have to facilitate practical solutions to enable data sharing.
“Peer reviewing forms a fundamental part of the scientific process and has a long tradition. It is important because it serves to uphold the quality of the literature and to advance the scientific knowledge-base. Peer reviewing allows access to a larger breadth of the scientific literature. It also enables reviewers to read the most up-to-date research that others do not yet have access to and before it is put into the public domain. Critical analysis of research is a skill that is developed through practice and experience in peer reviewing. Importantly, this is often turned inwards to critically appraise and improve one’s own research and writing. There is now a trend towards increased standardization of training in peer reviewing, to help peer reviewers develop these skills. Several platforms have emerged to recognize the work peer reviewers do, providing peer reviewing with a bright future,” says Prof. Boussios.
Seong Hwan Kim
Seong Hwan Kim, MD, PhD, currently serves as the Assistant Professor at the Department of Orthopedic Surgery, Chung-Ang Univ. Hospital, Seoul, Korea. His areas of research include: 1) knee surgeries, sports medicine, arthroplasty; 2) artificial intelligence including neural network, randomforest, support vector machine etc.; and 3) cartilage regeneration methods. He serves as an editorial board member of The Journal of Arthroscopy, and as a reviewer for various journals including The Journal of Arthroplasty, Knee Surgery and Related Research, Journal of Knee Surgery, The Knee, and BMC Musculoskeletal Disease. The full profile of Dr. Kim can be accessed here.
To Dr. Kim, peer review is essential to establish a good journal. During peer review, authors could take the feedback from researchers in many other hospitals, universities, and even countries who had different points of view. The article can thus be improved and be more scientific, from which readers can also take robust messages.
What makes a good reviewer? Dr. Kim believes that in the peer review process, reviewers should have a critical point of view in terms of the study’s hypothesis, statistics and flow. The hypothesis should be inferred by a detailed review of previous studies and clinical questions. The study design, methods of collecting data (inclusion/exclusion criteria), and the way of proving their hypothesis by statistics should be verified. Each study has its own limitations and they should also be discussed in detail. Last but not least, the originality of a study should be guaranteed.
Speaking of the importance of following reporting guidelines, Dr. Kim says, “It would be important to make the article structured, but on the other hand, it might not be necessary to follow those guidelines entirely. Guideline is just a way to make the article better. Don’t make the tail wagging the dog. However, authors should bear in mind those guidelines to make their article more scientific, especially during preparation and design of their article.
“Reviewers can make mistakes too – Don’t be afraid. It is natural to have questions during review. It is not an exam. Just ask the authors what you are not certain about,” says Dr. Kim.
Dr. Amos Lal is a Critical Care Medicine Chief Fellow at the Mayo Clinic, Rochester Minnesota, USA. His major clinical and research interests include Sepsis management, COVID-19 and outcomes, use of artificial intelligence in Critical Care. Dr. Lal’s research focuses on clinical research related to improvement of quality of care for the critically ill. Dr. Lal has published over 120 manuscripts in high impact peer reviewed journals internationally and has given presentations on his work at multiple international meetings and academic conferences. His diverse publication portfolio includes work in pulmonary diseases, infectious diseases, internal medicine and critical care/intensive care medicine.
His other areas of interest include improvement in healthcare delivery in the underserved areas internationally by providing clinical care and teaching in developing countries such as Cambodia, Haiti and Serbia. Dr. Lal is an invited Fellow of the American College of Physicians, member Society of Critical Care Medicine and American College of Chest Physicians. He is involved closely with Society of Critical Care Medicine in-training steering committee. For more information about Dr. Lal, please visit his ResearchGate page or Google Scholar page.
To Dr. Lal, objective peer review is the backbone to maintain and develop high quality evidence in medicine. Timely return of objective comments not only improves the quality of the manuscript under consideration but also is helpful for the editorial office. He adds, “I often feel that the current peer review process lacks the “certainty” of having your manuscript reviewed by the expert (peer) whose work has been relevant to your own work. Way forward to overcome this issue would be to generate of pool of peer reviewers from each specialty and developing some machine learning algorithms that can provide the best match in terms of compatibility and qualification to assess the scientific literature.”
Speaking of what motivates him to peer review, Dr. Lal says, “Simple answer – To improve the quality of care for patients. I think involvement in good quality research makes a better physician.”
Lastly, Dr. Lal stresses the importance for retrospective studies to apply for institutional review board (IRB) approval. He explains that it is of prime importance that the research is conducted in the most ethical manner without jeopardizing the safety and confidentiality of our patients and patient data. IRB and Ethics approval forms the cornerstone for this.
Dr. Adrià Arboix is Associate Professor of Neurology at the University of Barcelona (Catalonia, Spain) and Senior Consultant in the Department of Neurology at the Hospital Universitari del Sagrat Cor of Barcelona. He is the former President of the Catalan Society of Neurology. His areas of interest include cerebrovascular diseases, lacunar strokes, acute stroke, and vascular cognitive impairment.
In Dr. Arboix’s opinion, peer review is crucial to the advancement of science in the community. A solid peer review is fundamental to guarantee truthful and quality information for all, scientists and non-scientists alike. In this sense, it is well known that papers that have been approved for publication after passing the peer review methodology are better and of higher quality.
There are several points that Dr. Arboix thinks reviewers should bear in mind while reviewing papers: Firstly, reviewers must verify that the work is methodologically adequate, i.e. replicable and verifiable by others; secondly, that it constitutes a significant or novel contribution to the subject under analysis; and finally, that it provides scientific usefulness.
To Dr. Arboix, it is important for authors to complete Conflict of Interest (COI) Forms recommended by ICMJE. COIs represent circumstances in which professional judgments regarding the results of a research may be at risk of being unduly influenced by a secondary interest - financial or non-financial, and the resulting bias may be conscious or unconscious. The presence of COIs poses a problem for the confidence in the research. Therefore, he firmly believes that it is important for authors to declare any competing COI.
“Reviewing articles has a double benefit: On the one hand, the scientific and academic benefit, since it stimulates you to keep up to date on the subject in which you are an expert. On the other hand, it allows you to contribute to improve, from a personal perspective based on your own experience, those papers that you review,” says Dr. Arboix.
Cynthia H. McCollough
Dr. Cynthia H. McCollough, PhD, is a recognized leader in the development and evaluation of new CT technology and dose reduction methods. She currently serves as the Brooks-Hollern Professor at the Mayo Clinic in Rochester, Minnesota, USA, where she holds the rank of Professor in both Radiological Physics and Biomedical Engineering.
