New to reviewing, or just need a tighter flow? This guide walks through a clean, repeatable process you can use on any medical manuscript. It blends ethical ground rules, practical checks, and a step-by-step way to craft a helpful report in less time.
Completing A Peer Review For A Medical Journal: What Matters Up Front
Start the moment an invitation lands. Act fast. If the paper fits your expertise and you can meet the deadline, accept. If not, decline within a day and suggest substitutes. Editors need quick signals so the paper keeps moving.
Share any relationships or interests that could sway your view, even if they seem minor. The ICMJE disclosure form standardizes this step across journals. If anything feels tricky, ask the editor how to proceed.
Treat the manuscript as confidential. No forwarding. No lab chat. No use of ideas for your work. The COPE guidelines for reviewers set clear expectations on privacy, fairness, speed, and accuracy.
Scan the title, abstract, and cover letter. Confirm scope, study type, and patient group. Note any time-sensitive elements such as safety alerts or public health value. If a fast review would help, tell the editor what you can do.
Reviewer Intake Checklist
| Item | What To Confirm | Why It Helps |
|---|---|---|
| Fit | Topic, design, and stats align with your skills. | Raises quality and keeps you efficient. |
| Time | Deadline workable; plan reading blocks. | Prevents rushed notes and missed signals. |
| Conflicts | Financial, personal, or academic links disclosed. | Protects trust and the record. |
| Confidentiality | No sharing outside the journal. | Safeguards data and ideas. |
| Reporting Rules | CONSORT, STROBE, PRISMA, or other fits study type. | Anchors fair, consistent checks. |
| Tools | PDF reader, note system, checklist template set. | Speeds repeatable reviews. |
How To Do A Medical Journal Peer Review With Confidence
Work in two passes: a quick scan, then a deep read. The first pass maps the paper. The second pass tests claims against methods, data, and reporting rules.
Skim For Scope And Fit
Read the abstract and figure legends. List the main question, primary outcome, and main result. Flag mismatches between aim, methods, and claims. Drop notes in a simple grid: strength, weakness, question, action.
Read Methods Like A Detective
Check design, sampling, randomization or matching, blinding, and pre-specified outcomes. Look for power calculations, clear eligibility, and transparent protocol changes. If the study rests on lab assays or imaging, look for validation and reproducibility steps.
Use Reporting Checklists As Guardrails
Match the paper to the right checklist on the EQUATOR Network. For trials, think CONSORT; for observational work, STROBE; for systematic reviews, PRISMA; for diagnostic accuracy, STARD. You’re not doing box-ticking. You’re verifying that readers can follow what was planned, what was done, and what was found.
Check Statistics And Data Presentation
Confirm that the analysis matches the design and outcome types. Look for sound handling of missing data, multiple testing, and model assumptions. Point out when effect sizes and precision matter more than P values. Ask for raw numbers behind percentages in tables and text.
Assess Results And Figures
Each figure should tell a clean story. Axis labels, units, confidence intervals, and footnotes need to be clear. Watch for scale tricks or truncated axes that overstate shifts. Ask for data sharing statements or links when the journal policy requests them.
Judge The Discussion And Claims
Authors should link claims to data, note limits, and avoid overreach. If causal language shows up in non-experimental designs, flag it. If clinical practice gets mentioned, ask for guidance strength and setting. Suggest concrete edits, not vague warnings.
Spot Common Ethical Flags
Look for missing IRB approval, weak consent language, unclear trial registration, duplicate figures, or overlapping cohorts. Suspicious overlap with prior text may call for checks. When you see a red flag, tell the editor privately with clear, factual notes.
Write A Clear, Actionable Report
Editors need a crisp summary and specific fixes. Authors need a plan they can trust. Keep your tone calm and direct. Back every point with a page, line, figure, or table reference so the team can act fast.
Start With A One-Paragraph Summary
State the question, design, sample, main result, and your overall view on validity and usefulness. This helps editors place the paper and helps authors see that you understood the work.
List Major Comments
Group the big issues that affect validity, clarity, or reader safety. Tie each point to text locations. Offer the next step: add a control, clarify a method, move a claim, share a dataset, or adjust a figure. Number the items.
List Minor Comments
Collect fixes that polish the paper: small method gaps, reference updates, wording that could mislead, unit slips, or typos. Keep this list short and practical.
