The Gross Inefficiencies & Politics of Peer Review

A junior colleague described to me a review he was recently asked to perform for one of the leading journals in neurosurgery.  After a careful review he reported that the paper “sucked” and he recommended that it not be published. A few months later a revised paper was sent back to him, despite his rejection, leading him to again recommend that the paper be rejected. The next communication was a letter from the editor-in-chief asking my colleague to write a commentary of the paper in question which was to be published alongside the now twice-rejected article. Eschewing a discussion of whether this paper merited ultimate publication or not, I do question the entire peer-review charade that this vignette exposes. The reality is that too often reviewers have little say in whether a paper gets published or not. Instead journal politics and the discretion of the editor-in-chief is transcendent throughout the peer-review process. My lament is that if the editor-in-chief is intent on publishing a paper from the start, why not say so and at least ensure that the process is efficient; this is of course the Cureus process of peer review!

What the above story calls into question is  just what exactly constitutes peer review? What is its function? The stalwart champions of peer review argue that it alone uniquely enforces scientific quality. The “acceptance” of one’s scientific work by potential critics and academic rivals, represents the highest measure of personal and scientific integrity. It is hard to argue with such a high-minded proposition, but is it grounded in reality?

In my own, and many of my colleague’s considerable experience, the realities of peer review are nothing like the above idealistic notions bandied about by proponents. Gross inefficiency is often embraced in the name of scientific integrity by rivals who are in no rush to see the accomplishments of scholarly competitors lauded. Many reviews are little more than cursory reads by time-harried reviewers resulting in a thumbs up or down. Ironically when all is said and done this may not be the worst outcome!

Too frequently reviews become meaningless intellectual battles, which at their core are little more than exercises in power and ego. These many skirmishes are often expressed in the to-and-fro volleys between reviewers and authors centering around secondary or even tertiary measures of paper quality. Time-wasting reviewer obsessions with incautious conclusions, inadequate words of self-criticism (at times almost Marxist in nature), failure to reference important (reviewer?) publications, by the letter ethical processes, inconsequential statistical measures, etc. often mask the importance, and strip away the beauty, of science. Given human nature and a subjective system that deliberately selects reviewers from the pool of intellectual competitors, is it not too surprising that baser self-interested emotions too often trump fairness, or at least efficiency? There has to be a better way! Because we at Cureus believe there is, we invite you to learn more about our peer review process.

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Open Access Doesn’t Mean Inaccurate

Does important scientific writing mandate the close supervision of professional editors and other high priests of science? Or is it possible that an interested community can curate scientific writing equally well?  The conventional wisdom (and 200 years of history) strongly sides with the need for experts, but this conviction is increasingly at odds with the interaction and communication made possible by the internet.

One of the great challenges that Cureus faces is the assumption that because we’re an open access journal, the science we publish is not reaching the highest realms of scientific quality. “Open access” is still a scary term for many people, with many worried that the process compromises the quality of peer review and ultimately the scientific quality of published papers. At Cureus, we are fighting back against this misperception by publishing powerful and accurate science. Open access medical journals are still a new concept, but you don’t have to look far for what is perhaps the ultimate example of open access on the internet today. Yes, I’m referring to Wikipedia, the seemingly omnipresent internet resource. Featuring articles on everything from Ghostbusters to spinal stenosis, Wikipedia is a shining example of the power of open access.

A recently published study by Rayagopalan, et al. tested the accuracy of medical data provided in Wikipedia compared with that provided in the National Cancer Institute’s Physician Data Query (PDQ) website. The researchers, hailing from an assortment of universities and medical centers, sought to test their hypothesis that Wikipedia would suffer from a lack of complete and accurate content.

Their conclusion? That Wikipedia had similar accuracy and depth when compared with the professionally peer-reviewed PDQ. Granted, this is not exactly an apples-to-apples comparison. Cureus, although an open access journal in every sense of the word, still relies on a group of expert editors to ensure the accuracy and quality of all published articles.

Open access is a viable method for quickly gathering and publishing valuable information. It’s 2014 and more and more of the world is connected – there should be no excuse when it comes to delivering and sharing potentially life-saving medical science for free.