Dr. McCollough’s research revolves around the technology of CT imaging and its many clinical applications. As founder and director of Mayo’s CT Clinical Innovation Center, she leads a multidisciplinary team of physicians, scientists, and trainees to develop and translate into clinical practice new CT technologies and clinical applications. Dr. McCollough has contributed extensively to the fields of cardiac, dual-energy, and photon-counting-detector CT, and quantifies the impact of new CT technologies on diagnostic performance using reader observer performance and model observer approaches. She has contributed extensively to the measurement, management, and reduction of CT radiation dose and to the education of health care personnel and the public on this topic. For more information about Dr. McCollough’s work, please visit her page here or Twitter @cic_ct.
To Dr. McCollough, peer review is an essential step in ensuring that the scientific literature is of the highest quality possible. It’s not a perfect system (nothing is), but it is an impressive one. Countless hours are donated to the scientific community by volunteer reviewers, who are often reading manuscripts during their personal time. The societal benefit derived from science demands that the highest quality knowledge be shared in an objective and reproducible manner. Only by sharing trustworthy findings can scientists collectively piece together the answers to extremely complex questions and problems. Conversely, society pays a high price when inaccurate, misleading, or fabricated data are published; the impact of the fraudulent publications suggesting a link between autism and vaccinations is still felt today in the widespread mistrust of vaccinations. Peer review is intended not only to weed out poor quality science, but to enforce a high standard of rigor that ensures that a study’s conclusions are merited considering the presented methods and results.
In Dr. McCollough’s opinion, strong reviewers provide constructive critiques. It is much simpler (and faster) to enumerate weaknesses in a study than it is to suggest tangible ways to make the study better. They also take the time to read the paper carefully and check related references. Something can sound completely reasonable at first read but, if the reviewer probes a little deeper, errors in logic or inconsistencies with other statements or data in the manuscript can be identified. Clear, concise, and relevant writing is of course necessary for publication, but it is not sufficient. Reviewers must be careful not to allow an elegant presentation of the study to mask weaknesses in study design or execution. The reviewer must critically examine the experimental design, data collection, and data analysis methods and ask whether they are sufficient to answer the specific question under study and support the study conclusions.
Dr. McCollough further shares with us an interesting story during her review work, “On rare occasion, I have offered (via the editor) to unblind my identity in order to directly discuss a paper with the author. I have done this only when I found considerable strength in the science but recognized that the author needed specific guidance to make the work publishable (I will not accept authorship for such guidance). These experiences have been personally rewarding since I am not only helping good science to be published for that specific paper, but hopefully helping the author to publish more good science in the future.”
Lastly, from the reviewer’s perspective, Dr. McCollough stresses the importance for authors to disclose Conflict of Interest (COI) in their work. Potential COIs do not necessarily disqualify publication, but need to be disclosed and, when necessary, managed. Important work may be later discredited if a potential COI existed that was not disclosed in advance.
Dr. Pi-Shan Sung serves in the Department of Neurology at National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Her areas of interest include neurodegenerative disease, Alzheimer’s disease, vascular cognitive impairment, stroke, and cerebrovascular disease. Dr. Sung has her expertise and passion in the research of stroke and dementia, including the acute stroke treatment, the relationship between Alzheimer’s disease and stroke, and vascular dementia. Her daily work focuses mostly on clinical and basic research. She also has experimental work on the relationship between inflammation, neurogenesis and cognitive impairment.
In Dr. Sung’s opinion, peer review is very important for scientific research. Good and strong peer review ensures the high-quality scientific publications. Peer review and revision enables interaction between professional opinions from reviewers and authors. These opinions from different viewpoints may raise the quality and completeness of the prepared manuscripts and finally reaches better consensus for publication.
According to Dr. Sung, there are certain things that reviewers have to bear in mind while reviewing papers. Reviewers must ensure their suggestions are practical, unbiased, and constructive. Even for unacceptable manuscript, the authors try to deliver their special viewpoints and potential useful information regarding a specific issue. A constructive suggestion and practical ideas may help in refining their manuscript to provide better chance for future acceptance.
As a reviewer, Dr. Sung urges authors to follow reporting guidelines while performing their study and organizing scientific work for publications. Conflict of Interest (COI) is especially important for authors to disclose, as any potential COI may directly influence the study design or study results of a research.
“Physicians or researchers are always busy and the schedules may be occupied by lots of clinical or daily works. Review work is usually an extra task. However, through the review process, we may continuously train ourselves in reading, thinking and organizing scientific data,” says Dr. Sung.
Dr. Darshan Gandhi is Assistant Professor of Radiology at the UT Regional One Physician, Memphis, TN. He has completed his MBBS degree from the prestigious Smt. N.H.L. Municipal Medical College, Ahmedabad, GJ, India. He also did Radiology residency at P. D. Hinduja National Hospital & Medical Research Center, Mumbai, India and did radiology residency again in the United States to be an American Board Certified Radiologist from St. Vincent’s Medical Center, Bridgeport, CT, USA. He then moved to Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago for MR Predominant Body and Musculoskeletal Imaging Fellowship in 2020. His main interests are in body, specifically focusing on liver, pancreas and pelvic imaging and evaluating the different pathologies using FDG-PET, CT and MRI. Please check out Dr. Gandhi’s profile here.
Consistency, fairness, openness about the ideas of different reviewers – these are the few key terms for a healthy peer review system, according to Dr. Gandhi. There might be cases when one reviewer is rejecting a manuscript while another one is accepting with revisions. In these situations, Dr. Gandhi believes that it is the editor’s job to look over the points of views from different reviewers and give a rational and unbiased decision on the basis of his or her own knowledge and expertise.
To Dr. Gandhi, a good reviewer should comply to the following rules: First of all, one should be able to decline the review if there is a time constraint or manuscript subject is not of interest or knowledge. Secondly, once accepted to review, one should finish the review in timely fashion. Thirdly, one should give fair and unbiased review. And lastly, one should also be able to gauge that the manuscript would fit the journal or not.
Speaking of research data sharing, Dr. Gandhi thinks that it should be the authors’ own choice to decide if they would like to share. However, if the article is open access, there are better chances that people will read and gain knowledge from it.
“Peer reviewing keeps me motivated to learn about new and upcoming articles. While keeping up with my reading skills, I can also share my opinions if I have a say in something based on my knowledge,” says Dr. Gandhi.
