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  IN THIS Article
 ::  What is peer review?
 ::  How did it begin?
 ::  Who qualifies to...
 ::  What are the typ...
 ::  What are the adv...
 ::  What are the dis...
 ::  How are peer rev...
 ::  How do i become ...
 ::  What qualities s...
 ::  Do referees need...
 ::  What would i gai...
 ::  What are the res...
 ::  What are the aut...
 ::  Can editors over...
 ::  What can authors...
 ::  What is the futu...
 ::  In conclusion
 ::  References

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Year : 2001  |  Volume : 47  |  Issue : 3  |  Page : 210-4

Peer review -- process, perspectives and the path ahead.

Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry - 605 006, India. , India

Correspondence Address:
B Gitanjali
Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry - 605 006, India.
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Source of Support: None, Conflict of Interest: None

PMID: 11832629

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Keywords: Peer Review, Research, methods,standards,trends,Periodicals,

How to cite this article:
Gitanjali B. Peer review -- process, perspectives and the path ahead. J Postgrad Med 2001;47:210

How to cite this URL:
Gitanjali B. Peer review -- process, perspectives and the path ahead. J Postgrad Med [serial online] 2001 [cited 2023 Sep 25];47:210. Available from:

The publication process of a scientific article in a journal is a demanding and often lengthy process. Authors, reviewers and editors play a vital role in the transmission of scientific communication and therefore have to follow certain rules and shoulder some responsibilities. All editors depend substantially on the judgment and critical input of scientists who are working in a particular field to give guidance and help in choosing manuscripts that are of good quality. These “peers” or “reviewers” or “scientific referees” are not paid for this work and give their time freely for the enrichment and promotion of science. For many decades, the peer review system has come to be identified with biomedical publication and has become the hallmark of scholarly communication.[1] It is a system which is constantly evolving, as evidenced by the numerous changes being ushered in by some of the more progressive journals. In this review, some frequently asked questions on the peer review process, its strengths and fallacies are addressed.

  ::   What is peer review? Top

Peer review has been defined as “a negotiation between the author and journal about the scope of knowledge claims that will ultimately appear in print”[2] and as an “evaluation by experts of the quality and pertinence of research or research proposals of other experts in the same field”.[3] It is the assessment by experts of material submitted for publication[4] and is a critical component of the publication process in all major medical journals as it serves to validate the quality of the biomedical literature published in them. This should not be confused with the review process associated with awarding research grants, though some of the processes are similar to both.

  ::   How did it begin? Top

Nothing much is known about the beginnings of the peer review system, though it is thought that what started as an informal “opinion seeking” within colleagues by a few editors soon grew to a more formalized procedure. It may have started in the mid seventeenth century but became widespread after the Second World War.[5] Many reasons are attributed to the formal incorporation of this system into the publication process. With important advances in laboratory sciences and technology, the number of manuscripts being submitted to journals increased and editors may have wanted some help to decide which articles to choose for publication. Also, many of the editors were not specialists (at that time) and with increasing specialization in medicine and allied sciences they may have needed critical input from specialists in various fields.[5],[6] At present, biomedical journals need to have a peer review system if they want to be indexed by abstracting services such as Index Medicus.

  ::   Who qualifies to be a peer? Top

A “peer” is defined as “one that is of equal standing with another”.[3] A peer reviewer may be considered a consultant to the editor, a content expert, and an “arbiter for quality research”.[3] Since peer review is seen as being essential to the process of maintaining standards of science and scholarship,[7] anyone who is scientifically qualified, has a research background (has published original work as papers), is willing to set aside some time to review manuscripts and give comments to improve the quality of the submitted manuscripts and to spend (sometimes) for postage, faxing etc., will qualify to be a peer reviewer. A study in U.S.A. concluded that the best peer reviewers were young, from prestigious academic institutions, well known to the editors and blinded to the identity of the authors.[8] They were also quick to respond, and were junior faculty who were themselves publishing many articles.[7] A study by Das Sinha et al.,[9] which was done in India, concluded that the quality of reviewing was better by non-Indians. It was also seen that those with training in epidemiology and statistics made better referees.[10] There was a negative but statistically non-significant association between academic rank and review quality,[8] probably because senior academicians did not give enough time for review, refereed articles for many journals and also did a large amount of administrative work.

