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
Erik R. de Loos, Zuyderland Medical Center, the Netherlands
James O’Rourke, Royal College of Surgeons in Ireland, Ireland
Gabrielle Drevet, University Hospital of Lyon, France
John Mackintosh, The Prince Charles Hospital, Australia
John Kit Chung Tam, National University of Singapore, Singapore
Piotr Skrzypczak, Poznan University of Medical Sciences, Poland
Patrick Zardo, Hannover Medical School, Germany
Néstor J. Martínez-Hernández, La Ribera University Hospital, Spain
Benoît Bédat, University Hospitals of Geneva, Switzerland
Ashwini Arjuna, St. Joseph’s Hospital and Medical Center, USA
Nuria M. Novoa, University Hospital of Salamanca, Spain
Toyofumi Chen-Yoshikawa, Nagoya University, Japan
Roger L. Royster, Wake Forest University, USA
José Sanz-Santos, Universitat de Barcelona, Spain
Dominique Vervoort, University of Toronto, Canada
Hiroshi Kubota, Kyorin University, Japan
Edward Buratto, Columbia University, USA
Suk-Won Song, Yonsei University College of Medicine, Korea
Michael Brenner, University of Michigan, USA
Barry C Gibney, Medical University of South Carolina, USA
Alberto Cabañero Sánchez, Ramón y Cajal University Hospital, Spain
Avinash Aujayeb, Northumbria Healthcare NHS Foundation Trust, UK
Alex Fourdrain, Marseille University Hospital, France
Puja Khaitan, Mayo Clinic, United Arab Emirates
Ikenna Okereke, Henry Ford Health, USA
Savvas Lampridis, Imperial College Healthcare NHS Trust, UK
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.
Erik de Loos
Dr. Erik R. de Loos is a thoracic and trauma surgeon, working as a staff member at the Department of Surgery of Zuyderland Medical Center (Heerlen, the Netherlands) since 2011. His special interests are minimally invasive thoracic surgery, chest wall surgery and the treatment of thoracic, pelvic and acetabular injuries. Since 2015, he is vice-chair of the general surgical training programme and chair of the thoracic surgical training programme at his institution. He is actively involved in numerous national and international courses in the field of minimally invasive thoracic surgery, chest wall surgery and trauma surgery. He is a certified Advanced Trauma Life Support (ATLS) course director and board member of the Dutch ATLS Society on behalf of the Dutch association for trauma surgery (NVT). His research focusses mainly on minimally invasive thoracic surgery (uniportal VATS), chest wall pathologies including oncology, trauma and pectus deformities, and perioperative care. He successfully defended his thesis “Pectus excavatum: improvements in surgical care” and obtained a PhD degree at Maastricht University (the Netherlands). You may connect with Dr. de Loos on LinkedIn.
Peer review, in Dr. de Loos’ opinion, is a key part of scientific research. Peer review improves the quality of published literature, both in general as for individual papers. Almost in any case, comments by reviewers are constructive and aim to take the submitted manuscript to an even higher level. Furthermore, it ensures transparency in whether or not to accept an article for publication.
To ensure a review is as objective as possible, Dr. de Loos suggests reviewers read and comment on a manuscript not hampered by their own preoccupations. Being aware of one’s own preoccupations is important to set them aside and comment on a manuscript objectively.
From the perspective of a reviewer, Dr. de Loos emphasizes that transparency about any potential conflicts of interest (COI) is crucial. COI can have a significant impact on the quality of the manuscripts submitted and its review and acceptance processes. The reader deserves to be able to read objective and pure literature, enabling them to provide excellent patient care.
“By acting as a peer reviewer, I am able to make a small contribution to the quality of the published literature in my field. Broad willingness to review allows shorter turn-around times for submitted manuscripts. Furthermore, it stimulates my own interest, develops my general and specific knowledge, and boosts a broad orientation within my field. And last but not least, I really appreciate to receive timely and high-quality feedback on the manuscripts by our own research department. Noblesse oblige,” says Dr. de Loos.
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.
John A. Mackintosh
Dr. John Mackintosh, MBBS, FRACP, is a respiratory and lung transplant physician with the Queensland Lung Transplant Service at The Prince Charles Hospital, Brisbane, Australia. He completed a clinical fellowship in interstitial lung disease at the Royal Brompton Hospital, London. His special interest is in interstitial lung disease and particularly the role of genetics to aid diagnosis and guide management. His current research focusses on telomere disorders and their impact before and after lung transplantation. Dr. Mackintosh is currently conducting a clinical trial of danazol in short telomere associated pulmonary fibrosis.
Peer review is critical, according to Dr. Mackintosh, to ensure that science is presented in the most transparent form possible. The peer-review process provides constructive feedback to enable authors to improve their manuscripts. During the process, reviewers should keep in the mind the eventual readers and ensure that the data is correct and presented in such way that it is understandable to the non-expert readers.
As a reviewer, Dr. Mackintosh lays emphasis on the importance for conflicts of interest to be declared by researchers. The relationship between clinical researchers and pharmaceutical companies is important and helps to facilitate scientific progress. However, to ensure the transparency of any manuscript, such a relationship should always be declared to the readers.
“It is important to enjoy the review process. Despite the fact that manuscript review often occurs outside of ‘work hours’, it is an opportunity to see someone’s research before the rest of the world and provide feedback that might ultimately impact patient outcomes,” says Dr. Mackintosh.
John Kit Chung Tam
Dr. John Kit Chung Tam is Head and Senior Consultant Thoracic Surgeon at the National University Health System of Singapore, and Associate Professor of Surgery at the National University of Singapore. He is also Chairman of the Cardiothoracic Surgery Residency Advisory Committee in Singapore. He is passionate about creating innovations in the fields of minimally invasive thoracic surgery, uniportal thoracoscopic surgery, multi-modal pain reduction strategies, and enhanced recovery after thoracic surgery. His research work also encompasses translational research in molecular and cellular biology for early diagnosis of lung cancer. More information about Dr. Tam can be accessed here.
The due process of scientific enquiry is important to uphold high quality standards in research. This process culminates in the form of peer review by like-minded colleagues in the field before the manuscript can be accepted for publication. At best, according to Dr. Tam, the peer-review process can improve the quality of the paper, bring better clarity to the significance of what is being communicated, and crystalize the impact of the new research findings. The peer-review process also encourages reviewers to be up to date with latest advancements in the field, and brings reviewers together to become a more closely knitted scientific community.
In Dr. Tam’s opinion, a good reviewer should possess a spirit of service to the profession, to the scientific community, and to fellow colleagues. This is ultimately for the sake of advancing science to better serve our patients. In order to fulfil this role, the reviewer should be well grounded in the processes and methodologies of scientific inquiry, and they should endeavor to keep up to date with the current body of knowledge. The reviewer should possess an openness to new ideas and a willingness to challenge accepted norms and dogmas. The reviewer should possess a critical eye together with an analytical mind to impartially evaluate the validity of the evidence and its claims. The reviewer should be helpful to offer suggestions and advice whenever possible to improve the overall quality of the manuscript.
Obtaining institutional review board approval is now well accepted as an integral part of the scientific inquiry process. To Dr. Tam, this upholds the ethical standard of research conduct, protects the inherent rights of patients, and ensures the research is conducted in a humanistic manner. The approval process requires investigators to carefully think through the scientific enquiry process. This will help to ensure that the research is well grounded in science and that the best methodology is employed. The quality of research will suffer if this approval process is omitted, and such violations may bring harm to patients and disrepute to the profession.
“In the magnificent tapestry of scientific advancements, each of our individual contributions may seem small and insignificant. Yet, we must consider each and every one of us as vital, and not to count ourselves out. We must believe in the importance of our work, however meager it may be. The world runs by us doing our best with what is within our capacity. As E.B. White wrote: ‘As long as there is one upright man, as long as there is one compassionate woman, the contagion may spread and the scene is not desolate. Hope is the thing that is left to us,’” says Dr. Tam.
Dr. Piotr Skrzypczak, MD, currently works at the Department of Thoracic Surgery at Poznan University of Medical Sciences in Poland. He graduated from the Faculty of Medicine of the Poznan University of Medical Sciences and postgraduate studies in Biostatistics at the Jagiellonian University in Cracow. After graduation, he began his residency training in thoracic surgery, initially working in general surgery departments in district hospitals in Środa Wielkopolska and Kościan. Dr. Skrzypczak is passionate about ultrasound, which he tries to apply to many clinical issues, including lung imaging. His latest research focused on possible predictors of bronchopleural fistula formation, various possibilities of reducing the incidence of the bronchopleural fistula, long-term quality of life after thoracic resections, and the issue of complications in thoracic surgery in patients after Covid-19. In addition, he investigated the ability of Google Trends to predict epidemiological phenomena and global interest in health topics. Dr. Skrzypczak’s profile can be accessed here.
