Peer review in New York State. A guide. Dental Society of the State of New York, Council on Peer Review.
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Peer reviewers are blinded sometimes to authors' and institutions' names, but the effects of blinding on review quality are not known. We, therefore, conducted a randomized trial of blinded peer review. Each of 127 consecutive manuscripts of original research that were submitted to the Journal of General Internal Medicine were sent to two external reviewers, one of whom was randomly selected to receive a manuscript with the authors' and institutions' names removed. Reviewers were asked, but not required, to sign their reviews. Blinding was successful for 73% of reviewers. Quality of reviews was higher for the blinded manuscripts (3.5 vs 3.1 on a 5-point scale). Forty-three percent of reviewers signed their reviews, and blinding did not affect the proportion who signed. There was no association between signing and quality. Our study shows that, in our setting, blinding improves the quality of reviews and that research on the effects of peer review is possible.
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Peer review process is widely used to assess the quality of scientific research and select papers for publication in biomedical journals. The method lacks standardization and objectivity. To standardize the peer review process, evaluation and rating of the performance of individual peer reviewers using a sham paper is suggested. The present study of 7 reviewers revealed ratings ranging from 0.34 (SD 0.33) to 0.45 (SD 0.5), widely differing from the set standard (ideal 0). This indicates less than optimal performance by the peer reviewers. Feedback to the peer reviewers might help in improving the standards.
A peer review of breast operation statistics was conducted. Standards for the proportion of biopsies positive for cancer, and for length of postoperative stay following operation for benign and malignant conditions were developed and each surgeon was informed of his performance and how it compared with that of his colleagues. The same parameters of care were reviewed one year later to study changes in performance. Low volume of clinical material, failure of two surgeons to change, and a steady general improvement in all parameters in the years prior to the presentation of the peer review, confused the demonstration of improvement in the year after the educational effort. There was a statistically significant improvement in the proportion of biopsies positive for cancer, reflecting reduction in unnecessary biopsies, but the pre-existing annual improvement in reducing postoperative stays was not accelerated. Does continuing medical education by peer review really work? Probably.
Peer review is the assessment by experts of material submitted for publication. The peer reviewer serves the editor by substantiating the quality of the manuscript, and serves the author by giving constructive criticism. This system has benefits and drawbacks, including the tendency to select against novel work. Reviewers, whose work is generally unpaid, tend to be academicians who review for several journals and are authors and editors themselves. Editors often blind reviewers to authors to reduce bias, but reviewers frequently recognize the author anyhow. Blinding authors to reviewers may protect the reviewer. Manuscripts rejected by one journal because of peer review are usually published in another. Since peer review serves to validate the quality of the biomedical literature, the process should be valid itself.
Congress created the peer review organizations (PROs), in part, to check the accuracy of diagnosis related groups (DRGs) billed to Medicare. This study determined the accuracy of the peer review organizations' abstraction of DRGs during federal fiscal year 1985. A two-stage cluster design sampled 7050 medical records from 239 hospitals stratified by size. Credentialed medical record professionals used blinded techniques with reliability checks to abstract the ICD-9-CM codes and select the correct DRGs. Physicians reviewed medical records whose abstracted DRG differed from the DRG paid by the fiscal intermediary. The peer review organizations reported abstracting 1715 of these discharges. The peer review organization selected the correct DRG in 75.6 percent of the 1715 abstractions, a significantly lower proportion than the 80.3 percent paid accurately by the fiscal intermediaries. Upcoding compounded the peer review organizations' errors.
Publishing in peer reviewed journals is an essential activity for nurses working in higher education. This paper offers some reflections on the processes involve in the reviewing of articles submitted for publication, and explores some ways in which this system may be improved. All journals operate some kind of review process. This can range from, at one end, the editor making decisions about the suitability for publication of a submitted paper to, at the other end, papers being blind-reviewed by two (or sometimes more) external referees. This paper notes that there appears to be little or no consistency amongst the various nursing journals with respect to reviewing processes. Suggestions put forward in this article for consideration include: the standardisation of peer review systems across journals; the construction of guidelines for referees which caution against ad hominem attacks on authors; and the introduction of 'open' reviewing.