  ::   What are the types of peer review systems? Top

There are basically two types. In the first, the referees and authors are blinded to each other’s identity. Confidentiality serves to protect the authors from others stealing their ideas and discoveries, while the referees are safe from retribution.[11] This is not a very foolproof method since it is easy for referees to discover the names of the authors. In the second, the authors’ names are revealed to the referee but not vice-versa. Another more recent version of this process is the open method, wherein both authors and referees know the identity of each other. It has been said that this method is better than the other two since it promotes accountability, encourages civility, and generally improves the quality of the paper.[12] Some journals request authors to suggest names of referees though there is no agreement that the manuscript should necessarily be sent to them.

  ::   What are the advantages of this system? Top

“All peer review can reasonably do is detect major defects of originality and scientific credibility, together with commenting on important omissions, the rigor of the arguments and defects in writing style”.[13]

* The most obvious advantage is that it improves the quality of the articles published by journals,[2],[14] even though there is not much proof to support this claim. Editors and reviewers are usually in agreement over which articles to reject but do not agree to a great extent on what to accept.[15] It has been said, “editors separate the wheat from the chaff and then publish the chaff!”[16] Readers are exposed only to those papers which are scientifically sound and are acceptable examples of quality scientific work.

* It lends respectability and scientific credibility to those journals that have adopted the process.[1],[7] The peer review system protects the readers from being exposed to sub-standard work and helps them to decide on the importance and generalisability of the findings.[2]

* Duplicate and redundant publication is minimized because referees, who work in a particular field, have read the related literature and would know if the work had been published elsewhere. Hence, readers are prevented from wasting their time. Also, editors are saved the expense of publishing this type of work.

* Prevents poor quality work from being published. It has been proved that an article rejected by one indexed journal is usually rejected by other indexed journals.[17]

* It offers clinicians and scientists the opportunity to recognize, encourage, and support innovative research.

  ::   What are the disadvantages of this system? Top

Peer review has been described with unflattering adjectives such as subjective, prejudicial, crude, offensive, secretive[18] and as the “informed prejudices of old men”.[13]

* Even though peer review improved the quality of the articles and their abstracts, the readability of articles at publication remains poor.[19] However, the study that examines this hypothesis has used an instrument which measures readability by laypersons. Therefore comparing an article in a medical journal to the readability score of the editorial page of the New York Times is not congruous.

* Even if authors and reviewers are blinded to each other’s identity, the editors are not.[20] This has lead to some authors believing that editors may be acting in a high-handed fashion and arbitrarily rejecting manuscripts.[21]

* It has been criticised for its potential bias and inadequacy. It has been proven that reviewers from the United States (US) and outside the US evaluate non-US papers similarly; viewing papers submitted by US authors more favourably. US reviewers have a significant preference for US papers.[22] Novel work is usually rejected.[23],[4] Many peer reviewers find it difficult to accept new ideas and hypotheses that are totally in contrast to the prevailing ideas at the time.

* It delays publication[23] by increasing the amount of time spent in review.

* It cannot detect conflict of interest by the authors.[24]

* It is expensive.[23]

* Even though most journals practise anonymous peer review system there is no hard evidence that this is better than an open system.[12]

* It cannot determine (at all times) if the results of the study are presented honestly and without fraud[13] and whether the data were fabricated or embellished.

* Cannot ensure detection of duplicate publications always.