A healthy peer review system, according to Dr. Skrzypczak, is not only a fair and unbiased process, it must also run smoothly in terms of time: it should not be spread over several months. Collaboration between editors and reviewers should focus on effectively evaluating scientific papers: selecting those worth publishing and helping those that require improvement. The ultimate goal of healthy peer review should be to promote good-quality science and methodologically accurate.
To Dr. Skrzypczak, the reviewer’s attitude should combine vast knowledge and clinical experience with an understanding of biostatistics and research methodology. The combination of these features allows the selection of attractive, up-to-date, well-written, and methodologically accurate papers. However, there is no good reviewer without a bit of understanding and willingness to help. The main task of a good reviewer is to do everything to make a given paper better. It is often associated with the need to devote much private time. A good reviewer should point out possible mistakes and explain how they should be corrected. Thus, the reviewer should “eliminate the mistakes, not the researcher” - through empty comments containing no further clues or minimal willingness to help. Thus, the reviewer should feel obliged not only to evaluate, but also to help other researchers to improve their future scientific attempts.
From a reviewer’s perspective, Dr. Skrzypczak emphasizes that following reporting guidelines (e.g. CONSORT and PRISMA) during the preparation of manuscripts is crucial. Science makes sense only when it is conducted reliably, based on the appropriate research methodology, and following the basic principles of reporting scientific reports. These guidelines allow for organizing this complex and challenging process more accurately. Moreover, they help, especially novice researchers, include the crucial points that an excellent scientific article should not miss. Following reporting guidelines also improves the peer-review process.
“To allocate time for peer review, you need to love science and teaching. The peer-review process helps enrich and develop science with valuable articles and innovative discoveries. Also, when evaluating the scientific papers of other authors, you should always see an opportunity for your personal development. The peer-review process is a unique opportunity for that: to meet the responsibility of evaluating someone’s paper, you must read a lot and follow the latest reports in a given field. In addition, peer review teaches honesty and critical thinking and allows you to develop your research workshop. All these, combined with the satisfaction of effective help in improving someone’s work, makes peer review not another duty but another adventure in the world of science,” says Dr. Skrzypczak.
Dr. Patrick Zardo currently serves as Head of Thoracic Surgery in the Department of Cardiothoracic, Vascular and Transplantation Surgery at Hannover Medical School (Hannover, Germany). His main clinical interests include minimally invasive lung surgery under spontaneous ventilation, hyperthermic intrathoracic chemoperfusion in mesothelioma treatment and oncological resection on cardiopulmonary bypass. Recently, his scientific focus shifted towards understanding the role of miRNA in lung cancer and development of novel delivery routes for intracavitary chemotherapy.
Even though we believe science to be a highly objective way of pursuing knowledge, and we strive to draw scientific conclusions in as much an open-minded and bias-free way as possible, the way raw data is collected and interpreted may be prone for misinterpretation. In Dr. Zardo’s opinion, peer review helps in ascertaining quality of this process by challenging all involved parties to draw plausible conclusions solely based on sound data.
“Objectivity is crucial in reviewing the work of our peers,” says Dr. Zardo. To achieve this, he believes the reviewer should be familiar with the topic that is dealt with, be free of prejudice and be ready to getting challenged all along the way. An objective review is time-consuming, as one needs to carefully sift through the presented data and try to understand the thought process that ultimately lead to others drawing certain conclusions. Objectivity is served whenever every single step of this path remains reproducible, understandable and plausible.
Speaking of the need for original research to apply for institutional review board (IRB) approval, Dr. Zardo believes that it is an essential step in preventing human beings from getting harmed in physical or psychological form while taking part in scientific endeavors. This is achieved by reviewing research protocols and related materials as to their compliance with national and international ethical standards and by ascertaining that all participants are both fully informed and voluntary. By including non-academia members into IRBs or Ethics committees, we ensure a balanced and multifaceted appraisal of research proposals. Omitting this form of process would potentially promote conduct of unethical research, as no societal and ethical boundaries are set.
“Pioneers and leaders in their respective fields often strive to increase knowledge solely based on internal dedication and passion for their work. As peer reviewing is an essential part in helping scientific progress, I gladly support this progress by putting in some work,” says Dr. Zardo.
Néstor J. Martínez-Hernández
Dr. Néstor J. Martínez-Hernández is a consultant thoracic surgeon at the Department of Thoracic Surgery belonging to the La Ribera University Hospital (Alzira, Valencia, Spain). His daily clinical focus is the minimally invasive surgical treatment of lung cancer and airway (tracheal and laryngotracheal) advanced surgery. He is the editor of the Spanish Society of Thoracic Surgery Consensus Document of Airway Surgery and the author of several papers on tracheal surgery. He has also dedicated his academic research to airway surgery, with a special focus on tracheal substitution. He earned his PhD in 2020 with his dissertation titled “Development of an allogenic tracheal transplantation in vivo model in lagomorphous”, which won the Universitat de València Extraordinary PhD Award. He is currently the head of the Scientific Committee of the Spanish Society of Thoracic Surgery and a member of the editorial board for the Spanish Surgery Journal (Cirugía Española). Here are some platforms where you can learn more about Dr. Martínez-Hernández: LinkedIn and ResearchGate.
Peer review comprises the foundations on which the reliability of the entire scientific production model is based. In Dr. Martínez-Hernández’s opinion, peer review is what ensures a paper meets all the requirements scientific work must meet; not just when it comes to the correct expressions or spellings, but above all it is the tool that we – the scientific community – use to ensure the paper’s ethics and its accuracy, and to verify the entirety of its content before it reaches the publication phase, where it is accessible by everyone.
When Dr. Martínez-Hernández reviews papers, he tries to minimize any potential biases by adopting the following steps. First, he tries to work with as little personal information about the authors as possible. In this way, he tries not to take into account expressions which could be from a particular area, or even English imperfections which could also indicate the author’s origin. Usually, such imperfections are corrected during the review process and do not substantially change the paper’s message. It is important to always try to approach the paper in the most impartial way.
From a reviewer’s perspective, Dr. Martínez-Hernández stresses the importance for authors to share raw research data. To him, data form the basis for any conclusions the authors may draw. We cannot believe a statement to be true if we cannot verify the data behind it. Indeed, data are also what other authors will use to continue one’s research from where the original authors left it. In short, data sharing is of paramount importance for progress in the scientific community.
“Receiving a peer-review request always constitutes extra work. But it is not just work; it is responsibility. Your review plays an important role in the decision of whether or not a paper will be published, and if future medical and scientific decisions will be made in accordance with the paper’s findings. For me, this makes conducting peer reviews a task of great pride and self-satisfaction, so despite always having a very full schedule, I always manage to find the time, even if that does mean taking it from my free time,” says Dr. Martínez-Hernández.
Dr. Benoît Bédat currently serves at the University Hospitals of Geneva, Switzerland. After obtaining his medical degree at the University of Geneva, he began his training in surgery in Geneva and obtained his title of specialist in surgery. In 2015, he joined the service of Professor Triponez and began his training in thoracic surgery. Then, he completed his skills in thoracic surgery in Marseille and Lausanne at the CHUV, and obtained his title of specialist in thoracic surgery. Dr. Bédat obtained his doctorate in medicine and a certificate of advanced study in clinical research. His clinical research is focused on intraoperative fluorescence imaging and minimally invasive surgery. He is also the sponsor and the principal investigator of a multicenter randomized clinical trial on rib fractures. He is a member of the Swiss Society of Thoracic Surgery and of the European Society of Thoracic Surgeons. More information about Dr. Bédat could be accessed on his personal page.
To Dr. Bédat, peer review is the principal mechanism to ensure the quality of scientific research. The reviewer, thus, takes on a great responsibility. He feels that this sense of responsibility has increased due to a growing public distrust of science. He explains, “During the Covid period, we saw how article retraction in a high impact journal could discredit science, as well as predator journals. Therefore, the role of peer review is also to guarantee the quality, independence and ethics of scientific research.”
