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- ↵*Address correspondence to:
Anthony N. DeMaria, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology, 3655 Nobel Drive, Suite 400, San Diego, California 92122, USA.
Many parties contribute to the ultimate success of a medical journal. The authors are predominant, of course, since there is no journal without content. As editors, we in San Diego like to think that we make a major contribution to JACC. Not only do we administer the Journal, but we bear the ultimate responsibility for selecting the manuscripts to be published. In this regard, an under-recognized and under-appreciated group who are requisite to the success of the Journalare the external reviewers. These individuals provide the primary guidance upon which editorial decisions are based, and in a significant way determine the timeliness with which these decisions are rendered. We plan to change the lack of appreciation of this group by identifying and recognizing those who perform this function very well.
The selection of which manuscripts are to be published is the most important function performed by the editors. This task is a particular challenge with JACC, since we are able to accept <20% of the papers submitted. Moreover, given the diversity of specialization within cardiology, it is essential to maintain a balance of subject matter. The editors rely heavily on the evaluations of expert external reviewers in making these judgments. The peer-review assessment is particularly important in helping the editors make priority assignments among a group of manuscripts, all of which are acceptable for publication.
The selection of reviewers is one of the most important actions taken in the assessment of any manuscript. It is axiomatic that there are two crucial variables operative in the grading of any manuscript: the paper itself and the reviewer. The first qualification sought in any reviewer is, of course, expertise in the subject matter. Within this group we seek individuals who are highly objective and not susceptible to the influence of competitive pressures or personal differences. Additionally, it is important that the reviewers selected be capable of producing analytic critiques that identify the strengths and weaknesses of a paper in a constructive manner. We expect the referees to be able to convey clearly to us their opinion of the specific work under consideration as well as its importance within the broader field of cardiovascular disease. Last but not least, especially for the authors, we ask that the assessment be done in a timely fashion.
As those who have evaluated manuscripts for JACCare well aware, we ask reviewers to complete a form containing several sections. One section calls for comments to the authors, while a second section asks for a recommendation to accept or reject the paper; the amount of revision required; and specific grades (from A to F) for originality, methodology, presentation, relevance, and overall priority. The last section requests confidential comments to the editor and is meant to elicit a summary recommendation for a decision as well as the major reasons for the recommendation. Although this last section is often the most valuable for the editors, it is surprisingly omitted by many reviewers.
An excellent review has a number of characteristics. It identifies significant flaws and presents a constructive critique to the authors detailing the perceived limitations of the work and suggestions for improvement. It assigns grades that are consistent with the comments to the authors and includes a summary recommendation to the editors regarding the ultimate decision. A problem occurs when the comments to the authors differ significantly from those to the editors. Many of the inquiries we receive from authors after a manuscript has been declined result from benign comments to the authors in the face of a highly critical assessment presented to the editors. Finally, all this must be done in a timely manner. Clearly, the longest period of the entire peer-review process involves the evaluation by external reviewers. Based on the above characteristics, the editors have begun to evaluate reviews on a five-grade scale. As might be expected, review grades conform to a bell shaped curve, with a small minority as particularly good or particularly weak.
Given the importance of journals to the dissemination of new research discoveries, and the importance of critiques by external experts to the peer-review process, the rewards for the effort are relatively small. Reviewers accept the responsibility without financial compensation of any kind. In fact, they create written critiques with full knowledge that they will be seen only by the editors and authors—and will be anonymous to the authors at that. The invitation to serve as a reviewer is, of course, recognition of one’s accomplishments and stature in the field of cardiology. This recognition is expressed in its highest form by appointment to the Editorial Board. However, only a limited number of Editorial Board appointments are available, far less than the number of reviews required. As the number of manuscripts we receive approaches 3,000 this year, we will require some 6,000 reviews. Acknowledgment of service as a reviewer on the curriculum vitae or at the time of assessment for promotion is of value, but does not distinguish either the magnitude or quality of the contribution. In the final analysis, the major motivation leading experts to voluntarily undertake peer review of manuscripts is a desire to do their part as members of a community of investigators. It is not surprising, therefore, that exhortations to complete reviews by a given deadline sometimes fall on deaf ears and that grades and opinions are occasionally provided without supporting documentation.
In light of the foregoing considerations, it occurred to the editors that some additional recognition was in order for outstanding reviewers. We propose to identify a group of outstanding individuals to be designated as “Elite Reviewers.” The criteria for “outstanding” would include the contribution of an insightful review, well presented to both authors and editors, in a short period of time. An example of an outstanding characteristic is the provision of documenting references when reporting that a paper presents no new findings, or of supporting statistics when indicating that a study is underpowered. Elite reviewers are those who contribute high-quality critiques for a large number of papers within the requested time.
At the end of each year, the Editors of JACCwill identify the group of individuals who will be designated as “Elite Reviewers.” The criteria for selection will be those discussed above. We anticipate that approximately 10% of our reviewers will qualify for the “Elite Reviewer” designation. Those selected will be listed in an issue of JACC, will be recognized at the Editorial Board meeting, and will receive a letter from the Editors attesting to the contributions to the Journal. These letters will also be available to be sent to Department Chairs, Promotions Committees, or other groups identified by the reviewer. It is hoped that the “Elite Reviewer” designation will serve to emphasize the importance of the activity to the medical community, recognize excellent performance, and increase the enthusiasm with which individuals perform this service.
With the existence of 26 journals dedicated to cardiovascular disease, investigators are constantly beseeched with requests to serve as peer reviewers. Done well, the task requires time, effort, and judgment. At present, the tangible rewards for the service are modest, and the system is sustained by the voluntary efforts of the cardiovascular community. We hope that instituting an award that recognizes excellence as an “Elite Reviewer” will provide additional reward for this vitally important activity and serve as an incentive to perform high-quality and timely reviews.
↵* Editor-in-Chief, Journal of the American College of Cardiology
- American College of Cardiology Foundation