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PubMed1998

CDR review's editorial process in 1997 and the introduction of blinded peer review prepare the way for Communicable Disease and Public Health.

Openness about a journal's editorial process fosters confidence among its authors and readers. The time taken to accomplish steps in the Communicable Disease Report (CDR) Review's editorial process to be accomplished is described for papers published in 1997, and compared with similar data on papers published in 1995 and 1996. Over half of the papers published in 1997 had been submitted less than six months earlier. The introduction of blinded peer review was associated with an increase in quality of reviewers' reports. Communicable Disease and Public Health will follow the same procedures.

Bibliometrics↗
PubMed1987

Experiences with self-assessment and peer review among general practitioners in The Netherlands.

The relation between peer review and postgraduate training proved to be complex. Involvement occurred by way of three projects (PI, PII, and PIII) involving 1,200 general practitioners by directed or self-motivated assessment. The simple assumption that the discovery by audit of knowledge, skills of attitude gaps, automatically lead to appropriate training, proved to be untrue. Experience learned that auditing itself is an educational process which links up with the individual needs of the participants. More study, research and experience is needed with regard to the interrelationship between peer review and postgraduate training, but both are essential and integral elements of the striving for excellence and quality.

Educational Measurement↗
PubMed2006

Outcomes of National Institutes of Health peer review of clinical grant applications.

PURPOSE: We previously reported that National Institutes of Health (NIH) peer review outcomes in 2002 were slightly but significantly less favorable for grant applications for clinical research than for laboratory research. The present analysis was undertaken to determine if factors related to the review process might contribute to this difference. METHODS: The impact of each of the following factors on median priority scores and funding rates for clinical and nonclinical R01 grant applications was evaluated: (1) the percentage of clinical applications assigned for review to a study section, (2) the requested direct costs, and (3) the clinical research experience of the reviewers. RESULTS: Confirming our previous observation, in both 1994 and 2004, median priority scores and funding rates for R01 applications were less favorable for clinical research. In 1994, clinical applications did not fare as well in study sections reviewing relatively low percentages of clinical applications. This was not the case in 2004. Although requested direct costs were greater for clinical than for nonclinical R01 applications, median priority scores within each category were actually more favorable for applications requesting greater funding. Assignment of priority scores was not different for reviewers with or without experience conducting clinical research. CONCLUSION: These data do not support the hypothesis that the less favorable review outcomes for clinical applications are related to these review factors. We suggest that peer review outcomes for clinical research will benefit from the recent refinement of NIH review criteria, emphasizing the unique contributions of clinical investigation, and from increased training opportunities for clinical investigators.

Biomedical Research↗
PubMed1999

Can small group education and peer review improve care for patients with asthma/chronic obstructive pulmonary disease?

OBJECTIVE: To study the effectiveness of an intensive small group education and peer review programme aimed at implementing national guidelines on asthma/chronic obstructive pulmonary disease (COPD) on care provision by general practitioners (GPs) and on patient outcomes. DESIGN: A randomised experimental study with pre-measurement and post-measurement (after one year) in an experimental group and a control group in Dutch general practice. SUBJECTS AND INTERVENTION: Two groups of GPs were formed and randomised. The education and peer review group (17 GPs with 210 patients) had an intervention consisting of an interactive group education and peer review programme (four sessions each lasting two hours). The control group consisted of 17 GPs with 223 patients (no intervention). MAIN OUTCOME MEASURES: Knowledge, skills, opinion about asthma and COPD care, presence of equipment in practice; actual performance about peakflow measurement, non-pharmacological and pharmacological treatment; asthma symptoms (Dutch Medical Research Council), smoking habits, exacerbation ratio, and disease specific quality of life (QOL-RIQ). Data were collected by a written questionnaire for GPs, by self recording of consultations by GPs, and by a written self administered questionnaire for adult patients with asthma/COPD. RESULTS: Data from 34 GP questionnaires, 433 patient questionnaires, and recordings from 934 consultations/visits and 350 repeat prescriptions were available. Compared with the control group there were only significant changes for self estimated skills (+16%, 95% confidence interval 4% to 26%) and presence of peakflow meters in practice (+18%, p < 0.05). No significant changes were found for provided care and patient outcomes compared with the control group. In the subgroup of more severe patients, the group of older patients, and in the group of patients not using anti-inflammatory medication at baseline, no significant changes compared with the control group were seen in patient outcomes. CONCLUSION: Except for two aspects, intensive small group education and peer review in asthma and COPD care do not seem to be effective in changing relevant aspects of the provided care by GPs in accordance with guidelines, nor in changing patients' health status.

