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The art and science of reviewing manuscripts for orthopaedic journals: Part II. Optimizing the manuscript: practical hints for improving the quality of reviews.

Manuscripts submitted to musculoskeletal journals have several key components that need to be critically evaluated. There are specific methods to assess the abstract, illustrations, references, and other major elements of a manuscript under review. If each of these elements is assessed methodically, not only does the quality of the review improve, but it becomes more useful for the journal editor. Additionally, the method in which the review is conveyed has a marked impact on its usefulness. There should be a concise evaluation of the entire work, stating whether a publication should or should not be pursued. For poor manuscripts, several bulleted points that indicate the fatal flaw(s) are sufficient, but for good manuscripts, a systematic itemization of weaknesses will improve the quality of the manuscript. Reviews should not be derogatory and should be prompt and to the point.

Humans↗

Publishing a manuscript: analysis of reviewed manuscripts with discussion. Part I.

Fifty-one manuscripts that were submitted for publication to Radiologic Technology were analyzed. The acceptance, revision, and rejection rates of those manuscripts are discussed. The specific reasons for the rejection and for the major revisions needed for many of the manuscripts are emphasized. Manuscript preparation is also discussed.

Periodicals as Topic↗

Publishing a manuscript: manuscript preparation guide for authors. Part II.

Part II presents a guide for manuscript preparation. The guide describes 11 steps necessary to complete a manuscript and is designed to serve several purposes: making the process of having a manuscript published easier for the author and less tedious for the Editorial Review Board; reducing the number of revisions and the revision time; and providing the author with a better chance of getting his or her material published.

Publishing↗

Peer review at the American Journal of Roentgenology: how reviewer and manuscript characteristics affected editorial decisions on 196 major papers.

OBJECTIVE: The objective of this study was to examine the relative influence of manuscript characteristics and peer-reviewer attributes in the assessment of manuscripts. MATERIALS AND METHODS: Over a 6-month period, all major papers submitted to the American Journal of Roentgenology (AJR) were entered into a database that recorded manuscript characteristics, demographic profiles of reviewers, and the disposition of the manuscript. Manuscript characteristics included reviewer ratings on five scales (rhetoric, structure, science, import, and overall recommendation); the subspecialty class of the paper; the primary imaging technique; and the country of origin. Demographic profiles of the reviewers included age, sex, subspecialty, years of reviewing, academic rank, and practice type. Statistical analysis included correlation analysis, ordinal logistic regression, and analysis of variance. RESULTS: A total of 445 reviews of 196 manuscripts were the work of 335 reviewers. Of the 196 submitted manuscripts, 20 (10.2%) were accepted, 106 (54.1%) were rejected, and 70 (35.7%) were rejected with the opportunity to resubmit. Regarding manuscript characteristics, we found that the country of origin, score on the science scale, and score on the import scale were statistically significant variables for predicting the final disposition of a manuscript. Of the reviewer attributes, we found a statistically significant association between greater reviewer age and also higher academic rank with lower scores on the import scale. Reviewer concordance was higher for structure, science, and overall scores than on the rhetoric and import scores. Greater variability in the overall scoring of papers could be attributed to the reviewer than the manuscript, but both factors combined explain only 23% of the total variability. CONCLUSION: At the AJR, manuscript acceptance was most strongly associated with reviewer scoring of the science and import of a major paper and also with the country of origin. Reviewers who were older and of higher academic rank tended to discount the importance of manuscripts.

Analysis of Variance↗

Peer review is an effective screening process to evaluate medical manuscripts.

OBJECTIVE: To measure the effectiveness of peer review as a screening process to evaluate medical manuscripts. DESIGN: Retrospective. SETTING: The editorial office of the American Journal of Surgery (AJS). METHOD: A MEDLINE search was conducted of publications from 1984 to 1992 for manuscripts that were identical or similar to those rejected by AJS between January and December 1989. Manuscripts that were submitted to AJS by foreign authors were excluded because of the presumed difficulty in tracking foreign-language publications. MAIN OUTCOME MEASURES: The percentage of manuscripts rejected by AJS that were subsequently published in journals indexed by MEDLINE, the time from rejection to ultimate publication, and the journal of publication. The reasons for rejection were also documented. We assumed that the majority of rejected manuscripts would be published within 3 years after rejection. RESULTS: One hundred twenty-five manuscripts submitted by North American authors were rejected by AJS in 1989, and 62% were not subsequently published in another core medical journal during the study period. The average duration between rejection and later publication was 17 months. Of those manuscripts subsequently published, 54% appeared in general surgical journals, including 12% that were revised, reevaluated, and later accepted by AJS. Twenty-nine percent of the rejected manuscripts were published in specialty medical journals, 10% in state and local journals, and the remainder in general medical journals. Twenty-eight percent of the authors of rejected manuscripts had previously and subsequently published manuscripts on very similar subjects. CONCLUSIONS: Our data indicate that the review process serves as a sieve and influences whether manuscripts are published in core medical journals. This was demonstrated by the fact that rejected manuscripts often were not published in other indexed medical journals.

