Sahibzada Nasir Mansoor  ( Armed forces institute of rehabilitation medicine (AFIRM) Rawalpindi, Pakistan. )

Peer review is a recognized and established way of evaluating scientific literature and research practiced world over. It has its own merits, demerits and critique. Former editor of British Medical Journal, Richard Smith said that,” Democracy and scientific peer review have something in common: it is a system full of problems but the least worst we have”.¹ The aim should be, how to get the best out of this. Good reviewer is an important factor that translates into publication of good quality science and scientific writing. The main aim of the reviewer is to assess the scientific content and quality of the research along with its research writing skills. There are studies available on how to get good reviewers and improve the process of peer review.^2,3

In Pakistan the research writing and publishing culture has witnessed a boom in the past decade due to the impact of global research practices and norms in academia as well as revision of university’s policies for promotions and appointments including a certain number of research articles. There are more than 92 biomedical journals in Pakistan; 58 approved by Higher Education Commission (HEC), 35 are currently recognized, 16 are derecognized and 7 are permanently banned for recognition by HEC.⁴ Only 3 biomedical journals have an impact factor. This speaks volumes of the quality of medical journals and the apathy towards quality publication. The majority of Pakistani biomedical journals have become mere tools to get an article published in one’s name to get the benefits associated with it with no intent for development of science and its implications for society. Sadly, speaking peer review by and large in Pakistan has been considered an ad hoc, informal activity and a formality for publication process by a majority.

Increasing numbers of journals have increased the demand for peer reviewers. Peer reviewer’s selection and enrollment has been done casually by certain journals leading to poor quality of both the peer reviewers and their reviews. This increases the burden on the editor and leads to publication of a poor-quality research. The selection of good peer reviewer is a tough job for the editorial team. Few basic things to be kept in mind include, selection of subject specialist, publication record in the subject, teaching experience, practice and services in the relevant area and past reviewing experience for journals. The reviewers at the same time have different agendas. Some do it for passion, honour, recognition, learning, professional growth and others for personal gains and obliging the editor.⁵ It is the job of the editor to identify the right reviewers. Many in Pakistan get review requests because of their position or their seniority and not because of their expertise in scientific writing and publication resulting in a review that is vague and sketchy. At times they forward the review to junior colleagues and faculty that is bound to be faulty and suboptimal. With the online review and journal management system, even the login details are shared with subordinates to perform reviews online on their behalf. Such reviewers need to be weeded out of databases and the journals with good standing are doing it regularly.

Many journals just perform a formality peer review and get articles published without incorporating a single improvement suggested by the reviewers. Majority of the malpractices are prevalent in the low quality and struggling journals that are mainly started as a publicity stunt with no dedicated manpower, resource allocation and ad hoc disinterested staff employment.

Fake peer reviews have also been reported internationally from developed and developing countries alike and in our region reported from researchers from India, China, South Korea, Iran and Pakistan.⁶ There are certain predatory journals sending peer review request for published authors to trap them for unrelated manuscript fake review and using their names for authenticity. In my journey as a peer reviewer I have witnessed numerous instances of unethical practices in the peer review process. Members of editorial boards and at times authors directly approaching reviewers in the so-called blind peer reviews and pressurizing for positive comments to meet publication deadlines for promotions and other purposes. Many journals even publish manuscripts deserving desk rejections. This is either due to poor review or even after reviewer’s suggestion for the rejection. This happens mostly in struggling journals with few submissions that they don’t want to lose. Such decisions leave the reviewers frustrated as they spend a significant amount of time and energy in reviewing. I think that reviewers should be choosy in accepting review and should base their decision on the standard and credibility of the journal, past reviewing experience, the available time, personal preferences for the specific topic and any conflict of interest. Certain journals give unrealistic timelines to reviewers like 7 to 10 days which is at times unachievable as most of the reviewers are practicing professionals and involved with more than one journal. Any timeline of less than three weeks seems overwhelming and leads to either a poor-quality review or decline to review.

Reviewer training is the perfect way to improve the quality of review and for standardization of the review.⁵ The reviewers should be trained about the purpose of review, the specific review process and the deadlines involved. They should be taught and presented with good and bad reviews. They should be provided hands on experience and exercises on peer review followed by group discussions.⁷ Each journal should frequently conduct workshops and online refresher courses for their reviewers, identify the good reviewers and nurture and retain them. Initially a new reviewer inducted should be observed for the review by piloting their review along side seasoned reviewers and when satisfactory then they should be given independent reviews.

Peer review proformas should be standardized as it will help the reviewers as well as journals.⁸ There should be descriptive comments option in each section along with rating scale to assess the true value of each segment. Supporting file upload should be mandatory as the real-time comments, changes and improvement on the document gives the author and editor both a good feel of what the reviewer is trying to suggest for the improvement of the manuscript. At times all the details and corrections done on the manuscript cannot be translated in the reviewer proforma.

