Peer Review Questions & Answers: How?

Peer review is a collaborative process among reviewers and the journal editor to assess the validity and significance of submitted manuscripts. Constructive comments from peer reviewers improve the scientific writing of authors and ultimately readers’ confidence in the integrity of the published article (1, 2). To support the growth of peer reviewers, the Journal of Pain and Palliative Care Pharmacotherapy (JPPCP) has created a Peer Review Q&A editorial series to serve as a comprehensive guide to the peer review process (3). In this installment How? Part II, we will focus on the peer review process for particular article types: case reports, systematic reviews, narrative reviews, and opinion pieces. For general tips on thinking like a peer reviewer and reviewing research articles specifically, check out the How? Part I editorial published in the Quarter 2 issue of 2023 (4).

Case reports

Although there is no universal definition for what constitutes a case report, it typically involves reporting on an individual patient experience. For JPPCP, a case report “describes a phenomenon of interest (unique pharmacotherapy or medical issue, intervention, clinical finding, etc.) occurring in patient case(s) encountered in clinical practice” (5).

In general, case reports are thought to comprise the lowest levels of evidence with high quality systematic reviews representing the highest level. The position of case reports near the bottom of the evidence hierarchy is mainly due to the likelihood of bias (6). However, case reports can also be a valuable source of information around unique or rare situations that are difficult to replicate in higher level studies or represent new or novel information (6). For a submitted case report, a critical component in the peer review process is determining whether the probability of bias can be balanced by the importance of the findings.

Q. How do I peer review a case report?

A. Assessing a case report should start with the fundamentals, as outlined in previous parts of this series (3, 4). Remember to also familiarize yourself with author instructions on the journal’s homepage (5).

While reviewing the case report, consider the following (6–9):

• Why is this case report worthy to report? What does it contribute to the field? Why is it atypical or noteworthy?

• Does the case report provide all necessary information about the patient or the case?

• Was patient confidentiality and/or consent addressed?

• Are likely biases addressed?

• Were useful conclusions generated?

• Did authors address alternative causes that might explain the findings observed?

Peer reviewers should also utilize reporting guidelines or checklists, when available. For case reports, the CARE guidelines are a commonly endorsed resource (7). Consider using the CARE checklist to ensure that all essential information is included in the report. For instance, the title of the manuscript should include the words “case report” or “case series.” The introduction should describe why the case is unique and may include literature to emphasize its importance. The case description should include all necessary details of the case, including demographics, clinical findings, assessments, interventions, follow-up, and outcomes (6, 7). The case report should clearly explain what happened chronologically, and reviewers may request inclusion of a timeline in the form of a figure or table, if needed (6, 8). The discussion section should outline strengths and limitations related to the reported case, describe existing literature relevant to the case with references, and provide rationale for conclusions drawn. The report should conclude with key “take-aways” from the case and any implications for practice (6–8). Peer reviewers should provide constructive comments for any missing, incomplete, or unclear elements of the report.

Systematic reviews

A systematic review is defined as “a review that uses explicit, systematic methods to collate and synthesize findings of studies that address a clearly formulated question” (10). Systematic reviews may also (but not always) include a meta-analysis, which is a statistical analysis of pooled results from multiple studies (11). As a peer reviewer, it is important to distinguish systematic reviews from narrative reviews (refer to Narrative Reviews).

Q. How do I peer review a systematic review?

A. When assessing a systematic review, consider the following (11–12):

• Does the systematic review have a clear research question? This is typically described as a PICO or PICOTS (population, intervention, comparator, outcome, timing, setting).

• Did the authors provide a comprehensive literature search strategy? Are the search terms and eligibility criteria (inclusion and exclusion) clearly defined? Were all relevant studies included?

• What process was used to assess included studies for risk of bias? Was this method sufficient?

• Does the systematic review address quality of evidence?

• If a meta-analysis was conducted, were the results of individual studies combined appropriately?

These questions may be best answered while using standardized reporting guidelines or checklists, when available. For systematic reviews, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) is the most commonly used reference (10). Updated in 2020, PRISMA offers a flow diagram and checklist to ensure essential information is included in the report. PRISMA also offers an explanatory document to further review the requirements (13). For systematic reviews of observational studies, the MOOSE (Meta-analysis of Observational Studies in Epidemiology) checklist provides another source of guidance (14).