Dr. Wang-Xia Wang is currently an Assistant Professor in the Department of Pathology and Laboratory Medicine, and affiliated with Sanders Brown Center on Aging and Spinal Cord and Brain Injury Research Center at the University of Kentucky, in Lexington, Kentucky, USA. She is a leading expert in the field of microRNA biology in the neurodegenerative diseases and neurotrauma. Her major research interest is to understand the role of microRNAs in neurodegeneration and inflammatory response in brain, as well as using microRNAs as biomarkers for neurological disease. Recently, she begins a new project on understanding the regulatory role of microRNA subcellular distribution and trafficking in the organelles.
To Dr. Wang, peer review is an essential part of scientific and scholarly work. A constructive peer review process will ensure the sharing of high quality researches, ideas, and opinions in the research community, which is very important for advancing our knowledge.
According to Dr. Wang, a constructive review is high standard but respectful, critical but unbiased, evidence-based with transparency, allows different opinion when data support it, and provides suggestions for improvement. A constructive review should also take a responsibility of spotting ‘bad apples’ to ensure the research integrity in the scientific community. The bottom line is to treat the reviewing process as what you would want to be treated when switching roles as an author.
From a reviewer’s point of view, Dr. Wang reiterates the significance of Conflict of Interest (COI) disclosure. It is important to have public trust in our scientific and scholarly work. Financial or non-financial considerations may be perceived to compromise a researcher’s scientific conduct and judgement. Therefore, it is very important for authors to disclose any potential COI. It should also be ensured that no COI involves with editors/reviewers in the peer review process.
“I consider peer reviews as an important part of my scholarly work. As a scientist/researcher, participating in peer review process is a privilege, and is an important opportunity to share my own opinions about the research findings of others’ work. I accept the invitations for reviewing manuscripts that are within my expertise as much as I can,” says Dr. Wang.
PD Dr. Menno Pruijm is full time staff member (médecin adjoint) and head of the dialysis unit of the Service of Nephrology and Hypertension at the University Hospital of Lausanne (CHUV), Switzerland. He trained as MD in Leuven, Belgium, specialized in internal medicine in Leiden, the Netherlands and became nephrologist in Lausanne. His research focuses on the application of imaging techniques to unravel the pathophysiology and hemodynamic alterations in CKD. He is one of the main drivers of several local and national cohort studies, and has a large expertise in renal ultrasound and functional renal MRI. He is an international leader in the field of Blood oxygenation level dependent MRI (BOLD-MRI) and part of the European Union COST Action (‘PARENCHIMA’). Together with Bastien Milani, he developed a new method to analyze BOLD-MRI images. The so called TLCO method (twelve layer concentric objects) is now considered as the best way to analyze BOLD-MR images in kidneys with poor cortico-medullary differentiation, and has been disseminated to many international academic centers. He closely collaborates with PD Dr Anne Zanchi in the 'Program Cantonal Diabète' and in a cohort of locally recruited T2DM patients called SWIDINEP. His work was supported by SNF and other grants (Swiss Society of Nephrology, Swiss and European Society of Hypertension). He has trained numerous fellows in nephrology, and supervised the master thesis of six students and the PhD thesis of one physicist. He has published more than 140 peer-reviewed papers, was cited more than 2500 times and has an H-index of 30. Dr. Pruijm’s profile and work can be seen at ORCID and Scopus.
“A reviewer should be curious, passionate about his field, altruistic, and most of all possess the inner drive to bring research forward, towards better medicine and improved quality of life,” says Dr. Pruijm when he is asked about the important qualities of a reviewer. It is especially important when peer reviewing is often time-consuming and anonymous, so many researchers tend to decline an invitation to review.
The time-consuming aspect cannot be changed, but modern technology offers possibilities to make reviewer activities less unnoticed. Recent initiatives that link reviews to online platforms such as Publons are a first step towards quantification and a wider visibility of review activities. Once quantified, review activities could be integrated in a new concept, that could be called the “Review Index or R-index”. In analogy with the H-index, the R-index would represent a reviewer-level matric that measures both the number of reviews performed and the times their reviewed papers were cited. As such, a reviewer who has reviewed 20 papers that have all been cited 20 times or more has an R-index of 20. The R-index could quickly gain academic recognition, which is an easy way to quantify review activities. “Once I had written these lines. I decided to look online if someone possibly had had this idea before, and as often in research, I saw this is indeed the case. Although the authors defined the R-index slightly different, it also supports the idea towards wider recognition and quantification of review activities,” explains Dr. Pruijm.
From a reviewer’s perspective, Dr. Pruijm believes that both retrospective and prospective studies need ethical approval before they can be performed. This is an essential step in every research project in order to guarantee quality and application of ethical principles, such as doing no harm, anonymizing, and conducting research according to the rules of good clinical practice. Having this said, some ethical committees have gone too far in their administrative requirements to researchers. Instead of focusing on the content, they impose an impressive number of forms to be filled in, sometimes without clear purpose, demotivating the researchers to go forward with their projects. It thus becomes more and more difficult to combine the administrative workload of research with clinical tasks. As a clinician-researcher, Dr. Pruijm is afraid it will become impossible to combine both in the future: one will have to be either researcher, or either clinician. This would be a sad evolution, and may hamper the collaboration between both worlds.
“During review, there is the spark of excitement of being aware of new developments in a field before others. Then there is the feeling of belonging to the large world-wide research community. I have to admit, peer reviewing isn’t always exciting, and also about hard work to manage the review deadlines. I see it as part of my job as an academic physician. If no one will accept to review papers any more, science will be halted. Therefore, reviewing is an essential part to guarantee the progress of knowledge. Universities should appreciate this better, recognize review efforts, and integrate it in the task package of academics,” says Dr. Pruijm.
Dr. Romain Jouffroy, MD, PhD, is a physician in the Intensive Care Unit of Pr Antoine VIEILLARD-BARON - Ambroise Paré Hospital University Paris Saclay - Assistance Publique Hôpitaux Paris, France. His areas of research are on septic shock and out-of-hospital cardiac arrest, on which he has conducted several large randomized clinical trials. The first one entitled “SAMU SAVE SEPSIS study” compared two strategies for prehospital septic shock cared for by a mobile intensive care unit: one conventional and one aggressive based on early antibiotic therapy, hemodynamic optimization and intensive care unit admission. The other one is an ongoing randomized clinical trial entitled POTACREH study aiming to evaluate inpatients presenting with out-of-hospital cardiac arrest by ventricular fibrillation, refractory to 3 external electric shocks, and the efficacy of a direct intravenous injection of 20 mmol KCl on their survival at hospital arrival. He now joined the research groups of Centre de recherche en Epidémiologie et Santé des Populations - U1018 INSERM - Paris Saclay University and Institut de Recherche bioMédicale et d’Epidémiologie du Sport - EA7329, INSEP - Paris University, and welcome any students interested in sepsis, cardiac arrest and long-endurance running physiological and epidemiological impacts to join them with pleasure to assist in their research.