An important milestone in this direction has already been taken up by the Pakistan Medical journalists association conducting the first ever workshop for peer reviewers in 2002.⁹ Pakistan Association Medical Editors (PAME) and the University of Health Sciences Lahore in collaboration have started the first ever formal basic level course in medical editing in 2019 and the second batch is underway this year. It will go a long way in improving the editorial services and training to current and future members, improving the quality of journals as well as quality of review and reviewers. More such courses and frequent workshops should be conducted to improve the current situation and bring it to international standards.

Another way for improving peer review practice is to share the review comments of other reviewers for the same manuscript with each other.¹⁰ This gives  an insight about ones own performance and the area missed out and others perspectives about the same manuscript. It broadens the horizon as a reviewer. I personally learnt a lot from certain International journals sharing reviews among the reviewers once completed.

Peer review has little recognition and mostly considered a thankless job. Any efforts for making it more worthwhile than mere personal and professional satisfaction will improve both the numbers of reviewers and quality of reviews. There are now many websites available to give credit to peer reviews and improving their capabilities as peer reviewers. Publons, Pubpeer and Faculty of 1000 are few online platforms to give visibility and showcase reviews.¹¹ It brings more responsibility and accountability along with the associated credit of review. Publons also has excellent training and mentoring modules for peer reviewers training.¹² Other ways that journals retain reviewers are by recognition, publishing their names in yearly supplements and on websites, selection as editorial board members, reduced processing and publication fees, giving certificates of review, sending books and educational materials and awarding distinguished reviewers.² Few journals even pay honorarium to reviewers as incentives.³ Journal of College of Physicians and Surgeons Pakistan and another university has started giving CME points for review activity. These factors of good selection and retention of reviewers will help make the reviews more standardized and dependable and will remove the unpredictability of reviews.

Peer review is a purely professional and academic task and requires responsible, selfless and dedicated individuals with the only aim of approving and improving good science. They are the editor’s right hand. They should be carefully selected, meticulously trained and groomed, continuously monitored and respectfully retained for the good of the journal and science. As we all know that, “A chain is as strong as its weakest link”. We need to identify the weaker links in the whole chain of medical journalism and peer reviewer is one of the links.

 

Disclosure: None.

Acknowledgement: Gratitude is extended to Dr Farooq Azam Rathore and Dr Omer Yousaf for the final review and suggestions.

 

References

 

1.      Wingfield B. The peer review system has flaws. But it’s still a barrier to bad science. The Conversation. 2018.

2.      Jawaid SA. How to find, grow and retain Good Reviewers: An experience from Pakistan. International Journal of Information Science and Management (IJISM) Special Issue. 2014;pp7-11

3.      Sohail S. Fortifying the external peer review: an editorial perspective. J Coll Physicians Surg Pak . 2015;25:2-3.

4.      [Internet]. Hec.gov.pk. 2020. Available from: https://www.hec. gov.pk/english/services/faculty/journals/Documents/Sciences/Science-Journals/Most%20updated_Health%20Sciences%20Journals. [cited 8 November 2020].

5.      Jawaid SA, Jawaid M, Jafary MH. Characteristics of reviewers and quality of reviews: a retrospective study of reviewers at Pakistan journal of medical sciences. Pakistan J Med Sci. 2006;22:101-6.

6.      da Silva JT. Fake peer reviews, fake identities, fake accounts, fake data: beware!. AME Med J. 2017;2:28.

7.      Janke KK, Bzowyckyj AS, Traynor AP. Editors’ perspectives on enhancing manuscript quality and editorial decisions through peer review and reviewer development. Am J Pharm Educ. 2017;81:73. doi: 10.5688/ajpe81473

8.      Shah FA, Ali MA, Nazar Z, Rasheed HU. Pattern of peer review proforma of medical journals of Pakistan. Pak J Med Sci. 2019;35:1013-1017.

9.      Maqbool H. Proceedings of workshop on peer review system held at Karachi and Lahore. Pak J. Med Sci. 2002;8:328-333.

10.    Miller B, Pevehouse J, Rogowski R, Tingley D, Wilson R. How to be a peer reviewer: A guide for recent and soon-to-be PhDs. PS: Political Science & Politics. 2013;46:120-3.

11.    Menon V, Muraleedharan A. Credit and visibility for peer reviewing: An overlooked aspect of scholarly publication. J Neurosci Rural Pract. 2016;7:330-331

12.    Rathore FA, Farooq F. The Need for Formal Training in the Peer Review Process and Role of Publons Academy. J Coll Physicians Surg Pak. 2018;28:78-79.