What does peer review look like?

Publishing in peer-reviewed journals

Your job as s scientist will be easier when you know how to handle peer review. The worn-out publish or perish phrase underlines that original research publications are the crucial measure of scientific work. Indeed, not publishing your research is equivalent to not doing it at all. In such a situation, your effort will not contribute to the advancement of science or your career. A research project is thus unfinished even after you have conducted the study, analyzed the data, and written the manuscript. Especially because publishing an article in a peer-reviewed journal is tough. Only one-third of manuscripts submitted to such journals are published, with much lower acceptance rates in the best journals (source).

Before submission

Before submitting your research to a journal, you need to format your manuscript following the journal’s guidelines. Pay attention to word count, citation style, and other requirements listed on the journal’s website. After submission, the manuscript is evaluated by the editor, who considers primarily the originality of the results and research integrity. The editor can reject the manuscript immediately or send it for peer review. Journal editors, who deal with numerous submissions, typically do not read entire manuscripts but make decisions based on the information given in the cover letter and abstract. Write these two documents well to make a good impression and convince the editor your research is novel and sound. A clumsy cover letter or abstract will likely make the editor think your research was clumsy too, which will result in an immediate rejection. After all, there are plenty of other submissions on the editor’s desk. Having your manuscript sent for review is thus a little success.

Manuscript rejection

After receiving the reviews, the editor may reject the manuscript or reconsider its publication after revisions suggested by the reviewers. The decision to reject a manuscript is final, and you should not waste your time appealing. Instead, revise the manuscript and send it elsewhere. For a subsequent submission, you may choose a less prestigious journal with a higher acceptance rate. But if you are sure your study is sound, you may try in an even better journal, hoping for more favorable reviewers.

Response to reviews and revisions

It rarely happens that the reviewers have no critical comments, and the editor accepts your paper immediately after the review. A revision is usually required: 

  • Minor revisions may include adding citations, rewording some sentences, or listing study limitations. Your paper is almost published. 
  • Major revisions may require adding statistical analyses, changing the selection of participants, adding a control group, or doing additional experiments. The publication is possible if you can make the required changes, which sometimes may be unfeasible. 

Respond to the reviewers’ comments point-by-point in a response letter. The letter should be exquisitely polite even if you disagree with the comments or think they do not make sense. A real example of such a comment: Patients received treatment, so it is impossible to know the natural course of the disease. You usually agree with most of the reviewers’ comments. In particular, it is not worth breaking a lance with the reviewer over minor issues. But if you disagree with the reviewer, kindly explain your point of view, justifying why you think changes are unnecessary. Importantly, it is not enough to agree with the comments in the letter. You must correct the manuscript accordingly, highlighting the changes. 

Conclusions

Reviewers are experts in their field, and their suggestions will usually help improve your paper. However, the peer review process is often frustrating: it can take months and end in a rejection of your paper. It is not uncommon for researchers to send their manuscripts to multiple journals before getting published. But keep in mind that although it is not easy to publish an article in a peer-reviewed journal, you can do it, and the joy and satisfaction of being published will motivate you to work further. You will find more useful tips on getting your paper published in our knowledge center.

peer review

An example covering letter

Dear Dr. Cooper,

We wish to submit a manuscript titled “Heart rate predicts mortality in patients with ischemic heart disease: a multinational cohort study” for consideration by the “Heart Journal” as an original research article.

Our study was conducted in 8 European countries and enrolled nearly 300,000 patients with ischemic heart disease. The median follow-up was 11 years. To our knowledge, our study is the largest to date to investigate the relationship between heart rate and survival in these patients.

The main finding was that patients with a heart rate of 80 bpm or greater at diagnosis had over twice the risk of death than other patients (hazard ratio: 2.13, 95% confidence interval: 2.08 – 2.17). This relationship remained significant in subgroup analyses by country, sex, and age group and when adjusted for anthropometric variables, comorbidities, and use of medications.

Our results seem relevant for clinical practice, suggesting that lowering heart rate may improve survival in patients with ischemic heart disease. Therefore, we think our findings would be of interest to the readers of the “Heart Journal”. We hope you will find our work interesting and suitable for peer review. I appreciate your consideration. 

Sincerely,

Jan Kowalski, MD, PhD

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