In Dr. Jouffroy’s opinion, peer review aims to take a critical look by several experts in order to detect issues in a manuscript and to help researchers to improve the quality of their manuscript on its form and background. As reviewers come from varying countries, it provides different opinions and points of view on a same theme. It also helps to detect plagiarism and/or duplicate. Ultimately, peer review is useful in helping science and research to progress.
A good reviewer, to Dr. Jouffroy, is someone who elaborates comments on the background and the form. Another essential reviewer quality is to understand the methodological and statistical analysis issues that may alter a manuscript’s key messages so as to guarantee the messages are exact. The reviewers’ objective is to improve the quality and readability of an article, not only considering adverse sides. Nevertheless, when an article is not appropriate for the journal and/or when several issues exist, reviewers do not have to hesitate to recommend rejection of the article. Reviewers should keep in mind that the editorial assistant will make a decision based on their comments.
Viewing from the angle of a reviewer, Dr. Jouffroy reckons that the institutional review board approval for retrospective studies provides an additional guarantee for the respect of publication rules. To him, ethical statement is essential for researchers to prevent cheating or publication of erroneous results. Ethical statement helps authors to show that their research and manuscript is in accordance with ethical principles reassuring the scientific community about the soundness of studies. Sharing and working together is essential to build up on previous knowledge and elaborate new research to improve people’s living quality.
“I choose to review for ATM because it is an international, peer-reviewed, open access journal featuring original and observational investigations in various fields of medicine. In this objective, ATM allows researchers to submit various medical domains, not only on a specific area,” says Dr. Jouffroy.
Dr. Sebastian Clauss is a clinician scientist working as a board certified cardiologist and principal investigator at the LMU Hospital Munich, Germany. He graduated at the Ludwig-Maximilians-University Munich (LMU) in medicine in 2009 and obtained his doctoral degree in 2010. He worked as a postdoctoral fellow in Munich (PI Stefan Kääb), Montreal (PI Stanley Nattel) and Boston (PI Patrick Ellinor) before he established an independent research group focusing on Experimental and Translational Electrophysiology at the LMU Hospital Munich. Dr. Clauss’ personal page can be accessed here.
To Dr. Clauss, peer review is necessary because only peers from the specific field of research are qualified enough to assess the quality of the scientific work. However, peer review where only the reviewers but not the authors are anonymous confers the risk for unfair assessment of a direct competitor’s work. Furthermore, the imbalance of high publication fees and unpaid reviewers is a problem potentially resulting in low quality of reviews. Therefore, it is of utmost importance that reviewers should be passionate about research, unbiased, open-minded, and supportive.
Being a reviewer, Dr. Clauss also sees the importance of standardized reporting guidelines since they allow to reproduce and validate research findings. However, only if journals appreciate and publish such work which is “not novel” and therefore considered as “not relevant enough”, standardized reporting guidelines will be broadly applied and used.
“Being part of the peer-review process helps to develop a more critical view on my own work and thus, to improve my work,” says Dr. Clauss.
Dr. Heather Stevenson-Lerner is an Associate Professor in the Department of Pathology, Division of Surgical Pathology at the University of Texas Medical Branch, USA. Her clinical focus includes liver, transplantation, and gastrointestinal pathology. She is actively involved in several grant-funded clinical research projects including studies in patients with chronic hepatitis C (HCV), non-alcoholic steatohepatitis (NASH), and hepatocellular carcinoma (HCC). Primary research interests include studying the role of the hepatic immune response, including macrophages and lymphocytes, in fibrosis and HCC development. Her laboratory has also developed a Spectral-imaging platform to characterize and quantify these populations in human formalin-fixed liver biopsy tissue. She received a University of Texas Rising STARs award, is on the executive committee for medical school admissions, and received the Best Anatomic Pathology Faculty Award from UTMB’s pathology residents and fellows for the 2016-2017 academic year. She is also a recent recipient of a career development award from the Institute for Translational Sciences' KL2 (ITS Scholars) program and recently received her first R01 award as principle investigator for the National Institutes of Health (NIDDK). You may connect with Dr. Stevenson-Lerner through her faculty page here or Twitter @DrHSLovesLiver.
The peer review process is critical to the success of the scientific publications. Dr. Stevenson-Lerner finds it an honor to have other experts in her field critically review her work and to provide feedback. She recalls that there have been several times with the thoughtful reviews of her colleagues and peers that she has substantially improved her manuscripts. Sometimes reviewers have even suggested changes or made new observations about her data that have completely changed her hypothesis or sparked her next big experiment.
There is one rule that a responsible reviewer should always keep in mind, according to Dr. Stevenson-Lerner. When one is reviewing a paper that is outside of his/her area of expertise, he/she should either review the current literature thoroughly before reviewing the manuscript or should pass the review onto someone else that will be able to provide the authors with more constructive feedback. In summary, it is important for peer reviewers to know when they are in over their heads.
As an author herself, Dr. Stevenson-Lerner highly recommends the use of reporting guidelines. She indicates that these resources can be quite useful for clinical trials, observational studies, and large meta-analyses. Even though most of the work she has done so far is more basic science and translational in nature, she plans to use some of these for improving the quality of her publications in the future, especially when she begins her first prospective clinical trial.
“There are many reasons that I find the peer review process rewarding. First, you get to learn a lot and often get the chance to read cutting edge research in your areas of interest before anyone else does. Second, contributing to science and progress is an obligation of the career path that I chose (a physician scientist at an academic medical center). Third, all of my papers have been reviewed by my peers and the comments I have received were critical in improving the quality of these publications. Reviewing other investigators’ papers is a way to give back to the scientific community. Finally, reviewing papers improves my critical thinking and scientific writing,” says Dr. Stevenson-Lerner.
