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W2034991115 abstract "An ounce of prevention is worth a pound of cure.Benjamin Franklin The editors of a vascular surgery journal requested that a submitted manuscript be reviewed by an ad hoc peer reviewer. The editors chose the reviewer because of her known interest and expertise in the specific topic. The surgeon viewed the abstract and agreed to provide the journal with a review. When she received the full manuscript, the reviewer recognized that the submitted manuscript was very similar to a clinical project that she was currently working on. She had been considering submitting the results of her own similar project to the same journal. A manuscript describing a novel modification of a surgical technique was submitted to a vascular surgery journal and underwent peer review. One of the reviewers returned a critique that went into extensive detail describing how the reviewer also used this modification, although with slightly different variations than that described by the author. The manuscript was accepted for publication. Two months after it was published, a second manuscript was published in the same journal by another group describing their modification of the same surgical technique. The wording of the second manuscript was remarkably similar to the critique provided for the original work, suggesting that it was submitted by the individual who provided the peer review of the first manuscript. The original work was not acknowledged or referenced in the second publication. These two scenarios uncover potential conflict of interest issues relating to the peer review process. Most often, conflict of interest refers to financial or commercial interests that an author or reviewer may have that can introduce bias. In the above cases, however, it is not commercial academic conflict of interest but academic conflict of interest that is addressed. Manuscripts submitted to a journal are the intellectual property of the authors, and the authors expect that the content within these manuscripts will be treated with confidentiality. At the same time, the peer review process has been widely accepted to ensure that manuscripts published in scientific journals represent important new information, are scientifically sound, and are done ethically. As a result, situations arise when proprietary information is made available to a reviewer and a conflict of interest can be faced. When a peer reviewer is faced with potential academic conflict of interest, what should be the most appropriate response by the invited reviewer?AThe reviewer should avoid conflict of interest by declining the invitation to review the manuscript because he is working on a similar project.BThe reviewer should perform a review of the manuscript but cease to work on his own project, again avoiding conflict of interest.CThe reviewer should review the manuscript and continue doing his own research but should take care not to be negatively biased toward the manuscript if it is competitive with his own research.DThe reviewer should continue working on his project with the benefit of gaining insight and experience from the review, thus allowing him to improve on his own project, since this is an expected benefit of providing peer review.EThe reviewer should inform the editors of involvement in a similar project, including details, and should continue to review or not, depending on the editors’ decision. If the review is performed and information gained, the source should be credited in any future publication. The ethics in regards to scientific publications involves several areas of responsibility by authors, editors, and peer reviewers. The Committee on Publication Ethics (COPE) was established in 1997 to provide a forum for editors with concerns about research misconduct and publication ethics. This group has provided Guidelines on Good Publication Practice that begin to address many of the ethical dilemmas faced in scientific publications.1Committee on Publication Ethics (COPE). Guidelines on good publication practice. Available at: www.publicationethics.org.uk/guidelines. Accessed Jan 15, 2007.Google Scholar Most attention has been focused on author responsibilities concerning appropriate study design, data analysis, relationship with industry, plagiarism, and redundant publication. Perhaps less thought and attention has been given to the responsibilities and ethical considerations as they relate to peer reviewers. The Council of Science Editors published a white paper that includes the responsibilities of peer reviewers.2Council of Science Editors. CSE’s white paper on promoting integrity in scientific journal publications. Available at: www.councilscienceeditors.org/editorial_policies/whitepaper/2-3_reviewer.cfm#2.3.2. Accessed Jan 25, 2007.Google Scholar Among these responsibilities, the peer reviewer is to provide unbiased feedback, comment on originality accuracy and interest to readers, avoid personal criticism, refrain from direct contact with the authors, provide timely reviews, recommend a decision for acceptance or rejection, and note ethical concerns. It is the responsibility of the editors to ensure that material is selected for publication on the basis of its scientific quality. To this end, the peer review process is fundamental in establishing the reputation of the journal and for maintaining the quality of work published by the journal.3Young S.N. Peer review of manuscripts: theory and practice.J Psychiatry Neurosci. 