Adult↗
PubMed1996

Are retrospective peer-review transfusion monitoring systems effective in reducing red blood cell utilization?

OBJECTIVE: This research used a study-control group design and examined data collected from five hospitals to evaluate the effectiveness of retrospective peer-review systems on reducing utilization of red blood cells (RBCs). DESIGN: The effects of retrospective peer-review systems were studied in three parts: (1) trends of RBC utilization were compared by the slopes of linear regression lines that assessed the effect of time on RBC utilization among four study hospitals and one control hospital, (2) diagnosis-specific RBC utilization was compared between the control hospital and one matched study hospital, and (3) the effect of the retrospective review system of one study hospital was assessed by linear regression using data accumulated 1 year before and 2 years after implementation of the program. RESULTS: Three study hospitals showed no significant changes in RBC utilization during the 10-month study period. One study hospital and the control hospital demonstrated trends of reduced RBC use with negative slopes of regression lines; however, there was no difference in the degree of the two slopes, and the diagnosis-specific RBC utilization was not lower at the study hospital than at the control hospital. Furthermore, implementation of the retrospective peer-review system at one study hospital demonstrated no effect on RBC utilization. CONCLUSIONS: We conclude that the retrospective peer-review systems implemented at these four hospitals had no effect on reducing red blood cell utilization.

Erythrocyte Transfusion↗
PubMed2000

Developments in professional quality assurance towards quality improvement: some examples of peer review in the Netherlands and the United Kingdom.

This study will explore new developments in three clinical peer review programmes in the UK and the visitatie programme in The Netherlands and how these programmes can be linked, in the future, with other quality systems. The information about the English peer review programmes was gathered by conducting four structured interviews with the programme coordinators (see Acknowledgements). Information about the Dutch visitatie programme was gathered by the author working with different visitatie programmes at the Dutch National Institute for Quality Improvement. Comparing new developments in the models of the Institute for Standardization of Organizations and the European Foundation for Quality Management, common changes are identified which seem to reflect elements viewed internationally as necessary in quality improvement. This study will examine if and how these elements are or will be included in the clinical peer review programmes in the UK and in visitatie in The Netherlands.

Forecasting↗
PubMed2002

Author perception of peer review: impact of review quality and acceptance on satisfaction.

CONTEXT: To determine author perception of peer review and association between quality of review and author satisfaction. METHODS: Survey between May 1999 and October 2000 of 897 corresponding authors of manuscripts under consideration by the Annals of Emergency Medicine and had received final editorial decisions during the study period. A total of 576 authors (64%) returned the survey. Using a 5-point Likert scale, the survey assessed differences in satisfaction between authors whose manuscripts were accepted, reviewed and rejected, and rejected without full review. The association of author satisfaction with editor's assessment of review quality, publication decision, author sex, specialty, and publication experience were also assessed. RESULTS: Overall mean (SD) satisfaction score, indicated by agreement with "My experience with the review process will make me more likely to submit to Annals in the future," was 3.1 (1.0) and was significantly higher among authors of accepted papers (3.7 [0.9]) than among either group of rejected papers (rejected/reviewed, 2.8 [1.0]; rejected/no review, 3.0 [0.9]; P.05). Authors whose manuscripts were reviewed and rejected were the least satisfied with the time to decision (rejected/reviewed, 3.0 [1.2] vs accepted, 3.7 [1.0] and rejected/no review, 3.9 [0.9]; P<.05). Those whose papers were rejected without review were the least satisfied with the letter explaining the editorial decision (rejected/no review, 2.8 [1.2] vs accepted, 4.2 [0.7] and rejected/reviewed, 3.1 [1.2]; P<.05). Among respondents whose manuscripts underwent full review (accepted and rejected/reviewed), overall satisfaction was highly associated with acceptance of the manuscript for publication (odds ratio [OR], 6.12; 95% confidence interval [CI], 3.43-10.91) but not with quality rating of reviews (OR, 1.26; 95% CI, 0.84-1.90). CONCLUSION: Contributor satisfaction with peer review was modest. Authors of rejected manuscripts were dissatisfied with the time to decision and communication from the editor. Author satisfaction is associated with acceptance but not with review quality.

