In 2022, JTD reviewers continue to make outstanding contributions to the peer review process. They demonstrated professional effort and enthusiasm in their reviews and provided comments that genuinely help the authors to enhance their work.
Hereby, we would like to highlight some of our outstanding reviewers, with a brief interview of their thoughts and insights as a reviewer. Allow us to express our heartfelt gratitude for their tremendous effort and valuable contributions to the scientific process.
Eric C. Ko, University of Massachusetts, USA
Takuro Miyazaki, Nagasaki University, Japan
Rima S. Pathak, Tata Memorial Centre, India
James O’Rourke, Royal College of Surgeons in Ireland, Ireland
Gabrielle Drevet, University Hospital of Lyon, France
Eric C. Ko
Dr. Eric C. Ko is Vice Chair of Education, Associate Professor, and Attending Physician in the Department of Radiation Oncology at the University of Massachusetts Chan Medical School and UMass Memorial Medical Center (Worcester, MA, USA). He was previously a faculty member at Weill Cornell Medicine and New York-Presbyterian Hospital (New York, NY, USA), where he was a member and co-leader of the multidisciplinary thoracic oncology working group. His clinical interests include SBRT and its role in the management of lung cancer. He has longstanding research interests in immunotherapy, and his recent work has focused on the ability of radiation therapy to promote tumor immunity in oncology patients. Please visit Dr. Ko’s homepage and LinkedIn page for more information.
Peer review is central to the quality assurance of scientific investigation. It is vital to have an effective peer review process for there to be trust that scientific communication is valid, timely, and relevant. In Dr. Ko’s opinion, reviewers must be fair and impartial readers, but also critical thinkers. Reviewers must rely on their experience and unique perspectives to assess the significance and potential impact of each paper.
Seeing the prevalent use of reporting guidelines. such as TREND and RMARK, in recent years, Dr. Ko stresses that it is important for authors to adhere to these guidelines whenever possible. Standardization is the best way to allow meaningful comparisons and data synthesis across studies. This will then allow us to identify significant “big picture” findings that would otherwise be more difficult to discern.
“We are all striving to improve science and peer review in an effective way to accomplish this, even if it is an imperfect process. Through peer review, we learn about new research developments, and we can challenge and refine existing frameworks of thought. At the end of the day, we hope that our contributions help to consolidate knowledge gains in the field, which would then translate to improving the care of our patients,” says Dr. Ko.
Takuro Miyazaki, M.D., Ph.D. currently serves at the Department of Surgical Oncology, Nagasaki University Graduate School of Medicine, Japan. His research areas include thoracic surgery, lung cancer, and lung transplantation. His recent focuses have been on post thoracotomy pain and minimally invasive surgery. You may visit Dr. Miyazaki’s homepage here and follow him on Twitter @GtsTakuro.
The peer review system is essential, in Dr. Miyazaki’s opinion, that it proves the importance, novelty, and credibility of research. It works to point out what is unclear or lacking in the study, thereby increasing the value of that study.
Data sharing is prevalent in scientific writing in recent years. Dr. Miyazaki believes that it is crucial for authors to share their research data, since this attempt facilitates communication among researchers internationally, leading to an increase in citations.
“Peer reviewing allows me to broaden my perspective along with the authors,” says Dr. Miyazaki.
Rima S. Pathak
Dr. Rima S. Pathak is currently an Associate Professor in the Department of Radiation Oncology at the Tata Memorial Centre, Mumbai, India where she had also received her post-graduate training. She was awarded the Gold Medal for being the ‘Best Student of the Decade’ for her academic performance and research work done during her MD thesis. She was also awarded the travel fellowship by the European Lung Cancer Congress 2015 to exhibit her work on stereotactic treatments in stage-I NSCLC. She completed her first clinical fellowship at British Columbia Cancer Agency in Prostate LDR Brachytherapy and management of breast, skin and lung cancer cases in 2016. Subsequently, she completed her fellowship in Stereotactic Ablative Body Radiation at the Ottawa Cancer Hospital in 2017. She returned to her country and Tata Memorial Centre as a consultant in 2017 to serve the patients in India. Her primary research focus is on providing cost-effective and stereotactic treatments for breast and lung cancer patients. She is also pursuing her PhD in Clinical Research on Hereditary cancers. You may follow Dr. Pathak on Twitter @RimaPathak1.