Use Confidential Comments To The Editor When Needed
If you suspect misconduct, a breach of privacy, or an unresolvable dispute, flag it privately. Stick to facts and attach evidence or exact locations. Do not include these notes in the author-facing section.
Pick A Recommendation
Most systems offer choices like reject, revise, or accept. Your recommendation should flow from your major points and the journal’s bar for novelty and rigor. If you recommend revision, list what a successful revision would look like.
Ethics, Bias, And Fair Practice
Keep your identity private if the journal runs blind review. Do not hunt for author names unless policy allows it. Refrain from citing your own work unless it aids readers and truly fits the manuscript.
Use plain language that helps authors act. Steer clear of sarcasm and loaded terms. If you rely on software or AI to sort notes, do not paste text from the paper into public tools. Never upload the manuscript to external services without written approval. COPE advice on confidentiality applies to tools as well.
When a topic touches your clinical practice or research niche, audit your own leanings. Read twice, once for content and once for tone. Ask yourself whether a different team with the same data could reach a reasonable alternative view. If so, propose wording that reflects that range.
Time Management And Communication
Block time for three sessions: mapping, deep read, and writing. Short bursts beat one long slog. If a deadline looks tight, ask the editor for a small extension early. Silence hurts authors the most.
Set a timer for each pass. Fifteen minutes for mapping, one hour for the deep read, thirty minutes for the report, and a short final sweep. These blocks keep focus tight and stop perfectionism from soaking up your day. Keep a small template next to you and tick items as you go. If you need input from a statistician or method expert, ask the editor before seeking help and describe the plan in your confidential note. Keep your checklist within reach.
Practical Checks By Study Type
Randomized Trials
Look for registration, allocation concealment, blinding plans, deviations from protocol, and updated flow diagrams. Confirm whether effect measures match the design. Ask for absolute risks and numbers needed to treat or harm when readers would benefit.
Observational Studies
Look for clear exposure and outcome definitions, time windows, and strategies that limit confounding. Check missing data, model selection, and sensitivity checks. Causal wording needs extra care.
Systematic Reviews And Meta-Analyses
Expect protocol registration, search dates, selection flow, risk-of-bias tools, and transparent synthesis choices. Ask for forest plots with effect sizes and heterogeneity measures. Check whether small-study effects were considered.
Diagnostic Accuracy
Check reference standards, sampling, spectrum of disease, blinding between index and reference, and handling of indeterminate results. Ask for paired data and full 2×2 numbers when possible.
Qualitative Research
Check reflexivity statements, sampling approach, saturation, coding strategy, and evidence quotes that match themes. Clarity on context and transferability helps readers judge use in their setting.
Ethical Flags And What To Do
| Flag | How You Might Spot It | Action To Take |
|---|---|---|
| Unregistered Trial | No registry ID; date suggests post-hoc listing. | Ask for registration details and timing; alert editor. |
| Consent Gap | Vague or missing consent in methods. | Request exact wording or IRB waiver text. |
| Image Re-use | Figures look duplicated or spliced. | Note panels and pages; send concerns privately. |
| Text Overlap | Repeated phrasing across prior papers. | Share links; ask the editor for checks. |
| Selective Reporting | Primary outcome in registry differs from paper. | Request alignment or a clear explanation. |
| Data Access Issues | Policy requires a sharing plan; none provided. | Ask for a statement or repository link. |
Before You Submit: Final Pass And Self-Check
Read your report once more from the author’s seat. Are the steps clear? Can someone fix each item without guessing? Trim any extra words that don’t move the paper forward. Swap any sharp phrasing for precise, neutral wording.
Paste your numbered lists into the journal system and keep a copy. Attach marked-up files only if the editor invites uploads. Hit submit and send the editor a short note if any issue needs fast attention.
Handy One-Page Template
Try this quick structure when you write:
- One-paragraph summary of question, design, and main result.
- Numbered major comments with action steps.
- Short list of minor comments.
- Confidential notes to the editor, only if needed.
- Clear recommendation with a one-line reason.
Peer review is skilled work. With a steady checklist, a calm tone, and clear evidence for each point, you’ll help editors decide and help authors lift their science. Readers benefit from that care.