Manuscripts as Topic↗

Multiple blinded reviews of the same two manuscripts. Effects of referee characteristics and publication language.

OBJECTIVE: To study the association between referee characteristics and their manuscript assessments, the influence of manuscript language on referees' judgments, and the usefulness, quality, and extent of referees' free-text comments. DESIGN: Two nonauthentic, but realistic, short manuscripts with a number of common methodological flaws were sent to 180 Scandinavian referees. Through randomization, each referee received one of the manuscripts in English and the other manuscript in the national language. A structured assessment of the manuscript quality was expressed on a 5-point scale, and the impact of referee characteristics (age, gender, experience, and so on) was analyzed by multiple linear regression. MAIN OUTCOME: Manuscript quality assessed by referees. RESULTS: A total of 312 reviews from 156 referees could be used for the study of referee characteristics and language. With increasing experience, the referees gave lower quality scores (P < .05). A tendency toward stricter assessment with younger age was seen (P < .05). No influence of referees' gender, specialty, or nationality was found. For the test manuscript of the poorest quality, the English version was assessed to be better than the national-language version (P < .05). A total of 159 of 312 reviews included free-text comments applicable for the methodological study. In 54 reviews (34%), no methodological comments accompanied the assessment, and in six reviews they were only incomplete. Wrong sampling unit was mentioned by one fourth of 80 referees. Only one referee mentioned the incorrect use of a parametric test in the analysis of data whose distribution was nonparametric. CONCLUSIONS: Experienced and young referees gave a stricter assessment of the manuscripts than their less experienced and older colleagues. An English version seemed to be accepted more easily than a national-language version of the same manuscript. Most referees spontaneously mentioned the shortcomings of the manuscripts only as part of their overall judgment.

Humans↗

A bibliographical study on Shutei Nakagawa's "Mayaku-ko" (a collection of anesthetics and analgesics)--a comparism of four manuscripts.

The greatest achievement of Seishu Hanaoka, one of the greatest surgeons in the Edo period, was the innovation of an oral general anesthetic called "Mafutsu-San" and its clinical application, however, the detailed circumstances of the innovation remain unkown to us. Shutei Nakagawa, a close friend of Hanaoka, wrote a small pamphlet entitled "Mayaku-ko" in 1796. This brochure is very important for clarifying the process of Hanaoka's study on the general anesthetic. At present I have found four manuscripts of "Mayaku-ku" which are in the Fujikawa Library of Kyoto University, Soda's Library (Personal Library), the Kyo-u Library of Takeda Pharmaceutical Company, and Matsuki's Library (Author's Library). They are classified bibliographically into two groups. The one includes two manuscripts of the Fujikawa Library and Soda's Library, which describe twenty prescriptions. The other two are the manuscripts of Kyo-u and Matsuki's Libraries describing only fourteen recipes. Among them, the Fujikawa's manuscript is the best, because it has a postscript by Yakushi Mori who transcribed this manuscript from the orginal by Shutei Nakagawa. The Fujikawa manuscript has four illustrations of plants in the end of the manuscript which the other three manuscripts lack. As the original manuscript by Nakagawa was lost in a fire in 1867, it is possible to make an accurate reproduction of the original by bibliographical comparison of four extant manuscripts.

Analgesia↗

Who reviews the reviewers? Feasibility of using a fictitious manuscript to evaluate peer reviewer performance.

STUDY OBJECTIVE: To determine whether a fictitious manuscript into which purposeful errors were placed could be used as an instrument to evaluate peer reviewer performance. METHODS: An instrument for reviewer evaluation was created in the form of a fictitious manuscript into which deliberate errors were placed in order to develop an approach for the analysis of peer reviewer performance. The manuscript described a double-blind, placebo control study purportedly demonstrating that intravenous propranolol reduced the pain of acute migraine headache. There were 10 major and 13 minor errors placed in the manuscript. The work was distributed to all reviewers of Annals of Emergency Medicine for review. RESULTS: The manuscript was sent to 262 reviewers; 203 (78%) reviews were returned. One-hundred ninety-nine reviewers recommended a disposition for the manuscript: 15 recommended acceptance, 117 rejection, and 67 revision. The 15 who recommended acceptance identified 17.3% (95% confidence interval [CI] 11.3% to 23.4%) of the major and 11.8% (CI 7.3% to 16.3%) of the minor errors. The 117 who recommended rejection identified 39.1 % (CI 36.3% to 41.9%) of the major and 25.2% (CI 23.0% to 27.4%) of the minor errors. The 67 who recommended revision identified 29.6% (CI 26.1% to 33.1%) of the major and 22.0% (CI 19.3% to 24.8%) of the minor errors. The number of errors identified differed significantly across recommended disposition. Sixty-eight percent of the reviewers did not realize that the conclusions of the work were not supported by the results. CONCLUSION: These data suggest that the use of a preconceived manuscript into which purposeful errors are placed may be a viable approach to evaluate reviewer performance. Peer reviewers in this study failed to identify two thirds of the major errors in such a manuscript.