Dr. Daichi Sone, MD, PhD, is a Senior Lecturer of Psychiatry at Jikei University School of Medicine, Tokyo, Japan, as well as an Honorary Research Associate at Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK. He began his clinical career as a neuropsychiatrist through basic and specialized training. From 2012, he started working at National Center of Neurology and Psychiatry, Tokyo, Japan, specializing in neuropsychiatry, epileptology, and neuroimaging. Most of his research topics focus on epilepsy imaging, although his interests are also involved in other neuropsychiatric disorders including dementia. He obtained PhD degree at Graduate School of Medicine, the University of Tokyo in 2017. In 2018, to develop the expertise in neuroimaging for epilepsy, he moved to London and launched the next career in Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology. His research projects have provided novel findings for seizure focus detection and new potential imaging biomarkers, using structural, diffusion and perfusion MRI and PET with advanced methods, such as network analysis and machine-learning. Dr. Sone is now on the following platforms: ORCID, Publons, Google Scholar, and ResearchGate.
Needless to say, the peer review system is an essential process that guarantees the quality of scientific papers. However, to Dr. Sone, peer reviewers are a limited number of researchers, and the resource of peer review system is also limited. With the current explosion in the number of journals and scientific papers, the burden on peer reviewers has become quite heavy. It may be desirable to develop a more efficient method that allows the editorial staff to review and judge the papers to some extent before peer review. Artificial intelligence and other automated methods may become useful in the future, but they are also risky and need to be introduced carefully.
While the review system has its limitations and is in need of enhancement, peer reviewers should never cease evaluating scientific papers critically and neutrally, in Dr. Sone’s opinion. Since science and academia is a kind of community, and reviewers are human, it might be difficult to be completely neutral at times – which may be another limitation of the system. Nevertheless, in order to make steady progress in science for humanity, it is essential for reviewers to evaluate papers fairly according to their own expertise.
It is without a doubt that reporting guidelines are important in nowadays academic world. To Dr. Sone, these guidelines provide a basic standard for the framework of scientific research. Many experienced researchers will be able to appropriately construct study designs by experience, and the degree to which the guidelines are strictly followed will depend on the type and significance of each study. Strict adherence tends to result in higher quality research, but it is not the only way to guarantee the quality and significance of scientific research.
“The biggest motivation for me to review is to make contributions to the science, which is also my responsibility as a member of the scientific community. As my own papers were also published after going through the peer review system, it is only natural that I would contribute back to that system. On the other hand, I sometimes find it difficult to maintain motivation when I am too busy. Recently, there have been attempts to raise the visibility of reviewers, such as Publons and recognition awards such as this Reviewer of the Month. I feel these are very encouraging and honorable,” says Dr. Sone.
Dr. Mitsuhisa Takatsuki is the Professor and Chairman of Department of Digestive and General Surgery, Graduate School of Medicine, University of the Ryukyus, Japan. He is an expert in hepatobiliary and pancreas surgery. His areas of interest include any kind of clinical HPB surgery, especially liver transplant tolerance. Previously, he introduced successful weaning of immunosuppression after pediatric living donor liver transplantation, and currently has expanded its protocol for adult cases. His most current interest is the relationship between gut microbiota and liver transplant immune reaction, and planning the original approach to induce liver transplant tolerance with simultaneous liver and gut microbiota. In clinical HPB surgery, he always tries to cure patients even with far-advanced cancers with multidisciplinary treatment including aggressive surgery. With development drugs such as immune checkpoint inhibitors, the possibility of curative resection has been gained, resulting in improvement of patient survival. Dr. Takatsuki’s profile can be accessed here: https://www.ryukyu-surg1.org/.
Seeing the rapid expansion of open journals, Dr. Takatsuki is concerned about the loss ofaccuracy to judge the quality of research and check the ethical problems including COI. To him, all we have to do is to make sure all reviewers recognize the importance and responsibility of reviewing papers and do not mislead researchers and readers. Also, we have to keep improving the review system according to the demands of the times and the society.
How to maintain the objectivity of a review has always been an important issue in scientific publishing. It has always been Dr. Takatsuki’s concern during review too. To him, it is important not to fall into self-righteousness while gaining cutting-edge knowledge by being interested in areas other than his own specialty. If necessary, he sometimes might ask a third party to confirm whether his peer review is objective or not.
On the other hand, Dr. Takatsuki highlights the significance for research to apply for institutional review board (IRB) approval. It not only ensures test transparency, but also guarantees safety and ethics. As a result, higher quality research results will be published, which will surely contribute to the future development of science. Some may argue that overly strict regulation hinders free and original research, but he believes that IRB approval finally will contribute to the development of science.
“I recognize ATM is one of the most novel and attractive journals which provides not only new, but meaningful research. I have been honored to be a reviewer of ATM,” says Dr. Takatsuki.
Susanna S. Park
Dr. Susanna Park, MD PhD, is a Professor of Ophthalmology & Vision Science and Director of the Retina Division at the University of California Davis, USA. As a practicing vitreo-retinal specialist and clinician scientist, she is interested in developing novel therapies to treat retinal disorders and in improving the understanding of retinal disorders using retinal imaging. In recent years, she has been conducting translational and clinical research exploring intravitreal administration of CD34+ cells as potential regenerative therapy for various retinal disorders. She also explored the use of novel in vivo retinal imaging tools, including OCT angiography, in evaluating retinal disorders.
Obtaining thorough and unbiased assessment of the manuscripts submitted for possible publication from leading experts in the field is the key to the peer review process, according to Dr. Park, such that the quality and integrity of the submitted work can be accessed. This, thus, often requires multiple reviewers.
During review, Dr. Park emphasizes that reviewers should bear in mind that the authors have invested a lot of time and effort in conducting the research and writing the manuscript. As such, any negative feedback should be aimed at helping the authors improve the quality of the work.
To Dr. Park, any research involving human subjects should seek approval from institutional review board (IRB). This is important to ensure that the privacy of the human subjects is protected, the subjects are adequately informed regarding the risks and benefits of the research to make a well-informed consent, and the research is carried out in a manner that does not pose excess risk to the subjects. Omission of IRB approval for human research is not acceptable for publication in peer-reviewed journals.
“I consider peer reviewing an important role as a researcher to share my expertise as a peer reviewer to ensure that any published research is of high quality. Reviewing manuscripts also provides an opportunity for me to learn about new areas of research that might bring new insights into research I am conducting. It also helps me become more critical of my own research,” says Dr. Park.
