What Editors Expect From A Medical Peer Review
Editors want a fast yes or no on feasibility, followed by a fair read. The review should check fit, rigor, clarity, and ethics. It should show familiarity with the field without drifting into opinion. State conflicts, stick to evidence, and respect confidentiality. When you cite rules, point to public standards so the author can act on them. The shortest path to a good decision is a report that is precise, polite, and anchored in method, not style.
Peer Reviewing A Medical Journal Article: Step-By-Step
This section maps a simple way to go from first look to a firm recommendation. Use it as a repeatable loop for clinical studies, lab work, qualitative papers, and reviews.
Set Up Your Review Workspace
Open the journal’s instructions for reviewers in one tab and the manuscript in another. Skim the abstract and the methods, then check for conflicts or topic mismatch. If you cannot be objective or cannot meet the deadline, tell the editor right away. Reviewers also follow clear ethics: protect confidentiality, avoid using ideas from the paper, and declare any competing interests. See the COPE guidance for the standard duties of reviewers.
Screen The Manuscript Fast
Start with two questions: does the paper fit the journal, and is there a clear research question? Then scan for ethics approval, trial registration when required, and data sharing notes. A paper can be out at this stage if the design cannot answer the question or if approval is missing. If the study looks workable, move on to reporting checks.
| Check | What To Look For | If Not Met |
|---|---|---|
| Fit to journal scope | Topic, readership, study type | If off-scope, suggest transfer or decline |
| Ethics and registration | IRB/IEC approval; trial ID if applicable | Ask for approvals or registration details |
| Study question | Clear PICO or equivalent, outcomes defined | Ask for a sharper question or outcomes |
| Design signal | Randomization, controls, sampling plan | Flag fatal design flaws early |
| Data signal | Availability statement, repository link | Ask for a plan to share or justify limits |
Verify Reporting Standards
Pick the right reporting checklist for the study type and compare line by line. CONSORT fits randomized trials; STROBE fits observational studies; PRISMA fits systematic reviews; SRQR or COREQ fits qualitative work; CARE fits case reports. The EQUATOR Network hosts those checklists and makes selection easy. When items are missing, cite the checklist item and the page or section where the fix belongs.
Methods And Statistics: What To Verify
Rebuild the study in your head from protocol to analysis. Look for prespecified outcomes, a sample size plan, and a clear path from raw data to estimates. Check randomization and concealment, blinding where possible, and handling of missing data. For models, look for assumptions, variable selection rules, and sensitivity checks. Ask for effect sizes with confidence intervals, not only P values. Where you see subgroup claims, ask for a rationale and an interaction test. When code or data are shared, try small spot checks to confirm that tables and figures flow from the files provided.
Results: Tables, Figures, And Data Signals
Scan tables for totals that match the text, denominators that stay stable, and outcomes that match the methods. Figures should show scales and labels that line up with the claims. Ask for raw counts along with percentages. Where the paper makes claims about clinical impact, ask for numbers needed to treat or harm when suitable. If a figure hides error bars or uses truncated axes, ask for a more honest view. When data sharing is promised, ask for links that work at review time if the journal permits secure access.
Ethics And Transparency Checks
Look for IRB or IEC approval identifiers, consent language, and safety oversight for trials. Check authorship statements, contributorship, funding, and data access roles. Trial registration before enrollment is the norm for interventional studies. Report any suspected plagiarism, dual submission, or image manipulation privately to the editor. The ICMJE Recommendations explain these basics and give shared language for reports to editors.
How To Write A Balanced, Actionable Review
Shape your report for fast use. Start with a short summary of the question and main finding. Then separate major issues from minor points. Major issues block a decision: missing methods, unclear outcomes, data problems, or safety concerns. Minor points tighten clarity, style, and small fixes. Keep a section for notes to the editor if you need to comment on novelty, policy fit, or ethics concerns not meant for the authors. Keep the tone calm and specific; match every claim with a pointer to a line, table, or figure.
Sample Structure For Your Report
Opening summary (2–4 lines). Major comments, each with the problem, why it matters to validity, and a concrete fix. Minor comments as a short list. Confidential notes to the editor, if any. Close with a clear action: accept, minor revision, major revision, or reject. Keep the whole report tight and free of sarcasm. Praise strong parts that you want preserved, such as a clean randomization or a thorough sensitivity check.
