Intro

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Besides some fields of my interest (like psychometrics and patient reported outcomes), the peer review process (learning, doing, and understanding it) [1-5, just to mention some of my favorite references], is one the most challenging task for me evoking a variety of different emotions, thoughts, and behaviors. This is my seventh year of being deeply submerged into this process, but I am still asking myself “can one be reviewed and do a review in the way that everyone gets the most of it, but not only to have an article accepted or rejected?”.
At the very beginning of my career, I was taught that you need a couple of good things if you want your research to be published. You need a good idea, good study design, good funders, good results, good writing skills, good journal, and many others. However, nobody told me, and I even did not read it, that you need good luck with peer reviewers as well or the most of all. I was even unaware of “those guys” who can throw in the wind a years-long work of mine. In the years that came, I familiarized myself with pre-publication peer review and here, I expressed my experience with it and only to a lesser degree my opinions and emotions about it. I was tempted to do so after I read the latest article of Mr. Mahawar [6], the founder of WebmedCentral that took revolutionary steps in biomedical science and publishing.
In this commentary, I shall not discus well-known and already recognized issues around the pre-publication peer review process. Instead, I shall give an overview of featured situations I encountered with the process. Considering peer review is a very complex process, with many sophisticated components, I have organized two sections, being reviewed and reviewing others, in order to simplify my experience. However, as you read you will see that is the same.

Being reviewed

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Searching my archives, I found 63 unknown-peer reviewers’ reports about my articles (by the way, I have 17 peer review publications). Here, I have selected to confess only the most striking situations in which peer reviewers put me or did for me, and I (didn’t) expected to be.
Experience with the quality of a peer review
The unknown-peer reviewers’ reports about my articles were of various qualities. Here, I define quality as: to what extent a peer reviewer’s report provides a critical and constructive review that I could used subsequently to improve my article. Simply, I classify all reports as being of high quality, low quality, or no quality.
Of all my reports, about 50% were of high quality. This means that peer reviewers gave constructive comments on my work mostly about statistical and other procedures, instruments, writing, presentation, etc. I was able to use the comments to improve my articles, what subsequently resulted with their acceptance by journals. Yes, I was very thankful to these reviewers and in several occasions, I wrote to editors asking to meet reviewers, but that was not possible.
About 40% of peer review reports I have were of low quality. This means that peer reviewers commented my work in an manner that I could think that they did not read the entire article, did not know what to review, or did not know the topic (not in their expertise). They mostly suggested unsuitable statistical procedures, inappropriate assessments or instruments, another group of participants in a finished study or even another type of a finished study. Some of them went further just giving their point of view what should have to be done. Some went even further just disagreeing with my idea without commenting anything. Some went too far being offensive and rude, or even malicious, and taught me a lesson. Understandably, my work was always rejected afterwards. Yes, I was very frustrated and upset. In all occasions, I would write to editors politely asking to reconsider my articles, giving the very detailed replies to reviewers’ comments (always referenced!). It happened only once when the editor of Quality of Life Research accepted to reconsider a submission, but others mostly reject to do so responding that their reviewers were experts in their research fields.
The rest, about 10%, of peer reviews reports I have were of no quality (useless). In these situations, reviewers have just suggested what editors should do with my manuscripts, accept or reject, without giving any justifications for their suggestions. The editors mostly (fortunately) ignored these reviewers’ reports. Yes, I was happy about this and always thankful to editors.
Reasonably, from the last two occasions, I could not use peer reviewers’ comments to subsequently improve my articles and the worst of all these reviewers kept me out of science.
Experience with agreement between peer reviewers
I have experience with several extreme situations.
It is always better to have two to three different opinions about various aspects of your article, because this could undoubtedly improves its quality at the end (certainly satisfying the high quality criterion I raised above). At least, I always consider reviewers to be experts and their opinions highly valuable and free of charge. However, in roughly 10% of the peer review reports of my articles, two unknown reviewers expressed quite opposite opinions about the same issue, mostly statistics or discussion, while in another 15% two reviewers expressed different, but lesser extreme, opinions on the same issue. In both situations, I am inclined to one reviewer, but once it was a disaster, when the editor of Scandinavian Journal of Caring Sciences rejected an article after its revision, because I failed to address all comments of both reviewers.
The next situation is that one reviewer suggested revision and the other one suggested rejection, while the third one was indecisive. However, all of them were concerned with different parts of my article and I could not believe that I did almost everything mistakenly in that particular research. Subsequently, my paper would be always rejected.
The next situation is that both reviewers agreed upon rejection. In about one forth of my rejected articles, the reviewers agreed upon similar things. However, I used their comments as much as it was acceptable to improve the rejected manuscript. Afterwards, I submit the article to another journal. Two reviewers of that journal, besides having new comments, commented the same parts I have already changed based on the first two reviewers. In two occasions, such manuscripts were rejected again. However, I was stubborn enough and resubmitted the same first version of the article to the third journal and after requesting revisions on quite different parts from the previous ones, the article was accepted. Another article of mine was revised and resubmitted five times, until it was accepted. This time, 11 reviewers that assessed it, agreed in about only 25% of their comments.