Reviewer responsibilities, according to Dr. Bédat, are at several levels: towards the authors providing constructive feedback or criticism; towards the editors alerting about any personal conflict of interest; towards readers ensuring good quality of the article; and towards one’s profession and patients in order to improve one’s practices. The integrity and competence of the reviewer is, therefore, crucial for science.
Beyond the scientific and methodological judgment, Dr. Bédat always wonders if the article is relevant. He ignores the impact factor of the journal. If the quality is not good, it should not be published, even in a journal with a low impact factor.
On the other hand, from a reviewer’s perspective, Dr. Bédat emphasizes that research data sharing is crucial and should be mandatory. This would avoid any scientific dishonesty and perhaps improve the quality of the article, improving dialogue between authors and reviewers.
“I select the articles that I am offered to review. If it’s not in my area of expertise, I refuse. Having a good knowledge of the subject saves time. Second, I accept only if I have time to review and am able to render a good-quality expertise. I have no protected time for research. So sometimes I have to stay longer at work or work over weekends,” says Dr. Bédat.
Dr. Ashwini Arjuna is a lung transplant pulmonologist at Norton Thoracic Institute, St. Joseph’s Hospital and Medical Center in Phoenix, Arizona, USA. Her clinical areas of focus include advanced lung disease that may result in the need for a transplant and pre/post- lung transplant care. She is also very interested in research with her main focus being on two particular aspects of transplantation: primary graft dysfunction and antibody mediated rejection in transplantation. Her current research project is about optimizing immunosuppression in lung transplant recipients with an aim to minimize other organ injury through the use of a novel medication that is not readily available to transplant recipients. Learn more about Dr. Arjuna here.
JTD: Why do we need peer review? What is so important about it?
Dr. Arjuna: Medicine is rapidly evolving and changing, lending itself to endless opportunities for advancement and new discoveries. With any advancement, there is inherit risk of misappropriation of information, facts, figures, etc. The role of peer review is to allow others to follow the evidence-based medicine practice through evaluating articles, facts, figures and solidify the validity of the quality and originality of the scientific data being presented.
The benefits extend beyond the basic verification and fact finding. I have found that being part of a peer review community has allowed me to develop my ideas, hone my writing skills and navigate through a multi-disciplinary approach to available scientific information and brainstorming concepts from different perspectives. The additional feedback from colleagues motivates authors to improve their quality of work and help maintain scientific integrity.
JTD: Biases are inevitable in peer review. How to you minimize any potential biases during review?
Dr. Arjuna: Critical evaluation of a manuscript can become a slippery slope without a selection of appropriate reviewers to analyze the work. The responsibility falls to the reviewer to ensure that the least amount of bias – if any – enters their responses when reviewing manuscripts. It is very easy to become consumed by your area of research/work and carry forward an opinion on the subject without inserting some aspect of bias. Reviewers need to be transparent with the author and themselves in situations where a bias might occur. This includes being willing to forego reviewing work that cannot be appropriately evaluated without a bias towards the subject matter. I have had to decline manuscript reviews where I feel I cannot provide an objective evaluation.
JTD: Why is it important for a researcher to apply for institution review board (IRB) approval? What would happen if this process is omitted?
Dr. Arjuna: IRB serves as an excellent administrative body to help protect subjects and their best interests, follow needful regulations and meet institutional and ethical standards in the area of scientific research. The IRB review process guides the study so that necessary requirements are met and provide tools to help facility research without redundancy. Omitting the entire IRB process could potentially result in mistrust and breach of conduct while reviewing work from participating individuals. This raises the possibility of defeating the entire purpose of scientific contribution to broaden our knowledge.
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. Arjuna: The ability to understand and accelerate science is an ongoing process often involving long hours of arduous work and experimentation. The responsibility and role of a reviewer is to allow work to reach a larger audience though, at times, difficult. However, the advancement of medicine relies heavily on the accuracy of new discoveries and the importance of evaluating each of these areas thoroughly including keeping up-to-date with information, wanting to learn, exploring ideas and networking with a bigger community to bring about change. I would like to thank the individuals who contribute to exponential growth in scientific activities. Your work is appreciated and I view your devotion and time as a means by which to give back to the medical community. I had the opportunity to become familiar with the peer-review process early in my career thanks to a wonderful mentor. As I continue expanding my own ideas, I view it as my responsibility to nurture and guide young clinicians/researchers on this journey.
Dr. Nuria M. Novoa is based at the University Hospital of Salamanca, Thoracic Surgery Department, developing research at the Salamanca Institute for Biomedical Research (IBSAL) and working part time at the University of Salamanca, Salamanca, Spain. As a surgeon, risk assessment is a must and it has led to much of her research. Lung cancer patients have been in the center of her investigation. Currently, she is working on a new joint guideline on fitness for radical lung cancer treatment. At this moment, being the ESTS Director of Education occupies her the most. It means to have all her energy focused on developing all the educational possibilities of the society. A list of research of Dr. Novoa can be found here.
JTD: Why do we need peer review? What is so important about it?
Dr. Novoa: Research is a long way to discover the unknown. At this moment, only cooperative investigation can bring us to a successful target. This cooperative investigation can progress if we are good enough at communicating our achievements. Proper communication means clear conclusions based on adequate methodology that produces robust results. The only way to confirm those steps are correct in a specific study is the peer review process. During this process, editors and reviewers confirm the innovation, the adequacy of the method and the value of the conclusions. Peer review adds real value to all manuscripts. Without peer review, uncertainty would be in the background of the communication process and science would not be able to progress.
JTD: What do you regard as a constructive/destructive review?
Dr. Novoa: Constructive review is the one that helps authors improve their paper. This means that reviewers look and ask for details to improve the quality of the presentation of the study and the quality of the communication. For instance, sometimes, authors who had in their minds a lot of information choose to present the study in such a way making the manuscript impossible for outsiders, although having an interesting and innovative study. Other authors have difficulties clarifying the main idea or ideas they want to communicate after a successful investigation. Those are situations in which peer review can help a lot. In the end, it is very interesting to compare the initial manuscript with the one that implements the different suggestions of the reviewers. They can be very different, although communicating the same and, of course, with better quality. Peer review is not easy. And, furthermore, we are not taught how to do it until you get a lot of experience reading, writing and reviewing papers.
Sometimes inexperience is at the base of a destructive review. Destructive review is the one in which reviewers do not try to help authors, but to change the paper using negative and impolite comments and suggestions. Normally, in these circumstances, reviewers do not suggest but impose. In my opinion, no matter how low-quality a manuscript is, it deserves full attention. Besides, rejection deserves a full explanation, normally larger.
Reviewing is a quality control task. Reviewers need to be professional showing respect to the authors, to their knowledge and to the way they try to communicate it. At the same time, it is necessary to be honest to you, to the editor and to the authors. Any other position would not improve quality neither during the research process nor during the communication. Comments over a certain study can influence the way a future study is planned by this group of authors. Reviewing involves a large responsibility. The final responsibility is on the editor’s shoulders but not only. It starts in the individual reviewer.
JTD: Why do you choose to review for JTD?
Dr. Novoa: I like the journal. Its open access has made available a lot of information that in other circumstances could be difficult to find. It has a large impact factor and it has obtained it in a short time, which means it has been publishing good-quality papers. I am proud to be part of the reviewer board of the journal.
JTD: Data sharing is prevalent in scientific writing in recent years. Do you think it is crucial for authors to share their research data? And why?
Dr. Novoa: I am in favor of data sharing, although I can understand it is a debatable topic and can be difficult. In my opinion, authors should be prepared to share their data under clear and justified requests. Data sharing has several advantages such as i) e-analysis of data helps verify results data, which is a key part of the scientific process; ii) different interpretations or approaches to existing data contribute to scientific progress - especially in an interdisciplinary setting; iii) well-managed, long-term preservation helps retain data integrity; iv) when data is available, (re-)collection of data is minimized; thus, use of resources is optimized; v) data availability provides safeguards against misconduct related to data fabrication and falsification; and vi) replication studies serve as training tools for new generations of researchers (1). Back in 2011, sharing practices were minimal. In 2020, a specific survey on data sharing and reuse showed that data sharing and data reuse were viewed positively (2): over 85% of respondents admitted they would be willing to share their data with others and said they would use data collected by others if it could be easily accessed. A vast majority of respondents felt that the lack of access to data generated by other researchers or institutions was a major impediment to progress in science at large, yet only about a half thought that it restricted their own ability to answer scientific questions. Despite this positive attitude, practice does not always support data storage, sharing, and future reuse. A long change in personal culture but also in the systems storing data beyond the life of the research process are basic to move data sharing into a normal scientific practice.