JTD: What do you regard as a healthy peer review system?
Dr. Pathak: Peer review in research is a tool for ensuring quality control of the manuscripts that get published. The reviewers are assigned with the task of establishing whether the information provided is accurate, valid, relevant and significant for the scientific community. Additionally, reviewers are charged with the responsibility of identifying research misconduct and basic flaws in the scientific process or report, separating fake from real research and ensuring that the study and its results have a scientific rationale. Journal editors shoulder the enormous responsibility of selecting appropriate reviewers to ensure a healthy peer review is possible. Appropriately selected individuals always strive to improve the article and help new and old researchers to show-case their hard work receive the desired recognition for it. It is important for the reviewers to approach each assigned article with less cynicism and disparagement and provide constrictive criticisms. It usually helps to not just point out issues but to also suggest possible solutions in their own capacity. Each individual develops different perspectives on a research topic based on their knowledge and experiences and therefore, it is advisable to have at least 2 or more individuals with domain expertise to evaluate the manuscript. It is increasingly recognized that the publication systems have favored research from the developed countries. Sensitized editorial boards are now being more inclusive and engaging individuals from diverse genders and geo-ethnic backgrounds who can help review work from developing countries and communities.
JTD: What are the limitations of the existing peer review system? What can be done to improve it?
Dr. Pathak: Increasing pressure of producing research papers have led to exponential rise in the number of publication houses and journals, further fueling the vicious cycle of publishing. Each submitted article needs at least twice as many reviewers. The existing peer review system is unfortunately ill-equipped with ensuring that the most suitable reviewer be assigned to a particular manuscript. There are far more articles and blogs published on how to write a paper than on how to review one. Reputed journals have tried to address this deficiency by making the peer review process more objective where all manuscripts are required to be judged on a set number of parameters. Additionally, reviewers have to provide supporting justification for the opinions provided. Such objective review process along with inclusion of formal training modules which have to be successfully completed prior to embarking on the review journey can help to further orient the reviewers that are new to a particular journal. Editorial and review boards have to be sensitive towards gender and geo-ethnic diversity to improve the global reach and appeal of their journal.
JTD: Is it important for authors to disclose Conflict of Interest (COI)? To what extent would COI influence research?
Dr. Pathak: A healthy peer review systems are built on honesty and integrity of the authors, reviewers and the editors so that readers can trust the published content. Trust, a core ethical value is the key to establishing credibility in the pursuit of scientific truth. It is obviously important to first recognize an actual, potential or perceived COI and then to report it. COIs arise in situations where aims of the author and reviewer are incompatible or when the reviewer tends to gain directly or indirectly from the decisions provided by them in official capacity. This is also an important reason why publication houses are unblinding the authors so that COIs can be recognized. COIs lead to a compromise in the objectivity and/or judgement and pose a problem for professional, patient, and public trust in research and the research enterprise. At an individual level, it has the potential to harm study participants and patients. Academic COIs stem from intangible benefits a scientist tends to gain from influencing the decision of a scientific publication. While completely eliminating bias in judgement is not possible, all individuals participating in the pursuit of scientific truth must recognize and report biases that diminish their objectivity towards the task assigned.
JTD: Would you like to say a few words to encourage other reviewers who have been devoting themselves to advancing scientific progress behind the scene?
Dr. Pathak: The peer review process may appear like an unrewarding job in the beginning; however, I have ended up learning from this process. It encourages you to read relevant articles, appreciate different research focus areas, study designs, methodologies, and statistical analyses. I have used some of these subsequently in my own research work. For those with altruistic bend, reviews are a way of selflessly helping the science and the research community grow and provide immense joy and satisfaction to see your reviewed articles get published. Thus, despite the lack of monetary gain, the indirect benefits are worth going through the tedious process for self and societal growth.
