Guide for AWS Reviewers Lois A. Killewich, MD PhD AWS AJS Editorial Board

Purpos e The purpose of this guide is to assist reviewers with completion of timely, well-done reviews of articles submitted for possible publication in the AWS issue of the American Journal of Surgery (AJS). Useful information for reviewing in general is also included.

Do’s and Don’t’s When you receive an invitation to review, you should respond to it promptly, within 48 hours. This helps to assure the editor that you will complete the review in a timely fashion. If you don’t respond promptly, you will be labeled as one of those who don’t read or don’t complete reviews on time, and you are unlikely to be asked again. This can also result in your being passed over for other types of writing assignments, because you are viewed as being less than fully responsible.

Do’s and Don’t’s (cont’d) A two-line review, or reviews which state “this is a great article and should be accepted” or “I hate this article-reject it” are never appropriate. Your review should include reasons as to why you rated the article as you did, and should show that you have read the article carefully and commented on each section. If you don’t write a detailed review (for example, you submit a paragraph), you are likely to be viewed as not interested, in a big hurry, or too busy with other things, and you are unlikely to be asked again. Remember, completing well- done reviews in a timely fashion gets you asked to do other writing assignments and gets you “moved up the ladder” to more prestigious spots such as editorial boards, guidelines writing groups, invited review articles, etc.

Do’s and Don’t’s (cont’d) Don’t be rude, sarcastic, or condescending. It is not useful and does not impress anyone.

Do’s and Don’t’s (cont’d) READ THE INSTRUCTIONS FOR THE REVIEW! Most journals, including AJS, have 2 narrative sections that should be completed: “comments to editors” and “comments to authors.” In the comments to editors section, you should describe why you gave the article the review you did, particularly if you decide to recommend rejecting it outright. These comments are not necessarily shared with the authors. In the comments to authors section, you should raise your concerns but also attempt to provide the authors with constructive ideas as to how the article could be strengthened. Don’t just copy the same thing in both sections—again, not useful, gets you labeled as a poor reviewer.

Do’s and Don’t’s (cont’d) In the “comments to authors” section, your comments should be related to the section in the article to which they refer. This means using page and line numbers from the article in your comments. For example. “On page ___, lines ___, the authors state that __________________. The article would be strengthened if they were to include____________ in this section.” This makes it easier for the authors to respond to your comments, and for the editors to evaluate the authors’ responses.

Do’s and Don’t’s (cont’d) Some journals have specific requirements for reviews, such as numbering your comments or placing “*s” next to the ones you feel are most important. Remember to read the instructions.

Rating Articles Most journals (including AJS) include a list of “recommendations” addressing what to do with the article, including Accept as is Minor revision Major revision Reject Very few articles receive “accept as is”; in most cases reviewers find something which should be revised. Minor revision usually implies acceptance after changes are made; major revision means whether the article will ultimately be accepted is still unclear. Papers rejected outright usually have one of the following problems: Fatal flaw in study design Very poorly written manuscript Nothing new in the manuscript; multiple other papers addressing the topic already published.

Rating for AWS We accept no papers for the AWS issue of AJS until all submitted manuscripts have been reviewed; we reject nothing before all 3 editors discuss the paper. Please remember that your recommendation may not be the same as what the manuscript ultimately receives; each manuscript is evaluated by 3-4 reviewers, and our decisions are based upon a compilation of all the reviews. Sometimes we send manuscripts back to a reviewer for a second review after the authors have made revisions; please be gracious in accepting this “re-review” and completing it in a timely fashion.

Working through the article Decide what type of article you are reviewing Basic science versus clinical research (90% of what you review for AJS will be clinical research) Prospective study Retrospective Database Systematic review Meta-analysis If you are unfamiliar with what makes each type of article good, look at other examples from the literature.

Article Types Prospective Generally, a hypothesis is identified, and the study is designed to address the hypothesis Study groups should be clearly defined Were patients entered in the study consecutively? If not, data from those not entered might have changed the results

Article Types Retrospective Essentially chart reviews-a “hypothesis” or purpose is identified and charts are reviewed to address it, but data were not collected based on a prior identification of a hypothesis/purpose Demographics” should be reported Database Retrospective, but allows for inclusion of much larger numbers of patients than can be gathered from a single institution study (1000’s) Limitation is always the validity of the data entered into the database Data usually analyzed with multiple regression analyses

Article Types “Retrospective review of a prospectively-maintained database” Data were entered into the database at the time the patient entered the study Not necessarily a hypothesis prior to study initiation; conclusions drawn from analyses of data

Systematic Review/Meta-analysis “Sophisticated” statistical evaluation of multiple already- published articles Usually benefit from evaluation by a statistical reviewer—don’t worry if you can’t do this, just recommend an evaluation by a statistical reviewer-AJS has a list of these and the editor managing the review can invite one

IRB Approval/Exemption Virtually all clinical research published now should have statements regarding IRB approval or exemption, and informed consent if indicated. Prospective studies in general should have IRB approval and informed consent; the other types generally have IRB exemption.

Parts of the Article Introduction Methods Results Discussion References Figures/Tables Legends

Some points regarding the parts Introduction: sets the stage” for the purpose/hypothesis of a study-generally should end with a clear statement defining the purpose or hypothesis. Methods: Looking at other papers of a similar type can help a reviewer to know what detail should be in the Methods Make sure a section on the statistical analyses is included Discussion: Interpretation of the results in light of what is already published Generally 2-3 doubly-spaced typed pages Should include a paragraph on “limitations of the study”

COMPLETE THE REVIEW ON TIME!