- Tenopir C, Allard S, Douglass K et al. Data Sharing by Scientists: Practices and Perceptions. PLOS ONE 6(6): e21101.
- Tenopir C, Rice NM, Allard S et al. PLoS One. 2020 15(3):e0229003
Dr. Toyofumi Chen-Yoshikawa is a Professor in Thoracic Surgery at Nagoya University Hospital, Nagoya University Graduate School of Medicine, Japan. He graduated from Faculty of Medicine at Kyoto University in 1997, and obtained Japanese medical license in 1997. After obtaining PhD in Kyoto University Graduate School of Medicine in 2007, he joined the faculty of General Thoracic Surgery at Kyoto University. He also underwent clinical fellowship in lung transplantation at Toronto General Hospital. From 2009 to 2019, he worked in Kyoto University with Prof. Hiroshi Date. In 2019, he became a Professor in Thoracic Surgery at Nagoya University Hospital. His main research and interests include lung cancer, lung transplantation (lung preservation, ischemia-reperfusion injury, surgical technique, living-donor lobar lung transplantation, and chronic lung allograft dysfunction), minimally invasive thoracic surgery, and surgical simulation and training. You may view Dr. Chen-Yoshikawa’s profile here.
In order to evaluate a scientific manuscript accurately, peer review is important. To Dr. Chen-Yoshikawa, peer review often not only criticize a manuscript but also sophisticate it. This is why peer review is essential to maintain the level of a journal. He explains, “A review that is instructive will become a constructive review. If not, it will become destructive.”
From the perspective of a reviewer, Dr. Chen-Yoshikawa recommends authors to disclose Conflict of Interest (COI). On one hand, disclosing COI can improve the transparency of the research. On the other hand, it will also affect the interpretation of research as well as its evaluation.
Roger L. Royster
Roger L. Royster, MD, is Professor and Executive Vice Chair in the Department of Anesthesiology at the Wake Forest University School of Medicine in Winston-Salem, North Carolina, USA. He is boarded in Internal Medicine and Cardiology as well as Anesthesiology and Critical Care Medicine. He is Chair of the Patient Blood Management program at his institution and has clinical interests in hemodynamic monitoring, coagulation and anemia management, and cardiac arrhythmias, and research interests in inotropic and vasoactive drugs, cardiac tamponade, and anesthesia for electro-physiologic procedures.
The process of having experts in their field reviewing and critiquing manuscripts prior to publication is an important process, in Dr. Royster’s view, to improve the quality of the paper, and also the application of science into the cutting-edge care applied to patients. Most peer-reviewed publications, including clinical trials, review articles and even case reports can add value to the practice of medicine for most physicians.
Often the personal experience of the reviewers inevitably plays a role in how a manuscript is reviewed. Dr. Royster thinks it is critical for the reviewers of journals to look at the data being presented with as much objectivity as possible, even if it might disagree with one’s thoughts and experience with the topic. He adds, “Our goal is to improve knowledge of physicians caring for patients, including your own. Also, the authors may have bias evident in the manuscript in terms of not including references that may contradict some aspects of the research. This is often an overlooked problem by reviewers.”
In Dr. Royster’s opinion, conflict of interest (COI) can play an important role in the publication of research and it is often not possible for a reviewer to determine COI in papers. Reviewers must carefully look at data and the conditions the data are being obtained. He explains, “I have had at least two manuscripts that I was very suspicious that the data were not real and it was important that I at least alert the editors of this possibility. However, this is a rare occurrence and I think most authors despite receiving grant money from companies will report their findings in an honest manner which is critically important since the research could eventually be applied to patient care. Honesty and integrity are required on both sides of this process.”
“I have found the review process to be educational to myself and I rarely review a paper that I don’t at least learn something about the topic or find a reference that I may not be aware of in an area of interest. Researchers are often reviewers, and reviewers are often researchers. I think the overall process improves both the quality of research and the quality of the review process,” says Dr. Royster.
Dr. José Sanz-Santos is currently the head of Department of Pulmonology at Hospital Universitari Mútua and associate professor at the School of Medicine at Universitat de Barcelona, Spain. He studied Medicine at his hometown Sevilla in Andalucia, and obtained his degree in Pulmonology in 2003 at Hospital Germans Trias Pujol in Badalona. In 2017, he moved to Terrassa and started working at his current position. His area of research, considering the topic of most of his scientific articles, is the mediastinal staging of non-small cell lung cancer, specially focused on EBUS-TBNA. You may connect with Dr. Sanz-Santos through Twitter @JosSanzSantos1.
A healthy peer review, according to Dr. Sanz-Santos, is one that is made by experts in the field and is minimally biased. He explains, “I only accept reviewing manuscripts that are clearly of my area of expertise, I try to be objective as much as possible and suggest only changes that I honestly believe can enhance the manuscript. Something that bother me a lot is when I must suggest many changes, even if they are minor changes. I think that reviewers must carefully evaluate the manuscript but rewriting the manuscript is not a reviewer’s commitment.”
Data sharing is prevalent in scientific writing in recent years. Dr. Sanz-Santos emphasizes that it is crucial for authors to share their research data. In his experience, many members of his family are biologists and their databases not only have to be published, but they must also be shared with other colleagues (who could make use of them). In Medicine, all the knowledge is based on trust to other colleagues. We all know there are many hidden interests of different kind that could bias the scientific publications. For this reason, he believes that medical scientific publications should be more controlled than they currently are, especially on these days of skepticism in science.
“What motivates me the most to review is the topic of the manuscript. If I think I can offer value to the manuscript (based on my experience or knowledge), I accept to review. Whenever I consider that I am not fully expert in the topic, I reject the invitation,” says Dr. Sanz-Santos.
Dr. Dominique Vervoort is a PhD in Health Services Research and Vanier Scholar at the Institute of Health Policy, Management and Evaluation at the University of Toronto, Canada, studying disparities in cardiac surgery. He completed his MD at the KU Leuven and his MPH/MBA at the Johns Hopkins University. Previously, Dr. Vervoort completed the Paul Farmer Global Surgery Fellowship at the Program in Global Surgery and Social Change at Harvard Medical School. He introduced the concept of global cardiac surgery to literature and advocates for the six billion people without access to cardiac surgical care as Founding President of the Global Cardiac Surgery Initiative and as World Heart Federation Emerging Leader. As an aspiring cardiac surgeon, his interests lie in aortic and congenital heart surgery and disparities in accessing cardiac care. He further serves as Advisor to the Global Surgery Foundation and Board Member for the Global Alliance for Rheumatic and Congenital Hearts. Connect with Dr. Vervoort on Twitter.
JTD: What do you regard as a healthy peer-review system?
Dr. Vervoort: A healthy peer-review system requires efforts from everyone involved. First and foremost, reviewers should have content and/or methodological expertise (as appropriate) and are required to be sufficiently critical. Such criticism should be constructive in order to improve the research at hand and indirectly build research capacity; after all, authors have much to learn from expert reviewers. Second, authors should facilitate peer review by adhering to the journal’s author guidelines, reporting guidelines (if available), and the principles of transparency and reproducibility. Third, editors and journals should respect authors and reviewers in terms of commitments, as busy professional and personal schedules often conflict with the time pressures of academia. In addition, as peer review is generally not compensated, reviewers’ voluntary time away from their work and families should be acknowledged. It is thus clear that a healthy peer-review system is a multi-stakeholder initiative. Ultimately, the goal of peer review is to help researchers and science at large: sound and noteworthy research makes everyone “win”.
JTD: What do reviewers have to bear in mind while reviewing papers?
Dr. Vervoort: Reviewers are often, albeit not always, experts in the topic or methodology of the paper that is being reviewed. When reviewing, the following points are important:
- Transparency: does the paper sufficiently describe the data used, methodologies applied, and results obtained?
- Reproducibility: based on the data and methodology, would readers be able to replicate the study and obtain the same or similar findings?
- Jargon and technicalities: would readers with only a superficial or minimal understanding of the matter be able to understand the scope and implications of the paper?
- Research equity: is the research conducted equitably, whether in terms of conduct (i.e., research ethics) or authorship (e.g., data used from a given setting or country without local authors being involved)?
