EDITORIAL

Some Suggestions for Reviewers and for Authors to Know What Reviewers May Be Looking for H. Ralph Schumacher, Jr, MD* and Joan M. Von Feldt, MD, MSEdÞ

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reviewer of submissions to the JCR: Journal of Clinical Rheumatology or to other medical journals generally accepts 2 important and related obligations. (1) Advising the editor with an opinion as to the acceptability of the manuscript for publication, a priority, and the need for revision. (2) Providing analysis and hopefully constructive detailed comments to the authors. Are there changes that could make the paper more useful? One should consider each of these obligations as the paper is read and then record comments in the places listed on the review form.

Reading the Paper We generally read fairly quickly through the abstract and paper to get first impressions. Is the subject matter appropriate for the journal? Have the authors identified a need for this paper to fill some gap in knowledge or to contest some established concepts? Are results clearly presented and tables or figures used appropriately to lead the reader through important points? Is there redundancy in text and table that could be omitted? Are the statistical methods appropriately applied? Are there discrepancies between the methods and the results (ie, no. of subjects, no. of outcomes)? Read the discussion carefully. The discussion should relate the new results to what is already known and why this is important. Before preparing the written report, are you confident commenting on all aspects? You have been invited because the journal has felt that you have experience or expertise on the subject. Are you comfortable reviewing the subject? Even so, you may not wish to comments on all aspects. Formats for different types of submissions vary. Original articles are required to have abstracts with headings: Background, Objectives, Methods, Results, and Conclusions. Such structured abstracts are not needed for other manuscripts, but many of the same points can be sought in other papers as they can make key messages clearer. Background and Conclusions are especially important as you can tell what the need was for this report and then, critically for JCR, what new practical conclusions there may be for clinical rheumatologists. It may be helpful to consider, early on, if there appear to be language problems and the position of the author (we do give priority to medical student reports and can provide help through a series of revisions). Have the authors read the instructions and are references, and so on, in the style of JCR? Are references appropriate and up to date? We prefer original work citations, not textbooks.

Completing the Review Forms The review form for JCR requests that reviewers consider 8 aspects of the manuscript and score them as 1 to 5 (1 being the best) to help determine whether you will conclude that the paper with or without revisions is high priority, acceptable, and even more importantly, as you read the paper, not publishable. Consider these same eight areas as you prepare comments for the editor and authors. (1) originality (2) clinical implications (3) data quality (4) adequacy of discussion (5) importance of findings (6) validity of findings (7) clarity of English (8) suitability for JCR From the *University of Pennsylvania and VA Medical Center, Philadelphia, PA; JCR: Journal of Clinical Rheumatology; and †Philadelphia Veterans Medical Center, and Division of Rheumatology, University of Pennsylvania, PA. The authors declare no conflict of interest. Correspondence: H. Ralph Schumacher, Jr, MD, VA Medical Center, 151K, University & Woodland Aves, Philadelphia, PA 19104. E-mail: [email protected]. Copyright * 2014 by Lippincott Williams & Wilkins ISSN: 1076-1608/14/2005Y0241 DOI: 10.1097/RHU.0000000000000132

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TABLE. Writing a Constructive ReviewVA Reviewer’s Checklist to Aid in Assessment FEEDBACK TO THE AUTHOR General Does the abstract accurately reflect the paper? Are there inconsistencies among the stated aims in methods used, results, and conclusions? Introduction Does the introduction have a brief background ? Are the hypothesis and clinical objectives stated? Methods Are the methods clear and accurate? Are the statistical methods appropriate? Results Are results clearly presented? Do the tables provide information clearly? Does the text not unnecessarily repeat many details from the tables? Do the tables enhance the results section? (ie, nonrepetitive of text/nonconfusing) Do the figures enhance the results? Are the figures easy to read? (graphics clear, properly labeled) Were the statistical methods appropriately applied? Discussion Is the interpretation of the study findings valid? (evidence of internal and external validity) If other interpretations could be made, did the author consider those? Did the author consider potential flaws or biases? Limitations should be listed. Is there repetition of information from the introduction or results sections that needs to edited/removed? Does the author explain how this paper fills a gap in knowledge or contests some established concepts? Do the authors make clear how findings are relevant to the clinician? FEEDBACK TO THE EDITOR (CONFIDENTIAL) Is the format correctly identified( articles, case reports, concise reports, images, or special reports) If incorrect designation, does it require resubmission, or can it be reviewed as is? Is the author a student or resident? (will possibly get special consideration) Does the English/grammar inhibit a thoughtful review? Are references, etc, in the style of JCR? Is the material interesting to a clinician? Is there sufficient originality of the data presented? Are you comfortable commenting on all aspects of the manuscript? If not, what sections would you like assistance with (eg, statistical analysis)

