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Berquist.Thomas{at}mayo.edu
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But what are the important aspects of each step in the publication process? What are the responsibilities of authors, reviewers, and the journal editorial team? Let's look at each step in the process from submission to manuscript decision.
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How should authors prepare the manuscript? There have been several excellent articles devoted to manuscript preparation. These reviews provide valuable assistance and outline the format and approaches for authors, specifically new authors [3–6]. Initial planning and study design are critical. Each section should be carefully prepared and address the specific content for that portion of the manuscript. Mark Kliewer [4] provided a useful outline in his article, including the key paragraphs for each section (Introduction, Materials and Methods, Results, Discussion, and Summary or Conclusions). In another article, James M. Provenzale [3], our Section Editor for Neuroradiology/Head and Neck Imaging, emphasized 10 critical principles that will increase the likelihood of publication. Several key points deserve mention.
First, proper organization of the manuscript is critical, including providing a structured, reproducible materials and methods section. Content in materials and methods needs to be clearly structured for the readers so the approach reported can be easily incorporated into their practices. Meticulous design of the materials and methods section also provides a template for the results section. The two sections together should demonstrate the authors' approach to conducting the study and should support the findings [3].
The discussion section should be concise and should explain the importance of the results compared with other studies and should indicate future direction. A long history of prior studies is not necessary [3, 4]. Limitations of the study also should be included. The summary or conclusions should not overstate the results of the study. Finally, following peer review, the author(s) should fully address the comments of the reviewers [3].
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Peer review for scientific publications engages experts in the field to evaluate scientific manuscripts for competence, significance, ac curacy, and quality [7]. Peer review should provide constructive criticism and define content areas that require further clarification or correction by the author. This process was initiated in 1731 when the Royal Society of Edinburgh published the first peer-reviewed Medical Essays and Observations [7]. Normally, peer review is a blinded process. The authors are blinded to those chosen as reviewers and the reviewers are unaware of the origin of the manuscript (authors or institution).
There have always been opponents to the peer review system. Efforts to modify and improve the process have resulted in numerous studies designed to evaluate the accuracy and utility of peer review. Though most studies define the positive aspects described above, concerns have been raised regarding reviewer competence, bias, publication delays, and inability to detect author misconduct [7–10]. For example, a recently published survey of researchers (authors) demonstrated that 62% expressed concerns about reviewer competence and about 50% were concerned about reviewer bias. More serious issues included breach of confidentiality and use of ideas or methods from manuscripts without permission [8].
Certain scientific journals advocate open peer review as a solution to the perceived shortcomings of blinded reviews. The open peer review system requires the reviewer to sign the review and in some cases the reviews are published. Supporters of the open system feel it increases the accountability of the reviewers; if published, the reviewer receives credit, and the system is thought to be ethically superior [11, 12].
Despite the potential flaws of peer review, the American Journal of Roentgenology continues to support blinded peer review to maintain scientific credibility. In 2005, Robert J. Stanley, Editor Emeritus, discussed issues related to peer review in his Editor's Notebook [10]. His editorial followed discussions at the Fifth International Congress on Peer Review and Biomedical Publication, which was held in Chicago that same year. During this meeting several presenters reported that "blinded reviewers, who do not know the identity of the authors, are less likely to exhibit bias in their assessment of the study [10]." A survey of AJR reviewers asked whether open review, single blinding (identity of author is revealed to the reviewer), or double blinding (identity of reviewers and authors is withheld) was preferred. The double-blind process was clearly preferred and remains in place at AJR today. Discussions regarding peer review will continue at the Sixth International Congress on Peer Review and Biomedical Publication to be held in Vancouver, BC, Canada in September 2009.
How are our reviewers selected? Currently we have more than 1,600 active reviewers for our journal. There are several mechanisms for entering the reviewer pool. Reviewers may be nominated by ARRS members, editors, or department chairs or an interested candidate can simply provide a letter of interest along with his or her curriculum vitae to the Editor in Chief or one of the Section Editors. Reviewers also can volunteer by indicating their interest at www.arrs.org/supportARRS;volunteerForm.cfm. Authors also are given the opportunity to suggest reviewers or oppose certain reviewers when submitting their manuscripts. It is important to note that all reviewers perform their critical task as volunteers.
What makes a good reviewer and how should they approach their responsibility? Providing an optimal review is not an easy task. Reviewers need time and training to become effective and consistent in their approach to evaluating scientific manuscripts. There are multiple articles available to reviewers that outline the process and approach to manuscript review [13, 14]. The article by Provenzale and Stanley [13] provides a simple workable training manual for reviewers and contains an appendix that outlines the key points to be covered in each section of a manuscript. This article should be required reading for all new reviewers and kept handy by more experienced reviewers. In addition, we are in the process of designing yearly training opportunities for our reviewers.
Several studies have evaluated reviewers, including factors such as age, sex, subspecialty, number of years of service, academic rank, and practice category. Studies show that younger reviewers at academic institutions receive the highest reviewer evaluations [15].
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The relationship between the editors and the reviewers is critical to manage the "circle of publication" (Fig. 1). Each reviewer selects topic categories in the AJR's online peer review system that matchs his or her expertise. This enables editors to more appropriately select the most qualified reviewers for a given manuscript. The team of editors and reviewers works to maximize manuscript and, therefore, journal quality. The reviewers are expected to deliver their reviews in the allotted time and provide the editors with recommendations for acceptance, reevaluation following revision by the authors, or rejection. It is critical that we respect the comments of our volunteer reviewers.
It is important to monitor the effectiveness of all reviewers to maintain the consistency and quality of the journal. Reviewers are evaluated by the editors using a rating system. The reviewer score is useful for optimizing selection of the best reviewers for a given manuscript. Also, every 6 months we reevaluate the reviewers for each section. This gives us the opportunity to reward our volunteers and, in some cases, give inactive reviewers the opportunity to retire so new reviewers can be added to the pool. The distinguished reviewers for each year are listed on the masthead page (see list in this issue).
We will strive to continually improve our systems and enhance communication with reviewers and authors as we enter the era of journal quality improvement (JQI) [16]. To achieve our mission and vision we have established goals and metrics for the next 5 years that will be constantly monitored and, if necessary, modified to make AJR the "must read" journal in medical imaging.
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  T. H. Berquist Peer Review and Biomedical Publications: We All Have the Same Issues Am. J. Roentgenol., November 1, 2009; 193(5): 1199 - 1200. [Full Text] [PDF]
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T. H. Berquist The Year in Review: My How Time Flies! Am. J. Roentgenol., July 1, 2009; 193(1): 1 - 2. [Full Text] [PDF]
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T. H. Berquist Mentoring: Payback Time Am. J. Roentgenol., December 1, 2008; 191(6): 1625 - 1626. [Full Text] [PDF]
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