Ming Han Lincoln Liow
Dr. Lincoln Liow is a Consultant Orthopaedic Surgeon (Adult Reconstruction) in Singapore General Hospital, Singapore. He performs 300-400 operations per year and specializes in Enhanced Recovery After Surgery (ERAS) for hip and knee arthroplasty, robotic-assisted knee arthroplasty and unicompartmental knee arthroplasty. Dr. Liow is an academic arthroplasty surgeon and has published >100 peer reviewed articles. He was selected to undergo an Orthopaedic Biomechanics Research Fellowship at Massachusetts General Hospital (MGH), Harvard Medical School (HMS) in 2015. His work has been recognized at the international level, being nominated for the New Investigator Recognition Award (NIRA) during the 2016 Orthopaedic Research Society Annual Meeting, awarded the Jacques Duparc Award at the 2019 European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and Top 100 posters of American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting 2020. He serves as an editorial board member on several top-ranked Orthopaedic journals and is an invited peer reviewer for the British Medical Journal and Journal of Arthroplasty. He is currently studying the use of artificial intelligence in Orthopaedic imaging and medical device development for osteoarthritis treatment. He is constantly studying the outcomes of primary and revision knee/hip arthroplasty to provide the best care for his patients. You may follow Dr. Liow on Instagram here.
A constructive review, according to Dr. Liow, aims to enhance the paper through useful feedback to the authors. It is objective, directed at correcting the existing deficiencies of the manuscript and provides sound advice for all sections of the manuscript. Contrarily, a destructive review is one which states upfront to the Editor that the paper should not be accepted, not due to lack of scientific robustness, but rather due to reviewer’s individual biases.
Here a question arises – How do we make sure a review is constructive and objective? To Dr. Liow, first and foremost, the reviewer must not have any conflict of interest. The reviewer should have expertise in the area that he/she is reviewing and preferably conducted similar research. The review should focus on the methodology and results, and should ensure that the research is conducted ethically, reproducible and has valid results. In Dr. Liow’s own experience, he tries to provide line-by-line comments for the authors to ascertain if the authors have addressed potential blind spots which are not mentioned in their manuscript. Occasionally, language is an issue for some authors which may result in less favorable reviews. However, if the science is robust, he would help with language editing or propose suitable phrases to assist the authors to get their manuscript published.
From the perspective of a reviewer, Dr. Liow indicates that sharing of de-identified research data is a good initiative as it demonstrates credibility and accountability by the authors. This would reduce falsification of results and allow others to verify results or explore supplementary analysis using the open data. Sharing raw data would enhance transparency and authors should refrain from cherry-picking data to support manuscript results. However, the potential risks of sharing data must be considered, such as patient-related privacy protection concerns and misinterpretation of data.
“Doing peer reviews helps me to keep up-to-date with latest advances in my field. I usually allocate time on weekends to do research related work and peer review,” says Dr. Liow.
Michael D. Maile
Dr. Michael Maile is an Assistant Professor of Anesthesiology at the University of Michigan in Ann Arbor, MI, USA. His research focuses on the mechanisms and implications of organ dysfunction that occurs during acute physiologic insults such as sepsis or major surgery. Much of his past research has concentrated on the implications of cardiac dysfunction on critically ill patients and the metabolic changes that occur during times of acute stress. More recently, Dr. Maile has become interested in the mechanisms that lead to chronic pain after recovering from an acute illness. The goal of this research is to identify treatment strategies that can be implemented in the intensive care unit that will reduce post-recovery pain and help patients return more quickly to their baseline level of health. Clinically, Dr. Maile provides perioperative care to adult patients, with a focus on thoracic, vascular, and cardiac procedures. He is also passionate about education and currently serves as the director of the anesthesiology residency program’s research rotation. Finally, he is an associate director of the Michigan Center for Integrative Research in Critical Care (MCIRCC), which facilitates team science to develop new discoveries that can be used to improve the care of critically ill patients.
Never is there a system that is perfect. To Dr. Maile, the limitations of the current peer review system is that most reviews do not allow for interaction between the authors and reviewers. This produces a slow process in which it is easy for the multiple parties to miscommunicate. Finding a way for the partiers to interact in real-time may improve the process.
Dr. Maile considers an objective review to be one that evaluates the science and results without regard to preconceived notions about what the study would show. While this may lead to an increase in publications with disparate findings, it ultimately minimizes confirmation bias, which can slow scientific progress.
Speaking of frequently used reporting guidelines (e.g. PRISMA and TREND) for scientific manuscripts standardization, Dr. Maile deems that these guidelines are extremely useful and should always provide a framework on which to present the results of a study. With that being said, as guidelines, they sometimes need to be modified to optimally communicate the details of a study.
“I try to focus my reviewing efforts on manuscripts that overlap with my research interests. Since I would want to read these manuscripts, the review process is less burdensome and I can even feel privilege when reviewing a particularly innovative manuscript,” says Dr. Maile.
Yojiro Yutaka, MD, PhD is an Assistant Professor at the Department of Thoracic Surgery at Kyoto University, Japan. His areas of research include general thoracic surgery, minimally invasive surgery, biomaterial, and lung transplantation. Dr. Yutaka graduated from Kyoto University, Faculty of Medicine in 2004. He completed his surgical residency training in Kitano Hospital and Otsu Red Cross Hospital from 2004 to 2014. He proceeded to a PhD course in Kyoto University Graduate School of Medicine, and investigated the field of regenerative medicine using biomaterial, and minimally invasive surgery. He won a prize in 24th European Conference on General Thoracic Surgery in 2016. Now he works with Prof. Hiroshi Date in Kyoto University and is receiving advanced surgical trainings including lung cancer surgery requiring extended resection and transplantation. The profile of Dr. Yutaka can be accessed here.
Peer review is required to validate academic work, helps to improve and maintain the quality of published research, and increases networking possibilities within research communities. Manuscripts cannot be published in scientific journals until they have been verified by other experts in the field. In Dr. Yutaka’s opinion, reviewers offer a valuable service – They strengthen papers by checking them for mistakes, pointing out potential problems or gaps in the research, and offering suggestions for how the manuscripts can be improved.
“Never can a healthy peer review system exist without high-quality review,” says Dr. Yutaka. A constructive review has some kind of supportive feedback given to the authors to improve the weakness of the manuscript, even if it is deemed not acceptable for publication. On the contrary, a destructive review is one that does not provide any supportive advice to improve the manuscript.
Nonetheless, biases are inevitable in peer review. All peer review process can introduce biases. To enhance a healthy peer review process, Dr. Yutaka believes that we must first learn about biases in order to minimize them. He explains, “I can’t say that I have a clear method to minimize biases, but I think it is important to evaluate each manuscript in the same process.”