Dr. James O’Rourke is a Consultant in Anaesthesia and Intensive Care Medicine at Beaumont Hospital and Clinical Lecturer with the Royal College of Surgeons in Ireland (RCSI), Ireland. He is a board member of the National Organ Donation and Transplantation Advisory Group. He is also the National Clinical Lead for Donation after Circulatory death and is lead author on the National Guidelines. Dr. O’Rourke was educated at the RCSI and following specialist training, completed fellowships in Paediatric ICM and Anaesthesia at Children’s Hospital, Boston and The Hospital for Sick Children, Toronto. He is a primary consultant and clinical lead for patients with phrenic stimulators in situ. He is the local clinical lead in tracheostomy management and has co-authored local and national guidelines in tracheostomy care. He is currently leading on a national strategy for normothermic regional perfusion in the context of organ donation.
JTD: What role does peer review play in science?
Dr. O’Rourke: Peer review is central to the academic process. Today, Wi-Fi allows instant access not only to corroborated information but also to a wealth of logs, blogs, opinion and conjecture. Classrooms are increasingly being replaced by the virtual classroom; and the use of online platforms are now the norm. Social media such as Facebook, Twitter, TikTok and Instagram allow instant access to a massive audience. An instantaneous reactionary opinion may trend and influence those who cannot critically appraise source data. Every organization has its own site, and with search engine optimization can promote its visibility and agenda effectively. While development of the Internet has created the information highway and has been a massive improvement on Index Medicus, the old maxim of “paper never refused ink” extends into the worldwide web and “fake news” is a common term in parlance today.
The basic tenets of journalism such as checking of sources and verification of facts before publication are central themes. However, as clinicians, we must strive for a higher standard. We are in the fortunate position of being one of the most trusted professions and the rigor which we apply to the publication of medical literature must be transparent, scrupulous and non-biased.
The layout of each scientific publication is set by the journal and follows a reasonably standard pattern; abstract, introduction, methods, results, discussion and conclusions are the norm. The scientific process itself must be clear and unambiguous, and the manner in which it is written informed and succinct. Each of us may express opinions about the structure, readability, and language of a publication. English scholars frequently improve ways of expressing these thoughts and opinions; peer review is this and much more. Few of us can claim to be experts outside of our own narrow spectrum. The benefits of peer review are to get the unbiased opinions of recognized experts within the specific area covered by the manuscript. Peer reviewers may be particularly well positioned to attest to the originality and relevance of the work.
Peer review should provide a non-biased criticism which will markedly improve the quality of each publication. Rather than being a hurdle to publication, peer review can reinforce strong aspects of a publication and eliminate the tangential minutia. Following peer review, the publication is now a stronger article and more likely to withstand post-publication criticism and ultimately improve its number of citations.
JTD: Biases are inevitable in peer review. How do you minimize any potential biases during review?
Dr. O’Rourke: This statement is true. Biases are inevitable. Few of us can stand completely independent where scientific research is concerned. Clinical trials may be expensive to run and insure, far beyond what grants may allow. Company sponsored trials are commonplace and one needs to be conscious of the source of funding for a study. I frequently look through the conflicts of interest statement to frame the article I am reading. I personally would recommend the Users’ Guides to Medical Literature available online. The recommended evidence-based approach frequently cites the “PICOT” acronym when reading an article, considering the population, intervention, comparator, and outcome in what time (PICOT) is a very useful place to begin. Biases may be reduced by the appropriate design, blinding, randomization, analysis and by examining the outcomes. The series of questions presented in evidence-based medicine guides outlines clinically important outcomes as distinct from reported outcomes. Peer review when done correctly will decrease these biases and minimize their potential impact.
JTD: Why is it important for a research to apply for institutional review board (IRB) approval? What would happen if this process is omitted?