Authorship↗
PubMed2002

Peer review and innovation.

Two important aspects of the relationship between peer review and innovation includes the acceptance of articles for publication in journals and the assessment of applications for grants for the funding of research work. While there are well-known examples of the rejection by journals of first choice of many papers that have radically changed the way we think about the world outside ourselves, such papers do get published eventually, however tortuous the process required. With grant applications the situation differs in that the refusal of a grant necessarily curtails the possible research that may be attempted. Here there are many reasons for conservatism and reservation as to the ability of a grant allocation process based on peer review to deliver truly innovative investigations. Other methods are needed; although such methods need not be applied across the board, they should constitute the methods whereby some 10-20% of the grant monies are assigned. The nomination of prizes for specific accomplishments is one way of achieving innovation although this presumes that investigators or institution already have available the money necessary to effect the innovations; otherwise it is a question of the selection and funding of particular individuals or institutions and requiring them to solve particular problems that are set in the broadest of terms.

Diffusion of Innovation↗
PubMed1998

Peer-reviewed articles and public health: the mad cow affair in Italian newspapers.

CONTEXT: It has been suggested that early announcements of research works to be published in peer-reviewed journals may diminish newsworthiness of scientific articles, but this issue has not been widely studied. OBJECTIVE: To analyze the impact on the news media, in terms of volume and prominence of coverage, of a scientific article published in peer-reviewed journals about issues with relevance to public health compared with the impact of preliminary release of information on the same issue. DESIGN: Analysis of press coverage of Creutzfeldt-Jakob disease (CJD) and bovine spongiform encephalopathy (mad cow disease) in the 7 newspapers with the widest circulation in Italy, between March 20, 1996, when the British secretary of state for health announced the identification of 10 cases of a new-variant CJD, described April 6, 1996, in The Lancet, and May 10, 1996. Related newspaper articles were identified by hand search. MAIN OUTCOME MEASURES: Numbers of newspaper articles published before and after publication of the Lancet article. RESULTS: We collected 535 articles, of which 62 (11.6%) appeared on the front page. The number of articles published daily peaked on March 26 with 48 items and 1 article on the front page of all the newspapers. A total of 386 (72%) of the 535 articles and 56 (88.7%) of the 62 published on the front page were published in the first 2 weeks of the study period, before the Lancet publication. CONCLUSIONS: Our analysis suggests that, in the case of issues of public health importance, when peer-reviewed research is published after a health risk is disclosed to the public, its impact in the media is small. Coordination between news release by public health authorities and publication by peer-reviewed journals may improve the quality of public information.

Encephalopathy, Bovine Spongiform↗
PubMedDate not supplied

The role of peer assessment and peer review in nursing.

With the implementation of clinical governance and professional self-regulation, substantial responsibility is devolved on to clinical nurses. Central to these two concepts is accountability for practice. We are accountable for our professional competence and knowledge to various parties such as the professional statutory body, the employer, society as well as ourselves. Although self-assessment provides each individual with a medium for ascertaining his/her own level of performance and, therefore, identifying his/her learning needs, peer review and peer assessment provide healthy means for obtaining feedback and external perceptions. They also bring with them several other benefits and meet other recommended professional requirements. Peer review is an intrinsic component of clinical governance, and it can be initiated and implemented at one-to-one, departmental or organizational level.

Clinical Competence↗
PubMed2006

[Tidsskriftet, peer review and medical publishing].

The Journal of the Norwegian Medical Association is a peer review-based general medical journal in Norwegian. Peer review is a hallmark of scientific medical journals. The purpose of a peer review system is to evaluate and secure that only high-quality, up-dated and relevant articles are offered to readers. Peer review has been criticised as being subjective, time-consuming and hindering new hypotheses and thinking. During the last years, peer review has been evaluated scientifically. Increased attention is being given to editorial work and to scientific writing and reading.

