Author + information
- Valentin Fuster, MD, PhD∗ ()
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address correspondence to:
Dr. Valentin Fuster, Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, New York 10029.
We in the JACC family of journals—along with all other science and medical journals—are tremendously indebted to the expert reviewers who spend hours of their valuable time meticulously analyzing all aspects of a submitted manuscript. To provide a sense of scope for the peer review process for a weekly journal, more than 3,500 reviews were requested and submitted to the Journal under my editorship from April 2014 through late November 2014. We recognize these individuals do not only review for our Journal. In fact, the “exponential increase” in the number of manuscripts submitted for publication worldwide, estimated in the millions annually, places tremendous burden on the capability of qualified reviewers (1). Nevertheless, while I recognize the numerous hours required to properly review manuscript, I also view this task as an obligation of physicians and investigators, because it is a service to our academic enterprise to move research in appropriate directions.
Since I have taken on the role of JACC's Editor-in-Chief, many colleagues have encouraged me to call special attention to those people who review a large number of papers—and I am particularly grateful to these individuals. However, I am not comfortable to publicly state that those who review more papers are more or less insightful than those who review 2 to 3 studies with noteworthy diligence.
This leads us to an important problem within the review system: How should we reward reviewers for their generosity of time and tremendous intellectual efforts?
Before I address that question, there are 2 specific aspects of the review system that require attention. The first relates to the discrepancy in judgments of a manuscript between the reviewers and the second concerns the importance of comprehending the mission and level of scrutiny required by a given journal.
First, in order for this process to work appropriately, it is important that an experienced physician or investigator evaluates a particular manuscript through the lens of the previously published literature, as well as his/her own experience in that area of interest. Sometimes, as a result of the burden of manuscripts to be reviewed, we seek younger, but always reputable, physicians or investigators as an alternative to evaluate papers. Often, they provide long, in-depth reviews, but they are much stricter in their final determinations compared with their more seasoned counterparts. In general, when faced with any discrepancy among reviewers in our final decision-making process, we seek to provide balance to these disparate judgments through the perspective of our editorial board.
Second, an important, compulsory aspect necessary to properly conducting a review is understanding the mission of the journal and the level of scrutiny that the editors require for acceptance or rejection.
For JACC, these elements are very simple. The Journal seeks to publish manuscripts that affect the clinical care of all cardiovascular diseases. Our official criteria include considerations of priority, originality, methodology, presentation, and medical relevance. Implicit in these criteria, we are asking our reviewers to consider the importance or interest of this work to researchers and practitioners inside or outside of the field. We also ask reviewers to consider whether the study was conducted according to the highest ethical standards. Sadly, legibility is becoming an increasing problem; we can only publish papers that our readers can comprehend easily, so this needs to be taken into account. Finally, and most important to us, do the results and conclusions ring true with what you are seeing in patients or the laboratory? This final consideration is why long-term professional experience is so important for reviewers. Senior physicians and researchers have seen theories rise and fall in popularity, but investigating cardiovascular disease states over a lifetime will provide the perspective necessary to distinguish the probable from the impossible.
So, back to our original question: how should we appropriately reward reviewers for their much-needed time, intellect, and insight? One new open-access model is that authors will pay between $500 and $5,000 for peer review and the cost of posting their paper on a website (2). There are some who advocate that a portion of those funds should be distributed to the reviewers themselves. I am very concerned that funding could muddy the current unsullied review process. We all recognize that the peer review process is imperfect and flawed, but it also has served the medical community well for many years—and it needs to stay rooted in the integrity of the reviewers themselves.
Instead of financial rewards, I propose that we promote superior reviewers through academic and professional appointments at their institutions, as well as promotions to editorial boards; personally, I have written many recommendations for such advancements for strong reviewers. However, to ensure that these individuals receive proper recognition at their institutions, JACC is starting a new policy of sending certificates to reviewers who review the largest number of manuscripts and/or receive the highest ratings from our editors, so these people can include this certificate with their curriculum vitae for the purposes of promotion. Also, I am proud of the fact that the American College of Cardiology offers continuing medical education credits for reviewing papers for our journals, as I think this is an appropriate incentive. Another option, which we have not yet employed at JACC, is to have the submitted papers by avid reviewers rewarded through expedited reviews or a prioritization process (3). Of course, this latter option may be more controversial and could lend to perceived favoritism.
While we need to do a better job at rewarding these time-strapped individuals, I do consider the review process obligatory, especially for academically bound senior physicians and researchers who can help propel the quality of manuscripts that could eventually translate into changing clinical care for our patients. The responsibility of the advancement of cardiovascular medicine through newly published manuscripts falls as squarely on the shoulders of our reviewers as on our authors, if not more so. I conclude as I began, with an expression of gratitude to all our reviewers. We stand together with this responsibility of driving research forward.
- American College of Cardiology Foundation