JRSM introduces open peer review
Some news is hard to ignore. In the UK it might be a roasting on the BBC's Today programme or disgrace on the front page of The Mail—according to the government's calculus it is the UK's most influential newspaper. In the USA you wouldn't need to look much further than the New York Times for its ability to inspire dread among the people and organizations it chooses to write about. Proper media rarely tell good news stories. So when the New York Times decides to devote an editorial lamenting the woeful state of US medical journals you can imagine a wave of humiliation—perhaps anger—sweeping through editorial offices and research departments.
The argument advanced by the New York Times is that it is reprehensible for publication of research articles to be influenced by hidden conflicts of interest. There is a consensus among pragmatic editors and researchers—and it is one that I subscribe to. The consensus of pragmatists is that conflicts of interest are impossible to eradicate and it is unrealistic for everybody to be free of them. What pragmatists require is disclosure of those conflicts of interest—in this journal we term them ‘competing interests’ but that in many ways is an example of elegant variation. Pragmatists consider transparency to be almost a panacea, accepting that transparency may bring some—lesser—problems of its own.
As a consequence, you will notice that medical journals go to great lengths extracting statements of conflicts of interest from authors. Good journals will also publish editors' conflicts of interest in relation to published articles—indeed I declare my own in connection with the study by Bottle and colleagues (p 406). Good journals will also ask peer reviewers for conflicts of interest. But journals still have a long way to go in enforcing best practice. Hence, the general criticism from the New York Times is entirely justified and should act as a spur to responsible and pragmatic journal editors, researchers, and research sponsors around the world.
In many ways journals are locked in an endless struggle between secrecy and openness—and the more often openness can triumph the better. The New England Journal of Medicine, perhaps the world's most influential medical journal, has featured in the New York Times over its perplexing handling of the Vioxx studies. Richard Smith argues that those lapses at the NEJM have harmed all medical journals (see p 380). At a recent breakfast meeting at the RSM, a president of one of the RSM's sections suggested that the NEJM might have avoided its difficulties over Vioxx if it had used a system of open peer review instead of the traditional system whereby the identity of the author is known to the reviewer but the identity of the reviewer is not known to the author. My interpretation of the evidence on open peer review—and I have been involved in some of the research—is that open peer review does not affect the quality of the review. My experience of implementing open peer review at the BMJ is that open peer review makes reviewers more courteous and less inclined to torpedo a paper with emotional—and sometimes offensive—arguments. More surprisingly, few people shy away from this open debate and refuse to peer review, something that critics warn will be commonplace.
Openness in scientific discourse, I believe, is beneficial to all concerned and a value worth fighting for. As such the JRSM will introduce open peer review—where authors and reviewers know each others' identities—from this September onwards. It will become one of the world's very few journals with an open peer review process. The reviewer's comments will not yet be published though that is the logical next step.
To coincide with this we will be introducing on online submission system for the JRSM. Manuscripts are already received electronically but an electronic system allows better management of manuscripts. Authors will be able to track their submission through the system from submission to final decision. You will also be able to register as a JRSM peer reviewer on this electronic system—as long as you are willing to indulge in an open debate of course (visit our homepage http://www.jrsm.org from September). For anyone who prefers secrecy there are many thousands of journals to turn to. The JRSM will no longer be one of them.