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Editorial IGR 11-3
From the Chief Editor
Another Type of Peer Review
R.N. Weinreb, MD, La Jolla, CA
Perhaps I should not be surprised anymore when I come across a manuscript in a high- (I mean very high) impact peer-reviewed journal that should never have been published in its current form in any journal. Several weeks ago, I came across such a manuscript. It was not the first time that this prestigious journal erred in publishing a flawed glaucoma manuscript, and it will not be the last. I want to believe that the authors for each of these manuscripts were naïve to the frailties and deficiencies of their study and that they were not prepared to risk the obloquy and criticism of their colleagues by publishing something that was poorly conceived, planned, executed or analyzed. Regardless, the usual process of peer-review process was ineffective and the manuscript emerged in print. Fortunately, there is another type of peer review that still can mitigate against the permanent pollution of the pool of scientific knowledge by such manuscripts.
Scientific manuscripts are recognized as an established currency for progress in science and clinical medicine, and it is peer review that values them for the global community. The usual and most-recognized peer-review process subjects a manuscript to scrutiny prior to publication. The quality of a scientific manuscript that details the background, methods, results and interpretation of the results of a laboratory or clinical investigation is judged by reviewers who are experts. They endorse the value of the manuscript for the scientific or medical community when and if they are satisfied that the work is accurate, complete and meaningful. But there is another type of peer review that may be even more important, and it is not as straightforward to define. This other type of review takes place post-publication, rather than pre-publication as is the usual case. Both types of peer review have a direct influence on science, and also an indirect one as they can legitimize a body of work for appointment and tenure committees and funding agencies.
The usual type of pre-publication peer review, more often than not, appears to work well. Sometimes it can offer suggestions for better articulation of the methods or results of a study. Other times, it might suggest a new interpretation of the data or reveal a new conclusion. And, hopefully, it always improves a manuscript. It certainly has improved most of the manuscripts that I have submitted during the past three decades, and I am grateful to the hundreds of anonymous reviewers who have reviewed them.
Nevertheless, the peer-review process is imperfect and, for this reason, it attracts criticism. It also can fail and result in publication of a flawed manuscript. Sometimes authors receive a review that they believe is unfair. Reviewers, like everyone else, do have biases and sometimes these are reflected in their reviews. As reviewers almost always remain anonymous, authors often are unable to determine definitively whether they have a bias. Furthermore, sometimes an author receives a review that appears uninformed. Given the increasing multidisciplinary nature and complexity of science, there may be only a few individuals with the expertise necessary to comprehensively review a study. And with so many submitted manuscripts, thoughtful and expert reviewers, unfortunately, are not always available and the ones that are available may be overburdened. In some cases, this can lead to a publication that is scientifically incorrect, invalid and defies confirmation from other laboratories.
Given the limitations of the peer-review process, it is not surprising that there have been attempts to adjust and improve it. Some journals conduct a double-masked review in which the identity of the authors (name and institution) is not revealed to the reviewers and the authors remain anonymous to the authors. Having reviewed some manuscripts like this, I am unsure whether authorship really can be masked as most laboratories have a unique style and body of work that can be distinguishing . Another approach is to eliminate the review entirely. PLoS One, a journal published by the Public Library of Science, evaluates papers only for technical accuracy, and not subjectively for their potential impact on a field. Still another approach is the open review in which the identity of the reviewers is known to the authors.
At the International Glaucoma Review, a post-publication peer-review process is conducted with each issue. The Review has a long record of open post-publication review of manuscripts in which the identity of the individual offering the critique is disclosed. Although a manuscript already has been peer reviewed prior to publication and then published, it now is subject to another type of peer review that is performed post-publication. Both the Editor's Selection and the Glaucoma Dialogue are forms of post-publication peer review. For the Glaucoma Dialogue, as an example, a published manuscript that potentially has high impact is selected for discussion by several experts. The collective wisdom of a diverse group of such reviewers typically is remarkably well informed. The authors are provided with the comments of the reviewers and then invited to respond. This type of peer review is fundamentally different from the peer review that typically is undertaken prior to the publication of a manuscript. And such a review can help shape the pool of related scientific knowl edge. Post-publication peer review is ubiquitous and takes place in other settings, as well, such as laboratory meetings and conferences. This form of review helps to determine the significance of a study, and one can argue that ultimately it is the post-publication peer review that is more enduring than the usual type of peer review. Science should be a self-regulating process with peer review at its core. Even though the process sometimes is flawed, scientific truth ultimately prevails. Ultimately, it is only the truth that is likely to withstand the vicissitudes of the post-publication peer review that occurs when a manuscript is placed within the public domain.