Disclosure of conflicts of interest (COI) is another important step to minimize biases in a research, according to Dr. Yutaka. It reveals author’s position in the research project, and under what circumstances the project was performed. All in all, COI can influence planning of a project including its methods, but usually not the subsequent outcomes.
“Peer reviewing connects me and academia. I’m very happy to read and learn the latest insights, and update my knowledge. I had a lot of good feedback from reviewers to enhance my publications in the past, and I would like to play a similar role as a reviewer,” says Dr. Yutaka.
Tomohiro Yazawa, MD, PhD, is an assistant professor at the Division of General Thoracic Surgery, Integrative Center of General Surgery; Department of General Surgical Science, Gunma University Hospital, Maebashi, Gunma, Japan. His major clinical and research interests include lung cancer, mediastinal tumor, and thoracic surgery including segmentectomy. He graduated from Gunma University and received his MD in 2012. He further graduated from Gunma University Graduate School of Medicine and received his PhD in 2015. He completed his residency at the Division of General Thoracic Surgery, Integrative Center of General Surgery; Department of General Surgical Science, Gunma University Hospital in 2015. He then worked at the National Hospital Organization Takasaki General Medical Center and the Japanese Red Cross Maebashi Hospital as a Staff Doctor. Dr. Yazawa is an active member of the Japanese Association for Chest Surgery, the Japanese Association of Thoracic Surgery, the Japan Surgical Society, the Japan Lung Cancer Society, Japanese Society of Endoscopic Surgery, and a full member of the American Society of Clinical Oncology. He is also a board certified surgeon of the Japan Surgical Society.
A good review helps and encourages the authors to pursue future research. To Dr. Yazawa, peer reviewers should show respect to researchers since they are submitting articles in which they have put much effort. He elaborates, “When we review a researcher’s work with respect, I think that the content of the review becomes constructive.”
In Dr. Yazawa’s opinion, an objective review is essential to correctly assess the researcher’s work. If the reviewers do not judge objectively, a wrong information could be adopted in clinical practice, leading to patients’ disadvantages. To prevent this from happening, it is important to give an objective review. Personally, he applies the following rules during review: 1) to be unbiased, 2) to make a constructive and practical review, and finally, 3) to decline a review if he does not have adequate knowledge of the manuscript theme.
Dr. Yazawa supports the current trend of research data sharing. If agreed by the authors, data sharing will allow other scientists to begin new research, making the scientific field go forward, and hopefully, improve people’s living quality effectively.
“The workload of being a scientist and doctor could be heavy. Thus, I make use of the time between one work and another, especially in the morning or evening to do peer review. Peer review is an important part of my work as a surgeon,” says Dr. Yazawa.
Masayuki Nakao, MD, PhD, is an attending surgeon at the Department of Thoracic Surgical Oncology in the Cancer Institute Hospital, Tokyo, Japan. His research is related to lung cancer, thoracoscopic surgery and preoperative 3D-CTsimulation.
Peer review is an essential step to evaluate papers in a scientific and objective manner. To Dr. Nakao, in order to properly evaluate research content, researchers who are familiar with the content are appropriate. As a result, it is expected that the scientific credibility and academic value of papers will be enhanced.
Dr. Nakao further explains that a reviewer should be prepared to make an objective evaluation, have some knowledge of the content, and above all, make an effort to suggest ways to improve the research. In other words, a reviewer should also keep in mind to look for valuable and meaningful points, not just inadequate or inaccurate ones.
It goes without saying that the process of institutional review board (IRB) approval is necessary to ensure the ethics and validity of the research. Nevertheless, Dr. Nakao is concerned that the process has become too complicated and difficult in recent years, and that it hinders the progress of clinical research in certain respects. It is controversial about the overly strict criteria of IRB approval, especially for non-interventional, retrospective clinical research.
“Peer reviewing is fascinating that it expands the knowledge and develops insights for both authors and reviewers,” says Dr. Nakao.
Raúl J. Gazmuri
Dr. Raúl J. Gazmuri is Professor in the Department of Clinical Sciences and in the Discipline of Physiology & Biophysics at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA. He is also Director of the Resuscitation Institute at the same University where he leads basic and translational research in resuscitation from cardiac arrest and other life-threatening events with special focus on mechanisms at the molecular level working in small and large animal models. He is also Section Chief of Critical Care Medicine and ICU Director at the Captain James A. Lovell Federal Health Care Center. He has served in several subcommittees of the American Heart Association (AHA) Emergency Cardiovascular Care Committee and as member of the International Liaison Committee on Resuscitation. He is currently member of the organizing committee of the AHA Resuscitation Science Symposium and has contributed to the field of Resuscitation and Critical Care Medicine with more than 200 publications. You may find out more research work of Dr. Gazmuri through PubMed.
A healthy peer review system, according to Dr. Gazmuri should contain the following elements: unbiased participation by experienced reviewers with adequate knowledge in the topic being reviewed, having capability to assess the fundamentals of the manuscript, the soundness of the statistical methodology, and the clarity of the communication for the intended audience.
To Dr. Gazmuri, however, the existing peer review system may lack qualified reviewers with time availability for the peer-review process. He would suggest: 1) ensure a robust internal editorial triage limiting the number of manuscripts sent for external peer-review to those with a reasonable chance of being accepted, 2) consider editorial acceptance without peer-review in selected high-quality and flawless manuscripts, and 3) consider a targeted peer-reviewed process by which reviewers are asked to limit their review to selected aspect of the manuscript.
Disclosing Conflict of Interest (COI) has an indispensable role in both writing and reviewing a manuscript. In Dr. Gazmuri’s opinion, there are many different types of COI, some evident and some not so much. The importance for the audience is to be disclosed and for the reviewer to be honest and conduct a fair review independently of whether a COI exists.
“Even though peer reviewing is often anonymous, I am motivated by the recognition of the value of manuscripts been reviewed by peers and appreciation of the process by being at the receiving end, interest in learning new aspects of the science being presented and ensuring the scientific validity of the findings,” says Dr. Gazmuri.