 

Reviewing others

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I have 25 pre-publication reviews from the past three years (somehow, I have lost others!). Here, I have selected to confess only the most striking situations I encountered and where I put the reviewed ones (they might have (not) expected them).
I accepted (not) to be a peer reviewer
I do peer reviewing for several journals (Epilepsy & Behavior, Quality of Life Research, Value in Health, Epidemiology and Psychiatric Sciences, etc.). In these journals, I have publications and I have left on their article submission platforms clear descriptions of levels of my expertise (and interests as well). Nevertheless, I do not think that I am the right person to make appropriate judgments about anyone’s work. Nobody is! Once I accept to review someone’s research, after deep thinking about my expertise for doing so, I take huge responsibility to do that in the way that reflects not only some particular, but also the entire specter of scientific knowledge I have and nothing more.
Every forth article I am requested to review is in my area of expertise, but its procedures are entirely unfamiliar to me. Moreover, for every fifth article I was asked to review, I do not think that I am the right person. And yes, I always write back to those editors to consider somebody else. Occasionally, I am asked to see an article that is not in my area of expertise at all, but it has some parts that I feel I could assess, for example, it deals with my favorite statistical procedure (structure equation modeling) or an instrument development (Journal of Physical Activity and Health send me this kind of articles regularly). In this situation, I gave my comments, but I always request from an editor not to make final decision on my comments and to consider other reviewers as well.
I do not educate, but only communicate
My ultimate goal in as a peer reviewer is to help authors to improve their article, but not simply to suggest some changes, major and minor. I always put myself in authors’ shoes: “what would I do if it were my research?” and give constructive comments and solutions to all parts of a manuscript I think deserve improvement (at least I think so!). I always attached a file for authors, where I clearly write what would I change and how from the title to the conclusions. As far as possible, I reference my comments and solutions with previous publications.
I know the authors of the article I review
I highly appreciate the double blind review process (authors and reviewers are unknown to each other). Unfortunately, for every third article I saw, its authors were listed in the text (no blinding for authors). I think that this practice is not fair and it dramatically increases the likelihood of being rejected/accepted by a reviewer. Firstly, authors frequently suggest reviewers and secondly reviewers might know authors. The only good thing for me to have all listed authors is that I can easily look up for their previous publications searching for unethical activities.
It happens twice that I was requested to review the articles of authors among whom were listed my former professors (one of them I know personally). Considering that articles were in my expertise (one was even a replication of my study!), I did the reviews, but I informed the editors of that journals that I knew some of the authors and I requested to consider other reviewers as well.
It mostly happened what I had done
As a reviewer, I always receive a feedback from a journal, about the final discussion on an article I had reviewed. I do think that it is not me to destine the faith of an article, but only to comment a research presented in the article. I always try to make such comments that would let enough space to an editor to accept an article or to request a revision, instead of immediately reject the article after reading my report. For sure, the article must be free of any unethical activities [7]. In about 75%, it was requested a minor/major revision of an article or it was accepted as submitted.
The authors did what I suggested, but I did not receive a credit for
In all situations, the authors of the articles I reviewed, entirely revised the manuscript that was subsequently accepted for publication. Even rejected articles from a journal I reviewed for, were substantially revised according to my comments and they were submitted to another journals that accepted them. However, in both situations I received no credit for this! No thanks to unknown reviewers, even! I am sometimes so despaired about this that I would write to the authors to pay me for reviewing (improving) their work!

   

Summary

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The pre-publication review process is regarded as a “gate keeper” in science. However, I think that the current practice of “gate keeping” is much more “monkey business” than doing well for science. With my experience confessed here, firstly, I want to show how tricky pre-publication peer review could be, and what you could actually expect from peer reviews is a wide range of possibilities that are converted into dichotomy, being accepted or rejected. Secondly, obviously indirectly, I want to encourage post-publication peer review that surely faces similar practices, but it does not make you simply be accepted or rejected because of a peer reviewer doings. Finally, I want to encourage everyone not to be discouraged by reviewers, because every single article needs improvements, not simple changes and simple dichotomy.

References

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1.Burnham JC. The evolution of editorial peer review. JAMA 1990;263:1323-9.
2.ttp://journals.lww.com/academicmedicine/toc/2001/09000.
3.Wager E, Godlee F, Jefferson T. How to Survive Peer Review. London, UK: BMJ Books, BMA House; 2002.
4.oberts LW, Coverdale J, Edenharder K, et al: How to review a manuscript: a "down to earth" approach. Academic Psychiatry 2004;28:81–87.
5.Woolley KL, Barron JP. Handling manuscript rejection: insights from evidence and experience. Chest 2009;135:573-7.
6.Mahawar Ka K. Role of Peer Review in Biomedical Publishing. WebmedCentral MISCELLANEOUS 2011;2(4):WMC001863.
7.http://publicationethics.org.

Source(s) of Funding

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No fundings recieved.

Competing Interests

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Acknowledgments. I would like to thank to all peers reviewing my research, teaching me valuable lessons, and letting me progressing rapidly. Thanks to Ivana Tadic for commenting this text.
Disclosure. I am an ordinary physician and my hobby is biomedical research and publishing. I am not affiliated with any academic institution and I am not under the pressure to publish as much as possible. I am independent, free, and open to communicate my ideas, and as such, I do not have any conflict of interest (financial, material, intellectual, etc.).

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