  ::   How are peer reviewers chosen? Top

Generally editors choose peer reviewers after reading some paper(s) published by the reviewer under consideration. The editor then writes a letter to the reviewer seeking his willingness to be a referee. Members of the editorial board too often suggest names of prospective referees to editors. Some journals send open invitations to scientific referees often observing and assessing their performance closely for some time. Referee lists are updated from time to time deleting peers who are found to be inadequate.

  ::   How do i become a peer reviewer? Top

Publish quality articles in your field in indexed journals and you will be definitely selected by editors. If you are a member of the National Body of some speciality, try and present your papers at their conferences. Editors are almost certain to be present and if your work is impressive they will approach you. There is also nothing wrong with sending your curriculum vitae to the editor of the journal you want to be a scientific referee for.

  ::   What qualities should a peer reviewer have? Top

A peer reviewer should be unbiased in assessment, be open to innovative methods of experimentation, should be able to improve the manuscript so as to make it more readable. A sound scientific background including a good understanding of research methodology, a critical mind and keeping up to date with current advances in the field of interest are also attributes essential to a reviewer.[1] Above all, it is imperative that a reviewer should have a good knowledge of his own speciality.[3] It is also necessary for him/her to have adequate time to devote to this work and have a genuine interest in promoting good science. A good flair for language and grammar is an additional bonus.

  ::   Do referees need to undergo any special training? Top

No special training is required to become a scientific referee, though this has been cited as a lacuna of our postgraduate training. In fact, there is some evidence to suggest that training sessions have no impact on quality of peer reviews.[25] It is vital that one should have a thorough knowledge of research methodology and of the subject in which one is a referee.

  ::   What would i gain by becoming a peer reviewer? Top

There is no monetary or professional gain by being a peer reviewer since this service is not often acknowledged. Most however, “consider peer reviewing an honour, a privilege, and a duty, similar to a civic responsibility. As members of the medical community, they have the duty to pursue truth in research and to ensure that what is published is most accurate and of highest quality.”[3] One could also use refereeing to improve their literature-evaluation skills and critical-thinking skills and it will certainly help in planning and conducting better studies of one’s own.

  ::   What are the responsibilities of a peer reviewer? Top

* The most important issue is one of confidentiality. Reviewers often tend to talk to their colleagues of papers sent to them for reviewing sometimes even showing them the manuscript. This is a breach of confidentiality. If reviewers want to discuss a manuscript with a colleague they should obtain the editor’s permission to do so.

* Delaying a manuscript without a valid reason is unethical. If a reviewer receives a manuscript at an inconvenient time (while on holiday, during annual exams etc.) the manuscripts should be returned if he/she feels that it cannot be reviewed properly within the allotted time frame. Since peer reviewers may be working on similar areas of research, unduly delaying the manuscript until a similar paper is published by the reviewers’ own team has been documented in the past. Studies have shown that a reviewer, on an average spends 2-3 hours on a paper.[10]

* Plagiarism of ideas has been a major bugbear of authors, though this is more common with grant approvals. Stealing an idea yet to be published and using it to write a paper of one’s own is unethical.

* Rejecting articles due to previous enmity, country bias, institutional bias – in favour of well-established institutions and against smaller, lesser-known institutions have been reported. If a referee feels that there is a conflict of interest and he/she cannot honestly evaluate a manuscript then one should have the honesty to withdraw from evaluating the manuscript.

* Referees should have the humility to refuse to scrutinize manuscripts that are outside their area of expertise.

* Use courteous language; never correspond directly with an author (if you know the identity), address all comments to the editor. Peer reviewers can only recommend acceptance or rejection of an article. The final decision rests with the editor. Some journals expect reviewers to only assess the paper and not recommend acceptance or rejection.

* Spend adequate time with the paper and give it a whole-hearted effort. Do not pass it on to your students under the guise of training them.

* If you suspect fraud, scientific misconduct or plagiarism, bring it to the notice of the editor along with evidence where applicable. Not doing so on the basis of “well-respected person,” “from reputable college,” “one of my former teachers” etc., is unethical.

