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- Anthony N. DeMaria, MD, MACC, Editor-in-Chief, Journal of the American College of Cardiology⁎ ()
- ↵⁎Address correspondence to:
Dr. Anthony N. DeMaria, Editor-in-Chief, Journal of the American College of Cardiology, 3655 Nobel Drive, Suite 400, San Diego, California 92122.
I remember well several instances earlier in my career when, having received a manuscript for a journal, the recommendations I had made were not followed by the editor. On each occasion I experienced a succession of emotions. There was a brief sense of rejection; obviously the rationale underlying the recommendation I made was either not sufficiently compelling or not considered important enough to guide the decision. This feeling usually changed rapidly into one of irritation; why did they bother to ask me for my opinion if they were going to disregard my advice? In fact, I often thought that perhaps I should not waste my time reviewing for that journal in the future. However, by the time subsequent solicitations for evaluations were received I had usually long forgotten the initial emotions and went about the task. These recollections now recur frequently when we reach a decision to accept or reject a manuscript against the advice of a reviewer. And so, rather than writing an explanation to the consultant every time this occurs, I thought I would just write an open letter to all reviewers.
Although this Editor’s Page will deal specifically with the process of peer-review of original manuscripts, I suppose that it could apply in a general way to anyone whose recommendation about anything was solicited and then not followed. Surely the emotional response will be somewhat similar. In addition, the explanation will likely involve the same principles. That is, an understanding of the process, recognition of the various issues involved in the decision, appreciation of the individual roles in the decision making, and assurance that all opinions are given due consideration.
As acknowledged in these pages on several occasions, the process of accepting (or rejecting) manuscripts for publication is an imperfect art. The decision is based upon multiple factors, including the external reviews, subject matter, perceived interest to readers, competing manuscripts, and others. The involvement of multiple factors is almost certainly true for most complex decision-making. Therefore, the evaluation of expert consultants is only one of the factors that determine acceptance. A manuscript may have great appeal to experts in that area, but be on a subject which is out of the scope of the journal or perceived to be of interest only to a small group of authorities.
Another important determinant of acceptance is the number and quality of manuscripts competing for acceptance at the same time. Any reviewer sees 1 or at most 2 manuscripts under consideration in any week. However, the editors see every submission. Not surprisingly, a manuscript that seems strong (or weak) when viewed alone may appear otherwise when compared to other papers. This is an advantage enjoyed by the editors and often leads to a different evaluation from that of the reviewers.
Another very important determinant of the decision is the opinion of the editor overseeing the review process. As attested to by a recent article in the New York Times by Lawrence Altman (1), many individuals believe that the editors are largely scorekeepers who merely tally the grades assigned by the reviewers. However, each editor forms their own assessment of a paper independent of the referees, and these evaluations sometimes differ considerably. This should not be surprising. As indicated in the past, nearly 40% of submissions are assigned the highest priority for publication by one reviewer, and the lowest priority or rejection by the other. If individual reviewers can have honest differences in opinions about manuscripts, it should be predictable that editors can as well. The question then becomes how to rationalize all of the evaluations.
The final step in the decision process involves the weekly meeting of the editors. Every manuscript recommended for acceptance at any priority is discussed by the entire group. The editor supervising the paper presents a summary of the paper as well as their own recommendation and that of the external reviewers. They always elaborate on why they disagree with a reviewer when this occurs. Then all of the editors consider the paper from their own perspective and in light of the other competing manuscripts. A final consensus is then reached as to whether or not a given submission achieves sufficient priority to be included in the less than 15% of papers which can currently be accepted for publication. In the process, some manuscripts recommended for acceptance by reviewers are rejected and vice versa.
And so it is that every week we find ourselves notifying reviewers of decisions we have made contrary to their recommendations. Predictably, from time to time some reviewers will write to us asking for an explanation. I assume that they and others are experiencing the same feelings that I did when acceptance decisions were made counter to my advice. They wonder first where did they go wrong, and then why did they bother in the first place. However, the explanation is inherent to the process involved in reaching a decision. First, realize that the process is complex and involves a number of steps and individuals. Second, know that there are a large number of factors that enter the decision, only some of which can be evaluated by the reviewer. Third, recognize that reviewers are consultants, not juries. Finally, and most importantly, know that your opinions have been thoroughly read, carefully considered, and appropriately weighed. The information provided in every review is taken into account in reaching a final decision.
When I initially became an editor I often wrote short notes conveying the aforementioned sentiments to reviewers whose recommendations were not followed. However, the number of such notes soon became unwieldy. Moreover, it was clear that, just as was true in my own case, after a brief emotional reaction most reviewers soon understood and accepted the process and went on to the next review. So, to all those reviewers whose advice we have not taken, I say your opinions have been read and valued, you have influenced the decision process, we are grateful, and please accept our next request for a review.
- American College of Cardiology Foundation
- Altman L.K.