The Art of Peer Reviewing: Providing a Comprehensive Review of a Manuscript Presenters Jon O Neher, MD Valerie King, MD Fred Tudiver, MD

What Is FPIN? FPIN is a bi-national academic consortium FPIN is a membership organization FPIN is not for profit & self governing FPIN is a virtual knowledge community FPIN members include family medicine departments, residency programs, academic health science librarians, practice based research networks…..

History of FPIN Conceptualized in 1998 for AAFP research center grant Funded by AAFPs Univ. of Missouri FP Research Center First introduced to a national audience at STFM in 2000 Incorporated as a non-for-profit in 2001 Board of Directors meet for the first time at STFM in 2002 Form, storm, reform, perform

The FPIN Mission We are dedicated to improving patient care by using information technology to: translate useful research evidence into practice, teach the clinical scholarship of research translation, and facilitate the generation of new evidence from practice.

The FPIN Vision Our ultimate goal is answering 80% of questions with the best available evidence within 60 seconds of the clinician’s time at the point of care. Here is how we can achieve the goal…

Achieving the FPIN Vision Identify the most important questions asked by practicing family physicians Conduct a comprehensive structured search of the world’s most up-to-date literature Select and critically appraise the original evidence Write the answer For Clinical Inquiries: Assemble a team of 6-8, to include clinical author(s), editor(s), a librarian, peer reviewer(s), and a clinical commentator Verbiage from new brochure

Opportunities for Engagement Clinical Inquiries Published in Journal of Family Practice Published in American Family Physician EBP Newsletter Help Desk Answers Transforming Practice Evidence in Perspective Drug Profile PEPID Primary Care Plus Handheld and web-based comprehensive resource

General Comments on the Peer Review Concept

Peer Reviewer’s Function Assist the editor in determining whether: The article is well written The article presents information clearly The most relevant studies have been included The results of the studies are correctly interpreted and applied The article reaches appropriate conclusions The article should be published

What makes a good peer reviewer? Clinical expertise on the topic Experienced in critical appraisal What if I don’t feel qualified (yet)? FPIN is a great place to learn this skill Arrange to work with a mentor experienced with peer review

The peer reviewer gets… A copy of the manuscript. A “Comments to the Editor” form that is unique to the publisher. A “Comments to the Author” form that is often little more than a blank piece of paper. These may be actual paper or an on-line equivalent.

General Peer Review Comments for the Editor Comments for the Author Key concept is to help the editor decide what to do with this particular manuscript. Comments for the Author Key concept is to help the author improve the paper…and write better papers in the future.

Comments for the Editor One Paragraph Is the paper appropriate to journal/audience? Often includes a checkbox section for you to suggest one: Accept Reconsider after revisions Reject

Comments for the Editor Give very brief overview of major strengths and weaknesses: Writing quality Sources of potential bias Research methods Valid conclusions

Comments for the Author Make specific comments about each section of the paper. For standard papers, this will be several lines about: Title Abstract Introduction Methods Results Discussion References Tables

Comments for the Author Maintain a CONSTRUCTIVE tone Be generous with your words to enhance CLARITY Sprinkle PRAISE along with recommendations for change May refer to changes made directly to manuscript (commonly used for spelling, punctuation, and minor sentence structure improvements) Frequently, an idea or bit of logic will not be clear. Simply ask for an explanation.

FPIN’s Tools for Peer Reviewing FPIN Checklist

Peer Reviews of a Clinical Inquiry The reviewers goal is to improve the paper. It should be clear, concise and relevant. Identify possible areas of confusion and make specific suggestions. Use Track Changes and/or Comments

PR Checklist for a CI Question Is the question posed the one that is answered? If a change in wording is suggested, the Associate Editor must approve the change

PR Checklist for a CI Evidence-Based Answer Checklist Note: Does it answer the question? Is the SOR correct? Is the writing focused? Checklist Note: Conclusion is concise and accurate; GORs (if any) assigned appropriately? _____Yes _______ No

PR Checklist for a CI Evidence Summary Checklist Note: Is the research made transparent? Is there logical flow of ideas? Does the summary support the answer? Was outcome data selected and used? Did the author use EBM statistics (LR, NNT)? Checklist Note: Evidence Summary is well-documented; high quality studies used to support conclusions; sample sizes appropriate in studies; GORs assigned appropriately _____Yes ______No

PR Checklist for a CI Recommendations from Other Checklist Note: Were reputable sources used? Is it clear and concise? Checklist Note: Recommendations were from authoritative sources; were recently issued or updated _______Yes ________No

PR Checklist for a CI References Checklist Note: Were any critical papers missed? Is the bibliography in standard format? Checklist Note: References will be checked by the librarian coauthor or a librarian editor for accuracy and format. However, the peer reviewer may point out if key references have not been included.

PR Checklist for a CI Tables Is the table clearly labeled? Is information in the table repeated in the text? If there is no table, should there be one?

Small Group Exercises

Small Groups Review a completed PR Checklist “See One” Each group reviews a submitted CI and completes the PR Checklist “Do One” Discuss what you learned “Teach One”

Discussion Questions: Completed Peer Review How would you feel if you received this? Is it courteous? Is this constructive? Is it clear? What do you have questions about after reading it? Does it help make the evidence more transparent? Does it help focus the answer?

Work on Your Peer Review Use the Checklist

Doing a Peer Review Using The Checklist Overall impression? What will you recommend to the editor? What was it like to use the form? Section comments: Evidence-based Answer Evidence Summary Recommendations from Others References

How to become involved?

Contact the FPIN office Obtain an FPIN password to view list of questions available for Peer Review Read the PR instructions Find a manuscript on a topic of interest to you Request the manuscript and begin the peer review

Want more information? Contact Heather Stewart, Membership Coordinator at heather@fpin.org. She can assist you with getting your FPIN user id and password and to discuss how you or your program can become involved.

With Gratitude AAFP National Network The Family Physicians Inquiries Network Consortium would like to extend its deepest gratitude to this distinguished group for their generous support and continued commitment. AAFP National Network