JTD: From a reviewer’s perspective, do you think it is important for authors to follow reporting guidelines (e.g. STROBE, PRISMA and CARE) during preparation of their manuscripts? And why?
Dr. Vervoort: Reporting guidelines have generally been developed through rigorous, multi-disciplinary processes and informed by experts from widely different backgrounds. The guidelines are intended to serve as a benchmark for authors, reviewers, and journals alike to adhere to research best practices specific to distinct study designs (e.g., PRISMA guidelines for systematic reviews), which can also facilitate reviewers’ ability to critically evaluate research. Accordingly, reporting guidelines serve to promote “evidence-based research conduct” in a similar way that rigorous research promotes evidence-based medicine.
JTD: Peer reviewing is often anonymous and non-profitable, what motivates you to do so?
Dr. Vervoort: Science should not just be about taking but also giving. I firmly believe in community-driven efforts and the concept of “do for others what you want others to do for you”. As a researcher, we rely on the expertise of peer reviewers to improve our research and publications, both in terms of academic rigor and to best convey our messages to the readers. Similarly, as a clinician, evidence-based medicine relies on rigorous and critically evaluated evidence to inform our practice. Peer review is one of the foundations of scientific rigor, and we all have a role to play to maintain that by serving as reviewers ourselves and continuing to grow in that role.
Dr. Hiroshi Kubota has been the Professor and Chairman of the Department of Cardiovascular Surgery, Kyorin University, Japan since 2011. He graduated from Tsukuba University and received his medical degree from Tokyo University School of Medicine. He completed his Cardiovascular Residency at the Tokyo University, and did his fellowship at Tokyo University and at Auvergne University in Clermont-Ferrand, France. In 1998, he joined the Tokyo University and Kyorin University as Assistant Professor of Cardiovascular Surgery. Dr. Kubota’s research focuses on the surgical treatment of arrhythmias, aortic surgery, brain protection, valvular surgery, and the development of a new surgical ablation device. His numerous studies have been funded by the “Japanese Ministry of Education Ministry of Education, Science and Culture,” “Japanese Heart Foundation and Pfizer Foundation,” “Fujita Memorial Medical Research Fund,” “Leading-edge Industry Design Project, Medical Innovation, Saitama Prefecture, Japan,” and “TERUMO life-science foundation.” He holds patents for “Infrared denature device” (Japan, U.S., France, Germany, and Italy) and “Stent graft delivery system” (Japan). Dr. Kubota is an editor, associate editor, and reviewer for numerous surgical and cardiology journals, and he has authored several book chapters and authored or co-authored numerous peer-reviewed articles. Please visit his homepage here for more information.
JTD: Why do we need peer review? What is so important about it?
Dr. Kubota: Science is based on absolute truth. Since medicine is a benevolent activity based on science and contributes to the well-being of all humanity, papers that have been submitted should be judged in a fair, transparent, and unbiased manner. Furthermore, a thorough review enables authors to improve their paper, and thereby increase its contribution to the advancement of medical science.
JTD: What are the qualities a reviewer should possess?
Dr. Kubota: It is very important to read the manuscript with a neutral and modest attitude.
If one does not get rid of oneself of prejudice, new insights may be lost. In order to be able to review a manuscript properly, a reviewer should have highly specialized knowledge and deep insight into the subject. However, since the subject of a manuscript rarely completely coincides with the reviewer’s field of specialization, reviewers often should study the subject before reviewing the manuscript. The review process not only improves the quality of the manuscript but broadens the reviewer’s knowledge, enabling deeper insights. As a result of having reviewed hundreds of manuscripts, I myself have acquired wider and deeper knowledge and insights that have been directly and indirectly reflected in improving my clinical performance. Finally, a reviewer is able to share in the pleasure and sense of satisfaction enjoyed by the authors in the knowledge that the published manuscript will contribute to medical science and human well-being.
JTD: Is there any interesting story during review that you would like to share with us?
Dr. Kubota: The review process provides opportunities for encounters between authors and reviewers. I once submitted a case report of an orphan adult-congenital cardiac disease to some journals. As it was a very rare disease, I comprehensively summarized every aspect of the disease, e.g., clinical course, operative procedure, electrophysiological findings, and electron-microscopic, microscopic, echocardiographic, radiographic, and angiographic findings including three reconfirmations of seldom reported findings and two new findings. If I had divided the findings according to specialty, the case would have generated several separate articles. Many reviewers made comments based on their expert knowledge, and some reviewers recommended that I separate the contents according to specialty. However, I preferred not to divide up the article, because so doing would make it difficult to get an overall picture of the rare disease. I was very impressed by the comments of one of the reviewers of the journal that ultimately accepted my case report. The reviewer’s comment was: “Dear authors, thank you for submitting this article. Put briefly, this is an exceptional article and I have no objections or suggestions for the manuscript. The research question is nicely selected and it is of great importance to have a thorough understanding of even rare cases. Authors are to be congratulated for this comprehensive approach to rare but interesting clinical entity.”
JTD: From a reviewer’s perspective, do you think it is important for authors to follow reporting guidelines (e.g. STROBE, PRISMA and CARE) during preparation of their manuscripts?
Dr. Kubota: Following guidelines is very important to maintaining the reliability and transparency of medical research. However, guidelines do not always resolve all of the problems of study design, study method, and incomplete data. On the other hand, it is important to not lose sight of the possibility of a “treasure” manuscript that has high impact but does not always follow the guidelines.
Dr. Edward Buratto, MBBS, PhD, FRACS, is a cardiothoracic surgeon who specializes in pediatric and adult congenital cardiac surgery. He is currently serving as an Instructor in Columbia University / New York Presbyterian, USA to gain experience in surgery for complex congenital heart disease. Having completed adult cardiothoracic surgery training in Australia, he undertook fellowship training in pediatric cardiac surgery at the Royal Children’s Hospital in Melbourne. He then worked as a consultant surgeon at the Royal Melbourne Hospital treating both acquired and congenital heart disease for 1 year under the guidance of Mr. Peter Skillington. Dr. Buratto’s research interests include the spectrum of atrioventricular septal defects, especially unbalanced and borderline subtypes, as well as aortic valve surgery in children and young adults. Connect with Dr. Buratto on Twitter @edwardburatto.
Peer review is the glue that holds together the entire scientific endeavor. In Dr. Buratto’s view, the importance of peer review is not simply to ensure the legitimacy and validity of the reviewed manuscript, but to actively help improve the quality of the research by asking additional questions and clarifying the presented information. The peer reviewer has a responsibility to both the authors and the prospective audience to make sure that high-quality research is presented in the clearest possible way.
During each review, Dr. Buratto bears in mind one ultimate question - whether the research represents a meaningful contribution to the scientific literature. This relates to the novelty of the findings, the interest of the topic to the readership and the potential impact on patient care. Having established that the topic can make a meaningful contribution, the reviewer should then aim to help the author to present the information in a way that is valid and accessible to the readers.
Data sharing will become an increasingly important part of research in the future. Technology has made it much easier to securely share scientific data. To Dr. Buratto, data sharing helps to fuel cooperation and collegiality, which in turn inspires creativity. Furthermore, as a scientific community, we should always endeavor to improve openness, as this helps to improve trust in research. One of the challenges for our community is to find more efficient ways to share our data, while maintaining adequate safeguards on patient privacy and ethical concerns. While technology has made this possible, our bureaucratic systems of Institutional Review Board (IRB) and data-sharing agreements pose significant hurdles and often impede multi-institutional data sharing. Streamlining of these processes will help maximize collaboration and productivity.
“I find that in surgical practice there are often gaps in the day, for example, when waiting for patients to get prepared in the morning or between cases. I try to make the most of these times to do peer review. I usually read the paper once, during one of these gaps, and then think about it for a few days. Then, I will complete the review on a separate occasion,” says Dr. Buratto.
Prof. Suk-Won Song works at Gangnam Severance Hospital, Yonsei University College of Medicine, Korea. He is a member of EACTS, STS, AATS, Korean Society of Cardiovascular and Thoracic Surgery. He has the skill of both surgeon and interventionist and has been the pioneer in defining the crucial role of the surgeon in aortic intervention. Since 2008, Prof. Song started aortic surgery, and until now he has performed more than 4,000 aortic cases, and is performing more than 500 aortic cases every year with mortality rate less than 3%. He established the Aorta and Vascular Center in Gangnam Severance Hospital, where the vascular team attends patients from diagnosis to follow-up, and another team formed of attending fellows carries out ongoing clinical studies with the National Research Foundation of Korea Grant and other studies with the granted approval of the institutional review board at the Yonsei University College of Medicine. You may find out more about Prof. Song through his profile page, PubMed, and ORCID.