Although these checklists clarify the reporting of systematic reviews and provide an important guide for peer reviewers, they do not assess the quality of the systematic review methods. For this, consider other resources such as AMSTAR (A MeaSurement Tool to Assess systematic Reviews) or the Joanna Briggs Institute (JBI) checklist (15, 16).

Narrative reviews

Narrative reviews, also referred to as literature reviews, are nonsystematic reviews which offer a broad overview of a topic but lack a systematic literature search and evidence synthesis according to a pre-specified protocol (17). Narrative reviews are typically intended for a wider audience and may be read by expert and non-expert readers (18, 19).

Q. How do I peer review a narrative review?

A. When assessing a narrative review, consider the following (18–21):

• Consider the uniqueness or importance of this review:

  • Has a review of this topic been published recently?

  • Does this review add to the discussion? Does it focus on new advances? Does it approach the topic from a different angle or provide a different interpretation of study findings?

  • Is this review written for a different audience (e.g., perhaps for a new practitioner)?

• Consider whether citations are appropriate and balanced:

  • What was the process used to gather the articles for this review?

  • Are recent or important references/studies missing?

  • Do authors only include literature that supports their own views? Or is balanced citation evident?

  • Are original studies cited, when appropriate?

  • Do the authors focus heavily on their own research/publications?

• Consider how the information is presented:

  • Is the topic or scope of the review clearly defined?

  • Has information been summarized correctly? Is there a logical structure to the manuscript (i.e., by theme, chronologically, etc.) or is improvement in organization needed?

  • Is the review understandable and clearly written? Is terminology defined for the non-expert and used accurately?

  • Is there critical evaluation of the studies included, and are findings interpreted correctly?

  • Do the authors draw any insightful conclusions or implications from the literature/concepts reviewed? Or are they simply summarizing what is already known on the topic?

Peer reviewers should check publication databases for similar or overlapping review articles during the peer review process. At a minimum, the authors should explain how their article is unique.

Peer reviewers should check to see if the authors have provided evidence of a comprehensive literature search. High quality reviews will state their pre-defined eligibility criteria for literature selection, which decreases the chance of selection bias (19). Peer reviewers should note if the papers selected tend to favor the authors point of view, and if needed, request that authors address any pertinent missing references with explanation. Additionally, reviewers should cross-reference at least a few author statements to citations to confirm their accuracy (19, 20).

Opinion pieces

Some journals permit submissions of opinion manuscripts, often under the article types “editorial,” “letter to the editor” or “commentaries.” Such submissions undergo editorial review by the editor, but a full standard peer review may not be necessary (22, 23). At the editor’s discretion, however, opinion pieces may be subject to peer review. Letters to the editor are often written to provide comment on an article recently published by the journal but may also serve as a short communication or reflection on a topic within the aims and scopes of the journal (22). JPPCP publishes a variety of opinion pieces, including letters to the editor and invited editorials, for which the expertise of editorial board members or external peer reviewers may be sought.

Q. How do I peer review an opinion piece?

A. When reviewing an opinion piece, consider the following (21–23):

• What is the value of the manuscript to journal readers? Does the article expand the discussion on a various research or clinical topic?

• Is the author’s opinion well-argued?

• What support for the opinion does the author provide? Is it logical? Are additional citations needed to support the assertion?

• Do the authors have conflicts of interest? If so, have these been disclosed?

• Is the author’s tone professional and constructive?

When reviewing an opinion piece, peer reviewers should be assessing for accuracy of statements, evidence-based support of commentary, and scholarly tone (24). If additional citations are needed to substantiate claims, peer reviewers should comment on this in their peer review report. If language is inflammatory or not collegial, peer reviewers may request revision to the manuscript to remove inappropriate content (22).

Q. I am ready to begin writing my reviewer report. How do I get started?

A. The final editorial in the Peer Review Q&A series will provide a comprehensive, step-by-step guide for preparing your reviewer report. This will be published in the Quarter 4 issue of JPPCP in 2023. In the meantime, check out the following resource available from the Journal’s publisher, Taylor & Francis:

• Peer review checklist: use this guide to write your reviewer report: https://editorresources.taylorand­francis.com/reviewer-guidelines/review-checklist/.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.