STUDY OBJECTIVE: We sought to determine whether peer reviewers who attend a formal interactive training session produce better reviews. METHODS: Peer reviewers were invited to attend a formal, 4-hour, highly interactive workshop on peer review. Attendees received a sample manuscript to read and review in writing in advance. The workshop included presentations on analyzing a study and the journal's expectations for a quality review, discussion of the sample manuscript's flaws and how to address them in a review, discussion of the reviews written by the attendees, and discussion of real reviews of other manuscripts illustrating key points. The performance of attendees on the basis of standard editor quality ratings (1 to 5) was assessed for the 2 years after workshop attendance. Control reviewers matched for previous review quality and volume were selected from nonattendees of the workshop. In study 1, all average reviewers received a standard written invitation. In study 2, 75 randomly selected average reviewers were personally and actively recruited with intensive follow-up by means of e-mail and telephone calls in an effort to reduce self-selection bias. RESULTS: In study 1, 25 reviewers volunteered for the course, were eligible for study, attended, and were compared with 25 matched control reviewers. Of attendees filling out evaluations, 19% thought it somewhat and 81% thought it very helpful. All thought it would improve their subsequent reviews, and 85% thought it would improve their review ratings. The mean change in rating after the workshop was 0.11 (95% confidence interval [CI] -0.25 to 0.48) for control reviewers and 0.10 (95% CI -0.20 to 0.39) for attendees. In study 2, of 75 reviewers intensively recruited, only 12 (41%) of those who said they would attend did. All of the participants thought the workshop would improve their performance and ratings. Test scores at the end of the workshop improved in 73% of participants compared with scores on pretests. The control reviewers' average rating changed by -0.10 (95% CI -0.49 to 0.29) versus 0.06 (95% CI -0.34 to 0.23) for attendees. CONCLUSION: Among invited peer reviewers, voluntary attendance at a highly structured and interactive workshop was low and did not improve the quality of subsequent reviews, contrary to the predictions of attendees. Efforts to aggressively recruit average reviewers to a second workshop were time consuming, had low success rates, and showed a similar lack of effect on ratings, despite improvement in scores on a test instrument. Workshop teaching formats, although traditional, are of unproven efficacy.
Peer review can be an effective tool for quality assurance. Many methods are available for a group of clinicians to use to evaluate the care that they deliver. Successful review often depends on the support of a nonjudgmental environment. When the goal of the review is problem identification and problem solving, not blaming, peer review can result in true quality improvement.
BACKGROUND: Peer reviewers are usually unpaid and their efforts not formally acknowledged. Some journals have difficulty finding appropriate reviewers able to complete timely reviews, resulting in publication delay. OBJECTIVES AND METHODS: A survey of peer reviewers from five biomedical journals was conducted to determine why reviewers decline to review and their opinions on reviewer incentives. Items were scored on 5-point Likert scales, with low scores indicating low importance or low agreement. RESULTS: 551/890 (62%) reviewers responded. Factors rated most highly in importance for the decision to accept to review a paper included contribution of the paper to subject area (mean 3.67 (standard deviation (SD) 86)), relevance of topic to own work (mean 3.46 (SD 0.99)) and opportunity to learn something new (mean 3.41 (SD 0.96)). The most highly rated factor important in the decision to decline to review was conflict with other workload (mean 4.06 (SD 1.31)). Most respondents agreed that financial incentives would not be effective when time constraints are prohibitive (mean 3.59 (SD 1.01)). However, reviewers agreed that non-financial incentives might encourage reviewers to accept requests to review: free subscription to journal content (mean 3.72 (SD 1.04)), annual acknowledgement on the journal's website (mean 3.64 (SD 0.90)), more feedback about the outcome of the submission (mean 3.62 (SD 0.88)) and quality of the review (mean 3.60 (SD 0.89), and appointment of reviewers to the journal's editorial board (mean 3.57 (SD 0.99)). CONCLUSION: Reviewers are more likely to accept to review a manuscript when it is relevant to their area of interest. Lack of time is the principal factor in the decision to decline. Reviewing should be formally recognised by academic institutions and journals should acknowledge reviewers' work.