  ::   What are the authors’ responsibilities towards the comments made by a peer reviewer? Top

* Read the comments carefully and carry out all the corrections pointed out. If any of the corrections are not carried out give reasons. Do not try to hide/gloss over mistakes.

* If you do not agree with a referee’s comments say so politely, stating reasons for rejecting the suggestions. Never lie to the editor that you have carried out the changes when actually you have not done so.

* Correspond only with the editor.

* Do not abuse or threaten a referee/editor who has rejected your paper; one day you may be in his shoes.

  ::   Can editors overrule referee’s evaluations? Top

Yes, they can but seldom do so. They may overrule a referee’s decision if they feel that the manuscript has not received the attention it should have, in which case they may refer it to another referee, or they may ask for the opinion of the local editorial board and reach a decision.

  ::   What can authors do if they do not agree with an editor’s decision? Top

Authors whose manuscripts are rejected by referees can reply back to the editor stating their case. Some journals have an “ombudsperson” who is a neutral figure and can be contacted in case of disputes.[26] The ruling of the ombudsperson is binding on the journal as well as the authors.

  ::   What is the future of the peer review system? Top

I do not foresee any major change in this system. However, anonymous review may lead the way to an open system wherein anyone can give their comments on a manuscript which is to be published and the authors and editors can decide on what changes to incorporate in a manuscript. A limited version of this had been tried previously[27] which has now metamorphosed into a system wherein all manuscripts submitted to the Australian Medical Journal are now processed online. Other journals such as the British Medical Journal have yet to implement this system completely. Since the Internet will be the platform on which this open review will be done, this has the advantage of many scientists having access to manuscripts and quality may improve further. Unnecessary time delay will also be minimised and authors can claim proper Acknowledgment of their work. However, doing away with peer review altogether may not be possible because of the far-reaching impact of scientific papers published as a part of biomedical research. If authors are allowed to directly correspond with readers, an uncritical or less than adequately knowledgeable reader may not be able to distinguish the chaff from the wheat with potentially grave consequences.

  ::   In conclusion Top

The existence of editorially independent peer-reviewed medical journals in which physicians, patients and the public can place their trust is one of the principal strengths of modern scientific medicine.[28] Readers believe that what these journals publish will be as scientifically correct as possible at that point of time. However, as Bailar and Patterson[29] succinctly described many years ago, peer review at its best can screen out investigations that are poorly conceived, poorly designed, poorly executed, trivial, marginal, or uninterpretable; it improves the quality of individual manuscripts, steers research results to appropriate journals, and helps people who are not experts to decide what to believe. The peer review system is not totally unscientific, arbitrary, or subjective, as some have proposed[18] or else would not have stood the test of time.