Preparing Comments to the Authors Start to read through the text again using any notes from your initial impressions with key comments that may be needed in mind. Do comment on any of the first 7 points mentioned above but do not feel that you have to comment on everything. Several carefully considered paragraphs on key points can be more useful than too extensive details. It is important to try to be constructive on changes or additions that can be made to improve the paper but also identify the flaws that would require a totally new approach or new data. Remember that considerable thought and efforts have been expended by the authors. Try to give comments in the order of the paper, number your comments, and identify specific pages or sections in the text. If appropriate, start with a positive statement on the merits of the subject and the effort. We have prepared a checklist of some points that you may want to consider (table) to help you organize. Do not make any statement to the authors about acceptability of

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Yes

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Not able to answer

Yes

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Not able to answer

the paper. It is not helpful to ignore concerns that you feel must be addressed. We encourage that you identify problems with English. If there are only a few errors, you may wish to suggest specific corrections to the authors. If there are many errors in an otherwise useful manuscript, do not feel that is your responsibility to correct these. You may point this out to the editor, and we may try to help or suggest that the authors get help from a native English speaker. Start with commenting on the abstract that should tell a clear story of what is reported, why and what the importance will be for JCR readers? Have the authors identified a need for this paper to fill some gap in knowledge or to contest some established concepts? What is new? Was the study rigorously designed and executed? Are the key points stated clearly? Virtually every discussion needs to consider limitations or potential limitations of the report. Are strengths and limitations addressed? Does the discussion focus on clinical implications as is appropriate for this journal? There may be true controversy in * 2014 Lippincott Williams & Wilkins

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the literature about associations, presentation, or management. Are the arguments well developed and both sides of the topic expressed? If you disagree with an interpretation, it would be helpful for you to comment as to why.

Providing Feedback to the Editor Comments to the editor can be limited and focused on key factors leading to your recommendations since the editor will also read and consider the comments to the authors. Focus on which of the 8 points that were to be graded has the greater influence on your final recommendation. If you are not comfortable interpreting some aspect such as statistics, you can suggest that review by a statistician may help. Recognize that there will likely be several reviewers and also in-house review by the editor and associate editor. Your recommendation about acceptance is important but will be considered along with other reviewers and in light of your more detailed comments to the editor and author. What type of report is the submission identified as? For JCR, manuscripts can be original articles, case reports, concise reports, letters to the editor, images, or special reports (Rheumatology Retrospectives, Practice and Health Policy, Clinical Practice Forum, News and Views from Latin America, and Basic Science for Clinicians). Is the paper correctly classified? Incorrect designation may require resubmission but need not require rejection. For the specific area of randomized controlled trials, there are CONSORT guidelines provided in the references that outline a 26-item checklist that should be consulted. The CONSORT guidelines are helpful in addressing the complexities of protocol,

* 2014 Lippincott Williams & Wilkins

What Reviewers May Be Looking for

randomization, and masking. These are, unfortunately, all too infrequency followed. Are the population, intervention, comparator, and outcome clearly described (the PICO format)? The guidelines also suggest a trial profile summarizing participant flow that is usually a figure in the paper and also makes suggestions for analysis especially about deviations in protocol. Remember that comments to the editor are confidential.

REFERENCES 1. Begg C, Cho M, Eastwood S, et al. Improving the quality of reporting of randomized controlled trials: the CONSORT statement. JAMA. 1996;276:637Y639. 2. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332, 26-item checklist. 3. Yurdakul S, Mustafa BN, Fresko I, et al. Inadequate description and discussion of enrolled patient characteristics and potential inter-study site differences in reports of randomized controlled trials: a systematic survey in six rheumatology journals. Arthritis Rheumatol. 2014;66:1395Y1399. 4. Schumacher HR. An editor writes: some thoughts about medical writing for the less experienced author. J Clin Rheumatol. 1998;4:231Y232. 5. Drubin DG. Any jackass can trash a manuscript, but it takes good scholarship to create one (how MBoC promotes civil and constructive peer review). Mol Biol Cell. 2011;22:525Y527.

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Some suggestions for reviewers and for authors to know what reviewers may be looking for.

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