Phrases That Keep Reviews Calm
Use neutral verbs: “report,” “show,” “estimate,” “suggest.” Try lines like “Please state the primary outcome up front,” “Report both absolute and relative risk,” or “Predefine subgroup rules or move them to exploratory status.” When you spot a gap, propose a remedy: “Add a flow diagram,” “Share the code that produced Figure 2,” or “Clarify inclusion criteria in the methods.” Replace blame with process: “The analysis plan does not match the outcomes; please align them.”
Reviewing A Medical Research Paper: Decision Paths
Your recommendation guides the editor, and your reasoning teaches the author what to fix. Base the call on method and reporting, not on taste or brand. Use the paths below to stay consistent across reviews.
When To Recommend Reject
Fatal design flaws that block any valid answer, missing ethics approval, unregistered trials with outcome switching, claims not backed by the data, or near-duplicate submissions merit a reject. Spell out the gating issue in one crisp line, then give a short list of points so the author learns from the read. If the work might fit another outlet, say so without naming a rival journal.
When To Invite Major Revision
Major revision fits papers with a sound question and fixable gaps. Typical gaps include unclear primary outcomes, missing sample size logic, mismatched analysis and outcomes, or weak reporting against a checklist. Ask for one round of strong fixes rather than many waves of small tweaks. Be clear about what would flip your call to accept after revision.
When Minor Changes Fit
Minor changes suit papers with a solid design and clean reporting that need polish. Such fixes include clearer labels, tighter abstracts, added data dictionaries, or small figure tweaks. Keep the list short, and ask the authors to mark changes so the follow-up read is swift.
Common Red Flags In Medical Manuscripts
Watch for spin: the abstract reads stronger than the results. Watch for outcome switching: prespecified outcomes ignored while secondary ones shine. Watch for p-hacking signs: many tests with no adjustment. Watch for salami slicing: many thin papers from one dataset. Watch for plagiarism or recycled figures. When you see any of these, alert the editor in the confidential section with clear quotes or page numbers. Match the tone to the seriousness of the issue.
Tools And Resources That Speed Up Peer Review
Set up a light toolbox. A reference manager saves time tracing citations. A stats notebook helps you check basic formulas. Reference checkers can spot retracted citations. The EQUATOR library helps you pick the right checklist for odd study designs. Browser split-view or a second screen speeds cross-checks between methods and figures. Keep a short personal checklist so your reviews stay consistent across journals.
| Tool | Use | Notes |
|---|---|---|
| Reporting checklists | Pick CONSORT, STROBE, PRISMA, SRQR, CARE from a single hub | Use the EQUATOR library or GoodReports |
| Reference checks | Identify retractions or mismatched citations | Cross-check with journal tools or Retraction Watch |
| Stats scratchpad | Quick CI, NNT, and power checks | Save small templates for reuse |
Time Management And Communication With The Journal
Say yes only when you can return a review inside the journal’s window. If you need a short extension, ask early and propose a date. If you find a conflict after starting, stop and notify the editor. Do not share the manuscript or invite a trainee to help unless the journal allows co-review and you name the person. Keep all files secure. After submission, be ready to clarify points or recheck fixes during revision rounds.
How To Be Fair To Early-Career Authors
Judge methods, not fame. Avoid asking for extra experiments that are not needed for the main claim. Point to public guides when a fix is routine so the author can learn. Praise good practice, such as data sharing or a clear analysis plan. If English is the barrier, ask for language editing without downgrading the science. Suggest a preprint link if policy allows and the science is sound.
Template Notes You Can Paste Into Your Report
• Please name the primary outcome and time point in the abstract and methods.
• Report effect sizes with 95% confidence intervals for all primary outcomes.
• Align the analysis with a prespecified plan; mark any exploratory work as such.
• Add a participant flow diagram with counts at each step.
• Share a data dictionary and code availability statement.
• State IRB/IEC approval and consent procedures.
• Register or cite the trial ID on the title page and abstract where relevant.
• Replace P values near the threshold with exact values and intervals.
• Expand figure legends so a reader can understand each panel without the text.
• Move clinical recommendations to a cautious, data-driven wording.
Keep Records And Protect Yourself
Save your notes and the submitted files in a private folder so you can answer editor questions later. Do not reuse unpublished ideas. If the paper cites you or you know the group, declare that history. If the editor shares other reviews, learn from them but keep your own voice. When the journal publishes peer review reports, accept the release if your wording stays factual and respectful. A steady record of fair reviews builds trust with editors and helps the field.