To publish or not to publish? That is the question

For more than 50 years medical research has been vetted through the peer-review process overseen by medical journal editors who assign reviewers to determine whether work merits publication. A study published in PLoS One investigates reviewers' recommendations and their influence on journal editors who are the ultimate arbiters of whether the research is published or not.

'Published research is becoming a more and more significant factor in scientific dialogue. Physicians and other researchers are no longer the only readers of medical studies. Patients and their families and friends now regularly access medical literature. This makes the review process even more important,' said study senior author William Tierney, M.D., a Regenstrief Institute investigator, Chancellor's Professor and professor of medicine at Indiana University-Purdue University Indianapolis.

'Peer review provides an important filtering function with the goal of insuring that only the highest quality research is published. Yet the results of our analysis suggest that reviewers agree on the disposition of manuscripts - accept or reject - at a rate barely exceeding what would be expected by chance. Nevertheless, editors' decisions appear to be significantly influenced by reviewer recommendations,' said Dr Tierney, who is the Joseph J. Mamlin Professor at the Indiana University School of Medicine.

A total of 2,264 manuscripts submitted to the Journal of General Internal Medicine (JGIM) were sent by the editors for external review to two or three reviewers each during the study period. These manuscripts received a total of 5,881 reviews provided by 2,916 reviewers. Twenty-eight percent of all reviews recommended rejection. However, the journal's overall rejection rate was much higher - 48 percent overall and 88 percent when all reviewers for a manuscript agreed on rejection (which occurred with only 7 percent of manuscripts). The rejection rate was 20 percent even when all reviewers agreed that the manuscript should be accepted (which occurred with 48 percent of manuscripts).

'We need to better understand and improve the reliability of the peer-review process while helping editors, who make the ultimate publish or not publish decision, recognise the limitations of reviewers' recommendations,' said Dr Tierney, who served as JGIM co-editor-in-chief from 2004-2009.