Confidence Intervals↗

A brief descriptive catalogue of Ayurvedic palm leaves manuscripts procured and preserved in the Indian Institute of Medicine.

It seems the survey for medical manuscripts has not been done thoroughly so far in India particularly in Andhra Pradesh. Though few Researchers toured many important places and collected a number of manuscripts, but still there are many villages and several families of physicians and scholars possessing many manuscripts, are not covered. One of the aims and objects of the Indian Institute of History of Medicine is to procure and study the rare and uncared medical manuscripts. There are many difficulties in this task as many of the families in possession of the manuscripts are generally not prepared to hand over the ancestry property i.e., manuscripts to any individual or institution due to their sentiments, though they are not able to preserve or make use of same properly. However, efforts were made by the Institute in this direction, visiting several families of hereditary physicians residing in different part of Andhra Pradesh, and procured 12 such valuable palm leaves manuscripts pertaining to Ayurveda and preserved in the Institute. A brief descriptive catalogue of these manuscripts is presented here.

Academies and Institutes↗

Writing manuscripts describing clinical trials: a guide for pharmacotherapeutic researchers.

Once researchers have completed a clinical trial and analyzed the data, they have a duty to make the results known to their peers by writing a manuscript suitable for publication in a biomedical journal. Before beginning any writing, those involved in the clinical drug trial first need to decide among themselves who is to be the first author and secondary authors, the readership they want to influence, and the most appropriate target journal to reach this readership. For content and formatting of the manuscript, writers need to carefully follow the instructions for authors as stipulated by the target journal. In general, a manuscript based on a clinical trial is presented sequentially in four sections: Introduction, Methods, Results, and Discussion (IMRAD). The introduction concisely presents background information about the topic that was researched in the clinical trial, provides the study hypothesis, and describes the study rationale, purpose, and objectives. The Methods section delineates the study design, subject/patient selection process, procedures, end points, and types of analysis conducted in the clinical trial to investigate the study hypothesis. The Results section presents the findings of the clinical trial, and the Discussion section interprets the meaning of these findings, assesses how the findings answer the study hypothesis, and compares the study data with findings reported in earlier studies. Writers should select a title for the clinical trial manuscript that is fewer than 10 words and which embodies the essence of the study findings clearly and specifically without being sensationalistic. Writers should create the abstract last; the abstract should provide an overview of the manuscript and stimulate readers' interest. Overall, following the above principles in writing a manuscript based on a clinical drug trial will make the actual writing easier and more enjoyable, as well as increase the possibility of the manuscript being accepted for publication.

Clinical Trials as Topic↗

Do readers and peer reviewers agree on manuscript quality?

OBJECTIVE: To study readers' judgments of manuscript quality and the degree to which readers agreed with peer reviewers. DESIGN: Cross-sectional study. SETTING: Annals of Internal Medicine. SUBJECTS: One hundred thirteen consecutive manuscripts reporting original research and selected for publication. Each of two manuscript versions (one before and one after revision) was judged by two readers, randomly sampled from those who said (based on the title) that they would read the article; one peer reviewer (peer), chosen in the usual way for Annals; and one expert in clinical research methods (expert). Each judge completed an instrument that included a 10-point subjective summary grade of manuscript quality. MAIN OUTCOME MEASURES: Agreement on the 10-point summary grade of manuscript quality between reader-expert, reader-peer, and reader-reader. RESULTS: Readers and peers gave high grades (77% and 73% gave a grade of 5 or better, respectively), while experts were more critical (52% gave a grade of 5 or better; P < .0001). Agreement was relatively high among judge groups (in all cases, > 69%) but agreement beyond chance was poor (kappa < 0.04). One third of readers (33%) thought that the manuscript had little relevance to their work. CONCLUSION: Readers, like most peer reviewers, are generally satisfied with the quality of manuscripts but would like research articles to be more relevant to their clinical practice.

Cross-Sectional Studies↗