As a peer-reviewer, Prof. Song tries to blind himself from the authors’ information, including country and affiliation, etc. to ensure he is as objective as possible. The only focus when he carries out a review is on whether the manuscript is audible, has something new to present, and gives lessons to the readers.
On the prevalence of data sharing in original research in recent years, Prof. Song comments that it is needed, yet not crucial. He explains, “We believe the authors are doing the right thing, the right job, and the right research. As a result, they are writing a manuscript, and trying to give lessons from their experiences and practices.”
“First of all, I appreciate Journal of Thoracic Disease giving me the opportunity to read many manuscripts. This can give me motives to see what other authors in the same field are doing and focusing on. Also, it motivates me to do new research in the field,” says Prof. Song.
Michael J. Brenner
Dr. Michael Brenner is an Associate Professor in the Department of Otolaryngology – Head & Neck Surgery at the University of Michigan, USA. He is a clinician-scientist with academic interests in tracheostomy, airway management and implementation science. At the University of Michigan medical school, he is Co-Director of Branch Science. He is also President of the Global Tracheostomy Collaborative, whose learning community spans over 200 institutions across over 25 countries. He mentors learners in medicine/surgery, neuroscience, nursing, and speech-language pathology. He chairs the Outcomes Research and Evidence-Based Medicine Committee and Centralized Otolaryngology Research Efforts study section, which reviews grants providing seed money for resident physicians and early career investigators. Dr. Brenner contributes to research and discourse and champions healthy equity. His research program has garnered NIH funding and foundation grants, which resulted in over 200 publications. He is passionate about growing future leaders and promoting patient engagement. Learn more about Dr. Brenner here.
JTD: What do you regard as a constructive review?
Dr. Brenner: When conducting a peer review of a clinical manuscript, providing a constructive critique is essential for the improvement of the manuscript and the advancement of scientific knowledge. There are several specific actions a reviewer can take to make a constructive critique. One is to begin by accenting the positive and by recognizing the effort that goes into any article submission. It is worthwhile to acknowledge the strengths and positive aspects of the manuscript. This approach helps to establish a supportive tone and shows that the reviewer has taken the time to appreciate the work done by the authors. It is also helpful to be specific and provide examples. It is helpful to use examples from the manuscript to illustrate the key points. Doing so makes it easier for the authors to understand the concerns and address them effectively, rather than becoming defensive. It is critical to provide concrete suggestions for improvement. Doing so can include recommendations for additional data, further analysis, or clarifications. Suggestions should be clear, feasible and support the scientific goals of the study.
It is also to retain a professional tone while focusing on scientific merit. A constructive review evaluates the manuscript based on its scientific content, methodology, and analysis. Key considerations include appropriateness of the study design, sample size, statistical analysis, and interpretation of the results. A constructive critique provides actionable feedback on any weaknesses or limitations in these areas, highlighting suggestions for improvement. In conveying these recommendations, a constructive reviewer maintains a professional tone throughout the critique. The goal is to help improve the manuscript, not to criticize. A constructive review covers all the major aspects of the manuscript but should be concise, lest the authors lose sight of the key points. A review should differentiate between major and minor issues in your critique. Focus on the critical aspects that impact the validity or impact of the study. Minor issues, such as typos, formatting, or minor statistical errors, can be mentioned at the end of the critique. Last, it is helpful to include a summary of the feedback. Highlighting the main points discussed can help the authors to grasp the key takeaways and prioritize their revisions accordingly. In summary, a constructive critique provides meaningful feedback to advance scientific knowledge and improve presentation.
JTD: What are the qualities a reviewer should possess?
Dr. Brenner: An outstanding reviewer of peer-reviewed science possesses a combination of personal and professional qualities that contribute to their effectiveness in evaluating and improving scientific manuscripts. Reviewers must adhere to high ethical standards and maintain confidentiality throughout the peer-review process. Reviewers should be dispassionate and treat the manuscript and the authors' work with integrity, respecting intellectual property and evaluating the work solely based on its scientific merit. Timeliness and responsiveness are also critical. An outstanding reviewer is prompt and respects the timeline for the review process. Reviewers must understand the importance of timely feedback for the authors and the overall publication process. Additionally, they are responsive to any clarifications or queries from the authors during the review process.
Critical thinking and interpersonal skills also play important roles. Outstanding reviewers possess strong analytical and critical thinking skills. They can evaluate the study's strengths and weaknesses, identify potential flaws, and assess the validity and reliability of the findings. A meticulous and detail-oriented approach is crucial for experimental design, data analysis, statistical methods, and accuracy of presented information. Although a reviewer never has complete knowledge of the field, it is important to bring expertise and understanding of the subject matter from a strong foundation of knowledge. This allows them to evaluate the study's scientific rigor, methodology, and interpretation of results effectively. Continuous learning is key to staying updated with the latest advancements in the field. Reviewers should approach their role with collegiality and respect. They should acknowledge the efforts of the authors and provide feedback in a constructive and supportive manner. Professionalism and respect in all interactions contribute to a positive and productive peer-review process. The way that critiques are delivered can sometimes be as important as the substance of the critique. Lastly, reviewers should articulate their thoughts and feedback with precise language, conveying concerns, ideas, and recommendations to the authors clearly. In summary, outstanding reviewers combine their expertise, objectivity, critical thinking, effective communication, and ethical conduct to achieve rigorous and constructive reviews.
JTD: Peer reviewing is often anonymous and non-profitable, what motivates you to do so?
Dr. Brenner: Peer reviewing is essential in the scientific community. Peer reviewing helps to advance the field and allows me to participate actively in the scholarly discourse, shaping the direction and quality of scientific research. By curating the rigor and validity of published work, I can contribute to the progress and knowledge. It also fosters professional development. Engaging in peer review affords exposure to cutting-edge research, methodologies, and emerging trends. It has also helped me hone my own critical thinking skills and, in doing so, build credibility in their field. High-quality reviews have led to invitations to write invited articles, serve on editorial boards, participate in podcasts and speak on panels at conferences. I enjoy networking and collaboration as well, particularly the opportunity to interact with editors and fellow reviewers, fostering collaborations and potential research partnerships. Such networking is personally fulfilling and beneficial for future research endeavors.
Peer reviewing is also part of a culture of lifelong learning. There is reciprocity around these activities, and they are part of the professional contribution. In addition to reviewing, I serve as an associate editor for several journals, and I appreciate the efforts of other reviewers who have evaluated work and given back to the scientific community. Not uncommonly, I tap these reviewers for other leadership opportunities. Contributing to the peer-review process is also a way to uphold the integrity and quality of the research enterprise. Peer reviewing allows researchers to stay informed and gain insights into ongoing research and developments before they are published. Working as a reviewer also improves the quality of scientific literature. By providing constructive feedback and recommendations, reviewers help authors enhance their research, strengthen the presentation, and improve the clarity and impact of their manuscripts.
While peer reviewing may not offer direct financial rewards, the intrinsic motivations related to professional growth, growing future leaders, reputation building, advancing the field, and serving the scientific community are compelling motivators to engage in this critical task.
Barry C Gibney
Dr. Barry C Gibney is an Associate Professor, and general thoracic surgeon at the Medical University of South Carolina, USA, where he is the section chief, program director for the integrated thoracic residency and the surgical director of the lung transplant program. He cares for patients with lung, esophageal, mediastinal and chest wall tumors, in addition to benign esophageal diseases and end-stage lung disease as part of the multi-disciplinary lung transplant team. His primary research interests are two-fold: in the field of immunobiology, his laboratory efforts aim to better understand the role of the immune system in lung cancer and to predict which patients will respond to immunotherapy. His additional research interest is in improving storage solutions for transplantation.
“Peer review is crucial – full stop,” says Dr. Gibney when he is asked about the role of peer review in science. He explains that for the researcher, it provides an unbiased evaluation of one’s work, and when done well, often strengthens a manuscript which will broaden the impact of that research. And for the reviewer, it provides an opportunity to contribute to science by critically reviewing work, helping the researcher improve their work, and ultimately influence what is published. Further, reviewing can often result in unearthing new questions that need to be answered.