Authorship↗
PubMed1984

Peer review, third-party payment, and the analytic situation: a case report.

The complexities of insurance coverage and peer review as they intrude into the analytic situation were discussed. The basic question was raised of whether becoming acceptable to major health providers through the peer-review program is truly a compromise of the analytic pact and a threat to the future of psychoanalysis. Practical as well as technical considerations facing the analyst when he is confronted with having to write a report to the patient's insurance company were elucidated. Countertransference feelings were emphasized. A detailed case illustration was presented to demonstrate that peer review, as it relates to third-party payment, need not compromise an analysis.

Adult↗
PubMed1998

A report of an evaluation of the pilot peer review scheme for general dental practitioners working in the general dental services in England.

OBJECTIVE: To evaluate the pilot peer review scheme for general dental practitioners, working in the general dental services in England. DESIGN: A retrospective analysis of a 50% random sample of end of project résumés. SETTING: The scheme was piloted from August 1991 to April 1996. At the end of each project a résumé was completed. METHODS: The random sample of résumés was subjected to content analysis by three reviewers who had previously undergone consistency training. MAIN OUTCOME MEASURES: The range of topics reviewed, the choice of single or multiple topics, the direct relevance of projects to patient care and the comments of the scheme's participants. RESULTS: 332 résumés were analysed, 89% included positive comments. Overall 42% of projects reviewed single topics, with participants in 4 out of 13 regions favouring this approach. 61% of topics related directly to patient care. CONCLUSIONS: The pilot peer review scheme was enthusiastically welcomed by the participants and achieved its objectives of encouraging initiatives to improve patient services and testing different types of peer review.

Dental Audit↗
PubMed1988

A first report of the Department of Defense external civilian peer review of medical care.

In mid-1985, the Department of Defense announced a plan for an external civilian peer review of selected medical and surgical cases in military hospitals. A medical advisory panel consisting of practicing clinical representatives from nine medical specialty societies helped develop written criteria and standards for specific surgical and medical cases. Abstracted data were compared with computer algorithms created from the medical standards and criteria. Those cases failing the review criteria were reviewed by a physician peer review panel. The sampled medical records represented approximately 7% to 8% of the total hospital discharges. Less than 1% of the overall sampled cases were in noncompliance with stated standards. The highest rate of noncompliance was for cases of diabetic ketoacidosis. The most frequent noncompliance event was hysterectomy. Although comparisons are not available, the quality of care among selected cases, as measured by compliance with civilian physician specialty group-endorsed standards, appeared high.

Algorithms↗
PubMed1984

The peer review privilege: a law in search of a valid policy.

The peer review privilege prevents patient-plaintiffs from obtaining the hospital records prepared in connection with quality review proceedings. The privilege, created by statute in most states, is rationalized by the need for confidentiality in promoting complete and candid peer review. In this Article, the Author argues that the privilege cannot effectively promote confidentiality since a common exception allows physicians to obtain the records when seeking judicial review of proceedings leading to their exclusion or dismissal from hospital medical staffs. More significantly, the Author notes that while the privilege began as a device to protect physicians from testifying against their will in malpractice suits--a condonation of the "conspiracy of silence"--it has evolved into a vehicle which enables hospitals to conceal the evidence of their own neglect.

Confidentiality↗
PubMed1981

Impact of peer review in reduction of permanent pacemaker implantations.

Because of a sharp increase in the number of permanent pacemakers inserted at The Brooklyn Hospital between 1972 and 1976, a peer-review committee was established to monitor subsequent pacemaker implantation. Total initial implants declined from 48 to 22 per year in the two years that followed. The number of implantations for sinoatrial bradycardias declined from 50 to 27 and the number of implantations for intraventricular conduction defects declined from 32 to five in the two years after peer review, compared with the two years before. There was no change in the number of pacemakers implanted for complete or advanced heart block. Almost 10% of patients who received a pacemaker between 1972 and 1976 had other conditions that might have accounted for the events that precipitated the decision to implant a pacemaker. The symptoms for which the pacemaker was implanted persisted in 19% of patients, despite a normally functioning pacemaker system. Patients receiving a permanent pacemaker before peer review had a 17% one-year and a 43% three-year mortality. When a more critical patient selection process was instituted, a smaller percentage remained symptomatic (9% vs 19%) and three-year survival rate was improved (86% vs 57%). From 1977 through 1978, when permanent pacemaker implantations declined, the number of hospital, medical service, and coronary care unit admissions increased. It is concluded that peer review can have substantial impact on permanent pacemaker implantations.