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Peer review of social work documentation has helped promote the uniformity and consistency with which services are delivered; and social workers are exposed to the professional practice of their colleagues, since all staff members participate in conducting peer reviews. The system also helps identify areas of weakness or deficiency common to staff members. The detection of such patterns is the responsibility of the peer review committee, which brings them to the attention of the social work service management and of the service's QA committee. Corrective action is then taken to remedy identified problems. The system also has the potential to help identify patient problems and needs not met by the existing system of health care delivery; such gaps in service can then be brought to the attention of the management of the medical center for consideration and possible resolution. By focusing on documentation elements as indicators of high-quality and appropriate social work intervention, the peer review system used by the social work service has helped enhance social worker performance and service delivery.
The records of medical peer review meetings at the Royal Children's Hospital, Melbourne, were audited for the period 1983-87. This investigation focused on the peer review process, but also evaluated the extent to which recommended changes in medical practice were carried out. The results showed that few recommendations arose from the meetings despite the clear recognition of a number of problem areas. In the instances where firm recommendations were made, few appeared to have been implemented. The main reasons for this failure were: (i) the review was not an integrated part of the medical management structure of the hospital; (ii) recommendations were frequently not made despite clear expressions of the need for action; (iii) the absence of a designated individual to ensure that recommended actions were implemented, together with the lack of a feedback or internal review process to monitor effectiveness; and (iv) a relatively low profile of the peer review. Despite these shortcomings, the peer review is widely perceived to be a valuable exercise, especially as a general educational tool. However, its potential is far greater, and a model is proposed for a more effective medical peer review programme.
The peer review process serves a vital role in the publication of biomedical information. When properly functioning, review should focus exclusively on questions of scientific validity and should avoid becoming enmeshed in questions such as "authorization" and "data ownership." We present a case in which the dissenting views of a coinvestigator were suppressed because the principal investigator and grantee institution informed a medical journal that the coinvestigator was not "authorized" to use the data generated by a publicly funded grant and because the editor of a scholarly journal refused to review the dissenting manuscript and to submit that dissent to external reviewers for peer review. The current peer review system, as shown by this case, is unable to embrace dissent within the peer review process and to use dissent to serve scientific truth and the public interest.
This article provides an extensive tutorial for writers and reviewers involved with the preparation and evaluation of manuscripts submitted for publication in dental journals. The contents were compiled from the Instructions for Authors printed in various peer-reviewed dental journals and from feedback from 10 workshops conducted for the Editorial Review Board of the Journal of Prosthetic Dentistry. The 10 major sections of a scientific manuscript are reviewed in detail in terms of content, format, and common errors; examples of good content are provided. The review process is described, and instructions on conducting fair and expeditious manuscript evaluations are provided for reviewers. In addition, a number of special topics are addressed, including potential conflicts of interest for an author, institutional review of experiments that involve human subjects or animals, and the reproduction of photographs and other images in color versus black and white. In summary, this article presents key guidelines to ensure compliance with the principles of sound scientific writing and the expeditious review of manuscripts prepared for publication in peer-reviewed dental journals.
You are the chief executive officer of Friendly Neighbor Medical Center, an acute care hospital. On your desk is a letter from your counterpart at The Behemoth Clinic, a large local medical group that not only is very active in managed care contracting in your service area, but also has an important relationship with your hospital. Behemoth has requested extensive access to Friendly Neighbor's peer review files and patient records in order to investigate the care provided by one of Behemoth's physicians. You happen to be aware that the physician has been the subject lately of peer review scrutiny at your hospital, and you would like to cooperate with Behemoth. Can you do so without jeopardizing the legal confidentiality protections available to your hospital's peer review records, not to mention the peer review process generally?