Dr. O’Rourke: Many among us consider IRB or ethics committees as a necessary evil impeding our own brilliance. Having been a part of our own local IRB and ethics committee at the RCSI, I appreciate the value they lend to research. Nobody is served by poorly conceived and conducted research. Having spent a considerable portion of my scientific life attempting to have uninteresting, unloved, and orphan projects published, I feel particularly qualified to attest to this fact.
Feasible, Interesting, Novel, Ethical and Relevant; the FINER criteria are the cornerstones of what we are taught on day one and it should be considered in the development of any hypothesis. This is then followed by the basic scientific approach of forming the hypothesis and either proving or disproving through rigorous scientific efforts. The scientific results must withstand critique; and the statistic validity of every proposal, both internal and external, must stand up to scrutiny. It follows also that the planning of every study is as important as the conduct of the study, funding, insurance, and the protection of study subjects whether this means their identity, health or from potential later sequelae of trials. The conduct of each approved study should not be found wanting because we have run out of funding or have inadequate insurance to cover all eventualities.
An IRB opinion is essential for all studies. It follows that many of the aspects outlined above have been addressed in the planning phase. It assures us that the work presented aspires to the highest standards. Many studies such as equipment studies or retrospective non-interventional studies do not need IRB approval. Nonetheless, it is reassuring to have their opinion so the study may be appropriately cited as an audit or service evaluation and registered within the organization.
In summary, IRBs are an essential part of scientific research. Indeed, they are part of its very fabric. We may all be subject to the late-night epiphany or flash of brilliance, but IRBs will ground us where it is more late-night than brilliance.
Dr. Gabrielle Drevet is a thoracic surgeon at the Louis Pradel Hospital, University Hospital of Lyon, France. She completed her surgical training at University of Lyon, France, followed by a thoracic surgery fellowship at Quebec Heart and Lung Institute, Quebec, Canada. While in training, she obtained a Master’s Degree in Surgical Sciences at the University of Paris. Dr. Drevet’s current research areas are mainly focused on thoracic oncology, in particular pleural malignancies and malignant pleural effusion management. Her recent projects focus on intra thoracic chemotherapy development. Dr. Drevet’s research page can be accessed here.
“Who better than peers to evaluate work on a specific topic?” says Dr. Drevet when she is asked about the importance of peer review. To her, experts in the field are excellent judges and can provide constructive commentaries and questions in order to improve the scientific value of the manuscript. Their role is to ensure that the methodology is sound, that the scientific facts reported are accurate, and that they are properly balanced against already published data. All this is aimed at avoiding the publication of incorrect results, especially nowadays, when our clinical decisions are driven by the scientific literature. Peers are also well aware of the impact that a work can have in clinical practice.
However, peer review is not without biases. To minimize these biases, Dr. Drevet tries to get rid of all possible prejudices she has and to look purely at the methodological and scientific value of a work. As an author, she tries to put herself as much as possible in the shoes of the authors and think about the difficulties they may have encountered. When she accepts a review, she accepts at the same time to be pushed around, to be challenged in the subject and the clinical practice that are exposed. In that way, she believes peer reviewers would be able to provide the fairest review they can.
From a reviewer’s perspective, Dr. Drevet believes that it is crucial for authors to share their raw research data. An investigator who performs studies and decides to publish them has implicitly agreed to divulge its work, which includes the responsibility to make the raw data available for control. If clinicians are ready to change their practice based on medical literature, they must have the opportunity to verify raw data and interpret them themselves. Later, this will potentially have the secondary effect of making researchers more punctilious about the analysis and interpretation of their data. Some researchers can be reluctant to release their data because it is a lot of work and they want to protect it, but they must keep in mind that the concern is more to advance science than to stigmatize researchers.
“If one wants to be honest with the authors and make a fair and constructive review, it does take time. But this is an important activity both for the authors who deserve to have their work evaluated and for the reviewers who keep abreast of scientific evolutions and the latest questions raised. This is why I try to organize my time as efficiently as possible so that I can have some ‘quiet’ time to review regularly,” says Dr. Drevet.