2003; 28: 327-330PubMed Google Scholar As a result, editors seek individuals who have established expertise in a given area to provide reviews of submitted manuscripts. This is appropriate in that these experts have the best ability to judge the work and give informed critiques to the editors concerning the quality of the submitted work. Studies have been conducted to identify characteristics of individuals who provide good peer review. Among the characteristics identified are age younger than 40, affiliation with a top-ranked institution, an individual known by the editor, and an individual blinded to the manuscript’s authors.4Evans A.T. McNutt R.A. Fletcher S.W. Fletcher R.H. The characteristics of peer reviewers who produce good-quality reviews.J Gen Int Med. 1993; 8: 422-428Crossref PubMed Scopus (102) Google Scholar Another study confirmed that younger age was important but also suggested that reviewers trained in epidemiology or statistics were characteristics that predicted better quality reviews.5Black N. van Rooyen S. Godlee F. Smith R. Evans S. What makes a good reviewer and a good review for a general medical journal?.JAMA. 1998; 280: 231-233Crossref PubMed Scopus (172) Google Scholar It is assumed, if not explicitly stated, that the reviewer has a responsibility to maintain confidentiality of the information he or she is privileged to view.1Committee on Publication Ethics (COPE). Guidelines on good publication practice. Available at: www.publicationethics.org.uk/guidelines. Accessed Jan 15, 2007.Google Scholar, 2Council of Science Editors. CSE’s white paper on promoting integrity in scientific journal publications. Available at: www.councilscienceeditors.org/editorial_policies/whitepaper/2-3_reviewer.cfm#2.3.2. Accessed Jan 25, 2007.Google Scholar, 6Liesegang T.J. Albert D.M. Schachat A.P. Minckler D.S. The editorial process for medical journals: I Introduction of a series and discussion of the responsibilities of editors, authors, and reviewers.Am J Ophthy. 2003; 136: 109-113Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar This process, however, introduces potential academic conflict of interest, an inherent risk because a reviewer likely has an academic interest in the subject matter and may have ongoing work similar to what is being submitted for consideration for publication. In this area of the review process, there seems to be little oversight because authors often do not know the identity of the reviewer. To a large extent, the person asked to provide peer review has developed a reputation based on prior publications or presentations related to the topic of the submitted manuscript. Having established such a reputation, it would be expected that the reviewer would continue to publish in this specific area. If option A were chosen as the most appropriate response, the peer review process would become ineffective. Experts would exclude themselves because of their ongoing academic endeavors, and a scientific review would need to be done by individuals without the specific knowledge offered by the expert in the field. It could be predicted that such a system would result in scientific reviews that would be little more than an editorial critique. A similar but opposite approach, as proposed by option B, would be that the reviewer would accept the invitation to provide a peer review but would cease work on his own project. The dilemma faced by the proposed reviewer would be whether to forgo his research interests to provide the review service or refuse to serve as an expert reviewer to maintain his own research and publication record. In some instances, a large portion of an individual’s practice or research endeavor may be spent in dealing with a specific and restricted problem. Not surprisingly, such an individual becomes very familiar with this narrow area and all of the nuances associated with it, leading to their recognized expertise. These individuals, through past efforts, have established protocols, research subjects, and studies that will ultimately add knowledge to the field. As investigators, they have responsibility to the public and the rest of the scientific community to continue their work. It is specifically this academic legacy that identifies them as potential reviewers.2Council of Science Editors. CSE’s white paper on promoting integrity in scientific journal publications. Available at: www.councilscienceeditors.org/editorial_policies/whitepaper/2-3_reviewer.cfm#2.3.2. Accessed Jan 25, 2007.Google Scholar Both option A and option B would eliminate academic conflict of interest; however, as in option A, choosing option B would result in a deterioration of the peer review process. If an individual were required to cease his own work to provide a peer review, most would refuse to do the review. Again, reviews would then be conducted by nonexperts, resulting in deterioration in the quality of the reviews. In theory, the fact that the reviewer is working on a similar project is considered an advantage, because the critique of the manuscript would be more insightful and meaningful, ultimately resulting in a better submission. When a reviewer accepts a manuscript for review and simultaneously continues his or her own similar investigation, will the reviewer gain inside information that could be used to his or her advantage? It has been shown that the amount of time spent on reviewing a manuscript affected the quality.4Evans A.T. McNutt R.A. Fletcher S.W. Fletcher R.H. The characteristics of peer reviewers who produce good-quality reviews.J Gen Int Med. 1993; 8: 422-428Crossref PubMed Scopus (102) Google Scholar As a result, it could be argued that the more time spent on a review, the more information from the manuscript will be retained by the reviewer. It is difficult to control and monitor how much influence viewing another’s work subconsciously affects one’s thoughts and approach to the similar problems. Because no one functions in a vacuum, information obtained consciously or subconsciously may ultimately alter how the reviewer continues his or her own research. If the investigator accepts the invitation to provide peer review but willfully uses the information provided in the manuscript to alter or to enhance ongoing work, this would clearly be unethical unless he credits the source of material. Option D can be dismissed. If the original work is published and then credited, it would be ethical for the reviewer to use information gleaned from a submitted manuscript in his or her own publication. Prior to publication, when the source cannot be cited, the only remedy would be to contact the authors and ask their permission to cite their work before publication as a personal communication. It would be unethical to use the information gleaned from a review before publication of the reviewed article without such acknowledgment. Indeed, accusations have been made against reviewers who have unethically used a confidential manuscript or have delayed the publication of a manuscript being reviewed to enhance their own work or allow their work to reach publication first.7Bad peer reviewers.Nature. 2001; 413 (Anonymous): 93Crossref Scopus (1) Google Scholar, 8Dalton R. Peers under pressure.Nature. 2001; 413: 102-104Crossref PubMed Scopus (22) Google Scholar Although most journals handle such problems on a case-by-case basis, protections should be in place to prevent and limit this possibility. As a means to limit use of confidential information, most agree that manuscripts submitted to a reviewer should be returned to the editor or destroyed. The Journal of Vascular Surgery uses a Web-based process, and manuscripts remain available to the reviewer on the web site only until all the reviews are submitted. Although this does not prevent the reviewer from making and keeping personal copies, it is consistent with published guidelines.2Council of Science Editors. CSE’s white paper on promoting integrity in scientific journal publications. Available at: www.councilscienceeditors.org/editorial_policies/whitepaper/2-3_reviewer.cfm#2.3.2. Accessed Jan 25, 2007.Google Scholar, 9Kempters R.D. Ethical issues in biomedical publications.Fertil Steril. 2002; 77: 883-888Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar It would appear that the best option is for the reviewer to inform the editors that the manuscript under review is similar to a current project, option E. This option alerts the editors that there could be potential academic conflict of interest. The editors can choose to seek another reviewer, or if they believe that the reviewer is most appropriate, make efforts to ensure that the reviewer does not take advantage of the situation. Most likely, these safeguards would be in the form of a disclosure statement that the editors would keep on file or could, under certain circumstances, choose to publish with the manuscript. It is likely that simply by taking the action of disclosing potential academic conflict of interest along with heightened awareness of a potential problem, that these steps will be sufficient to prevent a reviewer from using the manuscript for his or her personal benefit. Option C is less favorable than option E because it places the reviewer in potential conflict of interest. Almost all reviewers take the task of peer review seriously and avoid bias against others’ work even when it is competitive with their own. However, even a perceived conflict of interest should be avoided. For example, as in Case 2, potential problems can arise if the author of a manuscript detects similarities, even if unintentional, in a new manuscript written by the reviewer to the attention of the editors of the journal. Likewise, an inappropriately negative review, without disclosure of potential conflict of interest to the editor, could result in the reviewer being placed in a bad light. Such scenarios place a cloud of suspicion over the reviewer, and he or she may be less likely to be asked to give future reviews. The Journal of Vascular Surgery has been a leader in the publishing of quality work in the field of vascular surgery, ensuring that the identified authors have had key involvement in the study or creation of the manuscript, ensuring that the work published is original, and disclosing financial and commercial interests. The Journal has recently taken the step of providing training for individuals who are called on to review manuscripts. This should be embraced, because it is likely to provide more consistent and useful reviews, not only for the editors but also for the authors who submit their work to The Journal. The editorial board should consider developing guidelines for reviewers that address the ethical and appropriate response when a reviewer is faced with a potential academic conflict of interest situation. By considering steps to prevent even the appearance that a reviewer is using confidential material for personal use, potential accusations of academic conflict of interest could be averted, confirming what Benjamin Franklin so wisely stated, “An ounce of prevention is worth a pound of cure.”" @default.
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