Dr. Jitka Ismail Virag is the Associate Professor of Physiology, Brody School of Medicine, East Carolina University, USA. EphrinA1 is a proangiogenic, plasma membrane-anchored receptor tyrosine kinase ligand for EphA receptors. Dr. Virag’s team has discovered that cardiomyocytes express ephrinA1 and an injection of chimeric ephrinA1-Fc into the border zone at the time of LAD occlusion reduces the size of the damaged area and preserves cardiac function independent of alterations in perfusion. Using acute and chronic mouse and rabbit models of MI, they examine cardiac response to injury and treatment using echocardiography, histology, immunohistochemistry, MALDI-IMS, proteomic analyses, and RT-PCR. They also perform cell culture using iPSC-derived cardiomyocytes to resolve mechanistic questions. Understanding how ephrinA1/EphA bidirectional signaling operates during ischemia, reperfusion, and subsequently modulates tissue remodeling and fibrosis could profoundly change traditional treatment strategies and prevention paradigms, thereby avoiding excessive injury, improving repair, and reducing or even reversing the unremitting progression of deleterious remodeling that results in organ failure, morbidity, and mortality. You may learn more about Dr. Virag through the following platforms: LinkedIn, Twitter, ResearchGate.
Assessing the purpose, results, interpretation, quality and impact of a scientific study can be challenging. Having multiple investigators with various backgrounds and expertise validates these aspects of a manuscript and enhances the communication of the findings to the scientific community. This is the major role Dr. Virag believes peer review plays in science.
Since biases are inevitable in peer review, a question is often asked by the scientific community – how is it possible to minimize any potential biases? To Dr. Virag, one should try not to look at the authors or institution of origin before evaluating the manuscript. The double-blind review approach is thus encouraged.
From the perspective of a reviewer, Dr. Virag supports the idea of authors sharing and publishing raw research data along with their papers. There is no journal of negative results and there is certainly a considerable amount of data from pilot experiments in every lab that never see the light of day so having access to the large amounts of raw data that are collected using such mining techniques that produce extensive data sets could help to streamline hypothesis generation and approaches.
“Valuable insights are gained by evaluating the approaches and presentation styles of others who use similar techniques or study related fields. It helps to hone critiquing skills in a manner conducive to improving my own strategies and communication to improve the quality of science,” says Dr. Virag.
Dr. Takashi Matsushima, MD, PhD, is currently serving at the Department of Obstetrics and Gynecology, Nippon Medical School Musashi Kosugi Hospital, Japan. His research areas include adenomyosis, endometriosis, hysteroscopy and gynecological laparoscopy. Recently, he is working on exploring mechanism of heavy menstrual bleeding of unknown cause, conservative treatment for each subtype of adenomyosis, and standardization of treatment choices for retained products of conception. Dr. Matsushima’s profile can be accessed here.
Speaking of a healthy peer review system, Dr. Matsushima reckons that it is an absolute requirement that the reviewers have sufficient knowledge of the central topic of the dissertation and that their opinion is not biased. In addition, some knowledge of research methods (including statistical knowledge) is required. It is also an absolute condition that there is no conflict of interest in the publication of the paper.
In Dr. Matsushima’s opinion, the reviewer’s sufficient knowledge of the subject is often overly biased towards established opinion-based thinking. In view of this, reviewers should have a broad perspective and flexibility to embrace new facts. Reviewers should also try to point out accurately what is missing and what should be corrected in the paper, ultimately making the paper a better one.
To Dr. Matsushima, it is essential for original studies to apply for institutional review board approval, because it is possible to prevent mistakes in the research method by confirming that the author and the co-author have the same viewpoint on the research content and confirming the research content from a third party. Even if the author himself/herself thinks that there is no problem with the research content, it is often encountered that the problem is discovered by a third party. If this process is omitted, it is quite possible that research problems that are not visible to researchers will be overlooked.
“Losing anonymity and being profitable often unknowingly undermines the reviewer’s fair perspective. The protagonists of the paper are the research contents and the authors, and the reviewers are in a position to support them. This is because both the author and the reviewer are researchers, and they can be in opposite positions,” says Dr. Matsushima.
Dr. Natalia Reglero-Real currently works as a senior postdoctoral fellow at the William Harvey Research Institute at Queen Mary University of London, UK. After obtaining her degree in Pharmacy from the Complutense University of Madrid, she completed a PhD in Biomedicine and Molecular Biology at the Autonomous University of Madrid. Here, she studied the role of apicobasal polarity in hepatocyte-leukocyte interactions during liver inflammation. She then moved to London, where her current research focuses in investigating the molecular mechanisms that regulate immune cell interactions with venular wall components during inflammation in vivo, in particular through the use of high-resolution and real-time confocal intravital microscopy techniques to image the dynamics and behavior of immune responses in living tissues. The specific line of research she manages aims to decipher the role of the intracellular catabolic recycling system, autophagy, in regulating neutrophil migration across blood vessel walls during inflammation. You may follow Dr. Reglero-Real on Twitter @NatReglero.
To Dr. Reglero-Real, a constructive review always leads to improving the quality of the submitted work, regardless of whether the final decision is acceptance or rejection of the manuscript. In order for reviewers to constructively review a manuscript, they must ensure their suggestions are practical, unbiased and provide potential useful information and insightful comments to raise the quality of the manuscript at different levels, from suggesting new experiments, data collection and interpretation to comprehensive communication and discussion of the results presented. Even for manuscripts that are rejected, constructive suggestions may help in refining the manuscript to provide better chances for future acceptance. Furthermore, authors put a lot of effort into writing a manuscript, and rejections are often hard to deal with. She believes a constructive and positive spin on reviewers’ comments not only helps the science become sounder but also motivates researchers to generate better quality manuscripts, clearer and more concise.
One of the main limitations we face during peer review are the biases towards the topic of the manuscript and/or the authors. Dr. Reglero-Real thinks a good approach to avoid the latter will be to handle all the materials provided to reviewers in a blinded fashion, so authors’ names and affiliations are not displayed. In addition, she thinks scientists should assess thoroughly every aspect of a manuscript and not only focus on the aspect that is closest to their area of research. As such, an overall vision of the work might help the reviewer identify potential strengths or weaknesses they might have missed if reading the manuscript in a biased manner. Finally, although the editor plays a key role in reducing or eliminating potential reviewer biases to guarantee fairness in the reviewing process, Dr. Reglero-Real believes direct communication between reviewers and authors could help, at least sometimes, to reduce biases.
“It is incredibly hard to allocate time to peer review given the workload and continuous deadlines scientists have to deal with. I actually find this aspect a bit disappointing, given how rewarding and enjoyable I find the peer review process to be. For this reason, I accept reviewing manuscripts only when I am sure I will be able to dedicate enough time to carefully assess the work. On the other hand, I find editors to be quite comprehensive when reviewers need deadline extensions to finish assessing a manuscript. I think the latter is key to assure an adequate and thorough revision process and the possibility of providing helpful and constructive advice to the authors,” says Dr. Reglero-Real.