Arrhythmias, Cardiac↗
PubMed2004

NIH peer review of grant applications for clinical research.

CONTEXT: Support of research to facilitate translation of scientific discoveries to the prevention and treatment of human disease is a high priority for the US National Institutes of Health (NIH). Nevertheless, a perception exists among clinical investigators that the NIH peer review process may discriminate against clinical research. OBJECTIVE: To describe recent trends and outcomes of peer review of grant applications to NIH requesting support for clinical research. DESIGN AND SETTING: Peer review outcomes of grant applications submitted to NIH by MDs were compared with those of non-MDs, and outcomes of applications involving inclusion of human subjects were compared with those not involving human subjects. Analyses were carried out using an inclusive definition of clinical research and after stratifying clinical research into specific categories. MAIN OUTCOME MEASURES: Median priority scores and funding rates. RESULTS: Between 1997 and 2002, on average, 25.2% of total grant applications (ranging from 27 607 to 34 422 per year) were submitted by MDs, and 27.5% of awards (ranging from 8495 to 10 769 awards per year) were made to MDs. Median priority scores (239.0 vs 250.0) and funding rates (31.4% vs 29.1%) reviewed in 2 grant cycles in 2002 were more favorable for MDs than for non-MDs (P<.001). However, median priority scores (254.0 vs 244.0) and funding rates (23.9% vs 28.1%) were less favorable (P<.001) for R01 applications for clinical research (n = 7227 applications) than for nonclinical research (n = 10 209). This trend was most convincingly observed for clinical research categorized as mechanisms of disease (P =.006) or clinical trials and interventions (P =.001). Similar trends were observed for grant mechanisms other than R01. Concerns about safety and privacy of human subjects may have contributed to the less favorable outcomes of clinical research applications. CONCLUSION: Although physicians compete favorably in the peer review process, review outcomes are modestly less favorable for grant applications for clinical research than for laboratory research.

Biomedical Research↗
PubMed1998

Effect on the quality of peer review of blinding reviewers and asking them to sign their reports: a randomized controlled trial.

CONTEXT: Anxiety about bias, lack of accountability, and poor quality of peer review has led to questions about the imbalance in anonymity between reviewers and authors. OBJECTIVE: To evaluate the effect on the quality of peer review of blinding reviewers to the authors' identities and requiring reviewers to sign their reports. DESIGN: Randomized controlled trial. SETTING: A general medical journal. PARTICIPANTS: A total of 420 reviewers from the journal's database. INTERVENTION: We modified a paper accepted for publication introducing 8 areas of weakness. Reviewers were randomly allocated to 5 groups. Groups 1 and 2 received manuscripts from which the authors' names and affiliations had been removed, while groups 3 and 4 were aware of the authors' identities. Groups 1 and 3 were asked to sign their reports, while groups 2 and 4 were asked to return their reports unsigned. The fifth group was sent the paper in the usual manner of the journal, with authors' identities revealed and a request to comment anonymously. Group 5 differed from group 4 only in that its members were unaware that they were taking part in a study. MAIN OUTCOME MEASURE: The number of weaknesses in the paper that were commented on by the reviewers. RESULTS: Reports were received from 221 reviewers (53%). The mean number of weaknesses commented on was 2 (1.7, 2.1, 1.8, and 1.9 for groups 1, 2, 3, and 4 and 5 combined, respectively). There were no statistically significant differences between groups in their performance. Reviewers who were blinded to authors' dentities were less likely to recommend rejection than those who were aware of the authors' identities (odds ratio, 0.5; 95% confidence interval, 0.3-1.0). CONCLUSIONS: Neither blinding reviewers to the authors and origin of the paper nor requiring them to sign their reports had any effect on rate of detection of errors. Such measures are unlikely to improve the quality of peer review reports.

Authorship↗