The burden of being a scientist and doctor is heavy. In Dr. Gibney’s practice, he relies on three big tasks: 1) Once a week, he sits down for an hour (usually prior to the start of the work week) to write down what he wants to accomplish that week. These are tasks that run from the mundane like scheduling car maintenance, or paying the phone bill all the way to what experiments he wants to complete this week, and what manuscripts need to be written/submitted, etc. This list then goes into the second task: 2) physically scheduling time for the above tasks. For example, he knows reviewing most manuscripts would take him 90 minutes to read, critique and drafting his comments. This period of time is marked in his calendar so that he can focus on that task. 3) Prior to scheduling out the following week, he reviews the previous week and critically evaluate how he did in completing his tasks. “If I didn’t accomplish something, was it because of clinical emergencies that were unavoidable? Or was it myself that wasted time doing something else (e.g. chatting in the surgeon’s lounge). I use this weekly feedback to try and constantly improve my efficiency,” he adds.
Speaking of the prevalence of data sharing in scientific writing in recent years, Dr. Gibney highlights that transparency in research is critical for everyone to feel confident that the data being presented are the actual data. In addition, sharing the data can be useful for collaboration – another author’s group may have a new technique, or new method of analyzing that can use an existing dataset to further the research that is performed.
Alberto Cabañero Sánchez
Dr. Alberto Cabañero Sánchez works at the thoracic surgery department of the Ramón y Cajal University Hospital (Madrid, Spain). He obtained his medical degree from the Complutense University of Madrid and completed his training in thoracic surgery at the Ramón y Cajal University Hospital. He is currently the resident mentor and the safety referent of the thoracic surgery department. His areas of interest are thoracic oncology, minimally invasive surgery and multimodal management of the surgical patient. He belongs to several national and international societies related to thoracic surgery and respiratory pathologies, and collaborates with different clinical committees within his workplace. You may learn more about Dr. Sánchez through ORCID and LinkedIn.
Peer review is a necessary and fundamental process, according to Dr. Sánchez, as it ensures that a certain study meets the necessary conditions of quality or innovation to be published. The fact that several people who are experts in the field review a study not only guarantees that the study is of quality, but also possibly contributes to improving the study in the review process by adding other points of view to that of the authors themselves.
Dr. Sánchez believes that the mission of a reviewer has to be double. On the one hand, to ensure that the study has been done with the scientific rigor necessary to be published and on the other, to try to improve it by contributing a point of view different from that of the authors. He adds that criticism should always be constructive and help authors to realize certain errors or details that they have overlooked or enrich the study by adding different points of view.
“If there is something that matters in scientific research, it is sharing information,” says Dr. Sánchez when he is asked about the prevalence of research data sharing in recent years. “We are who we are and we do what we do today because the generations before ours passed on their knowledge to us, and based on it, we continue improving and innovating. If we do not share knowledge and experiences, the investigation runs the risk of stagnating and not moving forward. It is our task to share our advances with other colleagues and with future generations so that science continues to evolve.”
“It is lucky to be able to participate in peer reviewing because it is an opportunity to discover new lines of research or new points of view on known problems. You always learn in the process of reviewing an article, so I've never seen it as a burden, but rather as an opportunity to learn how other people work and try to be better at my job,” says Dr. Sánchez.
Dr. Avinash Aujayeb currently works as a Respiratory Consultant, Northumbria Healthcare NHS Foundation Trust, UK. He is the Pleural Lead. He is a member of the BTS pleural SAG and Secretary of Assembly 11 of the ERS. He is also an Honorary Clinical Senior Lecturer (Northumbria Base) for Newcastle University. His main area of interests include malignant and benign pleural effusions, pneumothorax, pleural infection and mesothelioma. Find out more about Dr. Aujayeb through ResearchGate and Twitter.
A healthy peer-review system, in Dr. Aujayeb’s opinion, is one that works in a concise and timely fashion and with accountability from all parties. Open peer review is such a method, and publishing the reviewers’ comments is important. However, the existing system is not without limitations. He says, “Everyone is extremely busy and peer review can feel onerous and add to the burden of work. I think requests should come during work hours, and come with, for example, discounts towards APCs, or possibility of editorials or even payments.”
Viewing as a reviewer, Dr. Aujayeb believes that all studies should have an explanation as to why ethical approval is required or not. Often for retrospective studies, which are more of service reviews or quality projects, no such approval is required, but it is important to have it considered and it logged at, perhaps, a central repository.
“Peer review work is important, and all of us contribute to the advancement of the scientific community. We should do what we can, and when we can,” says Dr. Aujayeb.
Alex Fourdrain, M.D., Ph.D., is a senior thoracic surgeon currently serving in Marseille University Hospital, France, within the Department of Thoracic Surgery, Diseases of the Esophagus, and Lung Transplantation. He was trained at Amiens University Hospital and Marseille University Hospital. He is specialized in surgical oncology (lung cancer and esophageal cancer), with a focus on minimally invasive surgery (VATS and RATS) in early-stage diseases and also broadened indication for advanced cases. He believes in the simplification of patients’ surgical pathways while maintaining an optimal standard of care, in order to provide the best short-term and long-term outcomes for patients. The research he conducted in the field of risk reduction in minimally invasive surgery was awarded the Young Investigator Award in the 2018 ESTS in Slovenia and the Young Researcher Prize from the French Academy of Surgery in 2022. Get to know more about Dr. Fourdrain here.
A healthy peer-review system, according to Dr. Fourdrain, should allow the authors to methodologically confront their ideas, hypotheses, results and points of view to the sharpest reviewers on a dedicated topic, respecting ethical and scientific concerns. Indeed, both authors and reviewers must ideally share the common interest to ameliorate the quality of the research work submitted to the medical community. He elaborates, “In everyday practice, if you want to discuss a complicated case, you ask your colleagues for advice to better adapt your strategy. Similarly, it is logical to consider a healthy peer-review system as a group of scientific peers assessing research work and providing useful feedback.”
In Dr. Fourdrain’s opinion, however, the limitations of the peer-review system lay in the existence of a preferred scenario for manuscript submission, with either: a description of a large cohort of patients without precise data limited by several biases; a small cohort with precise data but limited by a lack of power; and studies highlighting original/novel strategies without clinical relevance or perspective. To him, an ideal peer-review system should focus the debate on topics that matter, avoiding futile debate over technical aspects, preferring pertinent content, because their main goal is cancer-free survival and patient quality of life. He adds, “Each time I have to review a manuscript, I ask myself whether the subject is of interest, and if there is something valuable that could improve our medical knowledge, with the ultimate goal to improve patient care.”
From a reviewer’s perspective, disclosure of any conflict of interest (COI) is mandatory in Dr. Fourdrain’s opinion, without any exception. However, the existence of a COI is not necessarily associated with lower scientific accuracy. COI is an issue if it influences clinical practice and scientific reports, regardless of the impact on patient care. More than COI disclosure, honesty and objectivity should be the two priorities for authors, which need to be carefully evaluated by reviewers.
“Being a reviewer for JTD allows me to keep up with the state of the art in my field of expertise, maintaining a sharp mind and challenging my opinion on subjects that matter to me. It also drives me off-road regarding topics I may be less familiar with, strengthening my open-mindedness and medical knowledge,” says Dr. Fourdrain.
Dr. Puja Khaitan is currently a Consultant in Thoracic Surgery at Sheikh Shakhbout Medical City (SSMC), Mayo Clinic, Abu Dhabi, United Arab Emirates. Prior to this position, she worked as an Associate Professor at Georgetown University in Washington DC from 2017-2022 and was promoted to full Professorship in November 2022. She received her MD from University of Texas Southwestern Medical School and then completed her general surgery training at Emory University. During her training, she also pursued a T-32 research fellowship in cancer genetics followed by an ACGME-accredited cardiothoracic training at Brigham and Women’s Hospital under the tutelage of Late Dr. David Sugarbaker. As the Director of Surgical Robotics and Esophageal & Foregut Surgery at SSMC-Mayo, Dr. Khaitan strives to advance the field in minimally invasive techniques with state-of-the-art equipment and conduct research with the goal of delivering the highest quality care to patients and community. As a clinician-scientist, her key research interests lie along the breadth of oncological research in various aspects of lung and esophageal cancer - starting from screening to diagnosis and management of early-stage cancer to understanding tumor biology, response to immunotherapy, and radiation repair pathways. Lastly, she is extremely passionate about education and training the residents and fellows both in the classroom and operating room and therefore take great pride in surgical trainees with hopes to leave a legacy behind. Connect with Dr. Khaitan on LinkedIn and Twitter, and visit her homepage here.