 :: References Top

1. Polak JF. The role of the manuscript reviewer in the peer review process. AJR Am J Roentgenol 1995; 165:685-688.  Back to cited text no. 1    
2.Goodman SN, Berlin J, Fletcher SW, Fletcher RH. Manuscript quality before and after peer review and editing at Annals of Internal Medicine. Ann Intern Med 1994; 121:11-21.  Back to cited text no. 2    
3.Sylvia LM, Herbel JL. Manuscript Peer Review - A Guide for Health Care Professionals. Pharmacotherapy 2001; 21:395-404.  Back to cited text no. 3    
4.Olson CM. Peer review of the biomedical literature. Am J Emerg Med 1990; 8:356-358.   Back to cited text no. 4    
5.Burnham JC. The evolution of editorial peer review. JAMA 1990; 9:263:1323-1329.   Back to cited text no. 5    
6.Kronick DA. Peer review in 18th-century scientific journalism. JAMA 1990; 263:1321-1322.   Back to cited text no. 6    
7.Lock S, Smith J. What do peer reviewers do? JAMA 1990; 263:1341-1343.  Back to cited text no. 7    
8.Evans AT, McNutt RA, Fletcher SW, Fletcher RH. The characteristics of peer reviewers who produce good-quality reviews. J Gen Intern Med 1993; 8:422-428.  Back to cited text no. 8    
9.Das Sinha S, Sahni P, Nundy S. Does exchanging comments of Indian and non - Indian reviewers improve the quality of manuscript reviews? Natl Med J India 1999; 12:210-213.  Back to cited text no. 9    
10.Black N, Rooyen SV, Goglee F, Smith R, Evans S. What Makes a Good Reviewer and a Good Review for a General Medical Journal? JAMA 1998; 280:231-233.   Back to cited text no. 10    
11.Pitkin RM. Ethical and quasi-ethical issues in medical editing and publishing. Croat Med J 1998; 39:95-101.   Back to cited text no. 11    
12.Walsh E, Rooney M, Appleby L, Wilkinson G. Open peer review: a randomized controlled trial. Br J Psychiatry 2000; 176:47-51.  Back to cited text no. 12    
13.Lock S. Does editorial peer review work? Ann Intern Med 1994; 121:60-61.  Back to cited text no. 13    
14.Pierie JP, Walvoort HC, Overbeke AJ. Readers’ evaluation of effect of peer review and editing on quality of articles in the Nederlands Tijdschrift voor Geneeskunde. Lancet 1996; 348:1480-1483.  Back to cited text no. 14    
15.Howard L, Wilkinson G. Peer review and editorial decision-making. Br J Psychiatry 1998; 173:110-113.  Back to cited text no. 15    
16.Humphreys RP, Reigel DH, Epstein FJ. The editors’ labours: separating the wheat from the chaff. Pediatr Neurosurg 1995; 22:223-227.   Back to cited text no. 16    
17.Abby M, Massey MD, Galandiuk S, Polk HC Jr. Peer review is an effective screening process to evaluate medical manuscripts. JAMA 1994; 272:105-107.  Back to cited text no. 17    
18.Kassirer JP, Campion EW. Peer review. Crude and understudied, but indispensable. JAMA 1994; 272:96-97.  Back to cited text no. 18    
19.Roberts JC, Fletcher RH, Fletcher SW. Effects of peer review and editing on the readability of articles published in Annals of Internal Medicine. JAMA 1994; 13; 272:119-121.  Back to cited text no. 19    
20.Cleary JD, Alexander B. Blind versus nonblind review: survey of selected medical journals. Drug Intell Clin Pharm 1988; 22:601-602.  Back to cited text no. 20    
21.Altman DG, Chalmers I, Herxheimer A. Is there a case for an international medical scientific press council? JAMA 1994; 13; 272:166-167.   Back to cited text no. 21    
22.Link AM. US and Non-US Submissions: An Analysis of Reviewer Bias. JAMA 1998; 280:246-247.   Back to cited text no. 22    
23.Smith R. Peer review: reform or revolution. BMJ 1997; 315:759-760.  Back to cited text no. 23    
24.Horton R. The less acceptable face of bias. Lancet 2000; 356:959-960.  Back to cited text no. 24    
25.Callaham ML, Wears RL, Waeckerle JF. Effect of attendance at a training session on peer reviewer quality and performance. Ann Emerg Med 1998; 32:318-322.  Back to cited text no. 25    
26.Horton R. The Lancet’s ombudsman. Lancet 1996; 348:6.   Back to cited text no. 26    
27.Bingham CM, Higgins G, Coleman R, Van Der Weyden MB. The Medical Journal of Australia Internet peer-review study. Lancet 1998; 8; 352:441-445.  Back to cited text no. 27    
28.Lundberg GD. Editorial freedom and integrity. JAMA 1988; 260:2563.  Back to cited text no. 28    
29.Bailar JC, Patterson K. Journal peer review: the need for a research agenda. N Engl J Med 1985; 312:654-657.   Back to cited text no. 29    

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