In Dr. Khaitan’s view, peer review is central to good science. In order to ensure that the science being conducted and published is performed on an appropriate patient population with an appropriate research question and appropriate methodology and statistics, it is critical that clinicians stay engaged in the peer-review process. Basic and translational science also should be linked to a clinical question indeed. Some of Dr. Khaitan’s favorite studies include those conducted on national registries where peer review is even more critical to sift through large databases with limited information as the work needs an in-depth knowledge of the database and the parameters therein. As a reviewer, one can make a significant contribution to the scientific community and literature as well as play a critical role in strengthening the research caliber of the journal.
To Dr. Khaitan, an objective review must be unprejudiced and unbiased. It must keep “patients first” in mind and can only be made by experts in the field. If a subject is not well known to a reviewer, he/she must take time to read up on the current literature before making remarks and critiquing the work at hand or simply withdraw from reviewing the work. Next, they must be able to understand the study, its structure, and evaluate the results with a fine-toothed comb to ensure accuracy of interpreted results. The reviewers should make an effort to review the work with an eagle’s eye and ensure that there is no economic gain or inherent biases involved. Such a rigorous review would be able to provide good feedback and constructive criticism such that the submitting authors can revise their work with eventual acceptance of ‘good’ quality research.
“It may be true that there is no economic gain to become a reviewer or becoming a part of the Editorial team, but the process of participating in the peer-review process is extremely rewarding and fulfilling and simultaneously allows for both self and societal growth,” says Dr. Khaitan.
From a reviewer’s perspective, Dr. Khaitan stresses that it is crucial for an original research to apply for institutional review board (IRB) approval. To her, the goal of an IRB committee is to ensure that any research question or hypothesis posed is tested in a non-biased, remaining within the ethical bounds and without any harm to subjects with routine checks and balances. No financial gain should bias a study on how it is conducted or reported. If such a process is omitted, the result would be futile work performed on patients or surgical specimens that may be reviewed as flawed, thus resulting in lost time and money, and worst of all, at patients’ expense.
Dr. Ikenna Okereke is the current Vice Chairman of the Department of Surgery and Chief of the Division of Thoracic Surgery at Henry Ford Health, USA. He was raised in Detroit, Michigan and attended Johns Hopkins University. He attended Washington University School of Medicine in St. Louis. He did his general surgery residency at the Cleveland Clinic Foundation and his cardiothoracic residency at Beth Israel Deaconess Medical Center in Boston. He is active in basic and outcomes research and has been awarded numerous NIH grants. He went to Haiti for disaster relief one week after the devastating earthquake that killed over 300,000 people in that country. Inspired by this trip, he established the Okereke Foundation in 2013. He also mentors underrepresented high school students and began a summer internship program for these students in 2016. Learn more about Dr. Okereke here.
Dr. Okereke believes that peer review is a necessary step in producing quality science and advancing public health interests. It may not guarantee that only worthy studies are introduced into mainstream literature, but the peer-review process helps overall. Although it is difficult, he thinks that reviewers need to remove their biases as they go over a manuscript. He explains, “All of us have particular practice patterns or ideas that we espouse over others, but when we review a manuscript, we have to use the available data and evidence versus our inclinations. Certainly that review process will include using data from other studies, but we also have to give every article a fair chance from the outset.”
“Reviews can be time-consuming and tedious, but they are needed for research to occur. I consider this part of my obligatory service and responsibility as a caregiver,” says Dr. Okereke.
Speaking of the importance for research to apply for institutional review board (IRB) approval, Dr. Okereke points out that there, unfortunately, have been very dark chapters in the world history concerning projects labeled as “research”. Perhaps it would be fair to say that these labels were used perversely. The Tuskegee Syphilis Study is an example of the devastating results that experiments can have when they are conducted with the lack of a moral compass. To him, the IRB does not completely eliminate harm against vulnerable groups, but it does provide more protection than if the IRB did not exist.
Dr. Savvas Lampridis is a cardiothoracic surgeon at the Imperial College Healthcare NHS Trust in London, UK. He also serves as a Major in the Greek Army Medical Corps. His clinical and research interests include minimally invasive surgery, thoracic trauma, military medicine, translational cardiovascular medicine, surgical education and simulation, as well as health policy. His medical journey began at the Aristotle University of Thessaloniki, followed by graduation with honours from the Military Medical Academy of Greece. His surgical training spanned across Greece and the UK, including esteemed institutions like the Royal Brompton Hospital and University College London Hospital. After completing his specialty training in cardiothoracic surgery, he worked at leading UK centres, such as the Guy's & St Thomas’ NHS Foundation Trust. His commitment to continuous learning is evident through his master’s degrees in Translational Cardiovascular Medicine (University of Bristol, UK) and Health Policy and Planning (Open University of Cyprus), both achieved with Distinction. Dr. Lampridis has authored over 50 publications in leading journals and has presented his research at numerous international conferences. He serves on the editorial board of multiple peer-reviewed journals and has guest-edited several special issues. In addition, he has peer-reviewed more than 300 articles that have been published in over 70 biomedical journals, further demonstrating his dedication to the advancement of medical knowledge. Learn more about Dr. Lampridis from ORCID, Google Scholar, and Web of Science, and connect with him on LinkedIn.
JTD: What do you, as a reviewer, bear in mind while reviewing papers?
Dr. Lampridis: When reviewing manuscripts, I try to keep several principles in mind. First, I aim to provide constructive and respectful feedback to the authors, recognizing the significant effort involved in conducting research and writing for publication. My goal is to help the authors improve their work through clear, actionable suggestions. Second, I focus my review on the core elements that make a paper scientifically sound and impactful: the research question and hypothesis, study methodology and analysis, interpretation of the results, and quality of the writing. Third, I consider whether the conclusions are well-supported by the data presented. As a reviewer, thoroughly evaluating the evidence and methodology is the key. Finally, I aim to judge each submission on its own merits, assessing significance, novelty, and rigor. Upholding impartiality and fairness in peer review is crucial to maintaining integrity in academic publishing. By keeping these key principles in mind, I hope to provide reviews that are constructive for authors and advance science through discourse and debate on research.
JTD: Is it important for authors to disclose Conflict of Interest (COI)? To what extent would a COI influence research?
Dr. Lampridis: Transparency regarding potential COI is a vital part of upholding research integrity. Disclosing relevant financial, professional, or personal interests allows readers to objectively assess whether a study was influenced in ways that may introduce bias. While having interests related to a study does not necessarily invalidate the research, it is crucial that any competing interests are revealed. As a reviewer, I believe authors have an ethical obligation to disclose and thoroughly describe any real or perceived COI so readers can interpret the work accordingly.
The extent to which a COI affects the validity of findings depends on various factors. But nondisclosure removes the opportunity for informed analysis. Research influenced by undisclosed COI negatively impacts scientific literature by damaging trust in the process.
I applaud journals that require rigorous COI disclosure, such as the Journal of Thoracic Disease. Peer reviewers can also play a role by watching for potential unreported COI and requesting more details from authors as needed. Through openness from authors and diligence from reviewers, we can maintain credibility and transparency in scientific publishing.
JTD: Peer reviewing is often anonymous and non-profitable, what motivates you to do so?
Dr. Lampridis: I am intrinsically motivated to serve as a peer reviewer because I strongly believe in contributing to the scholarly publishing process that is so vital to scientific progress. High-quality, rigorous peer review helps ensure the literature reflects meaningful advances that can move fields forward. Though anonymous and non-monetarily rewarded, reviewing manuscripts provides valuable benefits. Staying closely connected to emerging research and engaging in scientific critique sharpens my own skills as a researcher and writer. The reviewer perspective also helps me strengthen research plans and manuscripts for my own work. Beyond self-improvement, reviewing gives me the chance to play a role in upholding scientific integrity on a broader scale. I aim to provide constructive feedback to authors to improve the quality and communication of their work. And I appreciate the opportunity to recommend acceptance for studies I find to be well-executed and impactful.
While reviewing can be time-consuming, I gain satisfaction in knowing I have used my expertise to contribute to the dissemination of rigorous research. The altruistic nature of the peer-review system depends on researchers' willingness to voluntarily invest time into advancing science. I am proud to do my part by serving as a conscientious reviewer.