Enhancing quality assurance in radiotherapy for gynaecological cancers: implementation of an on-demand peer review process.

OBJECTIVES: Ensuring high-quality radiotherapy requires peer-reviewing target volumes. The Royal College of Radiologists recommends peer review specifically for individual target volumes in cases of gynaecological cancers. This study presents the outcomes of implementing an on-demand peer review system for gynaecological cancers within our institute. METHODS: The peer review process was planned for gynaecological cancer cases intended for curative radiotherapy. After junior clinical oncologists (COs) completed the segmentation, two senior COs specializing in gynaecological cancers conducted the peer review. All peer review outcomes were recorded prospectively. The audit process compliance, the proportion of patients requiring major and minor modifications in target volumes, the direction of changes, and the factors influencing these changes were reported. RESULTS: A total of 230 patients were eligible, and out of these, 204 (88.3%) patients underwent at least one peer review. Among the patients, 108 required major modifications in their target volumes. P-charts revealed a stabilization in the need for major modifications at the end of three months, indicating that 38.2% and 28% of patients still required major modifications for the nodal and primary CTV, respectively. Multivariable analysis demonstrated that major modifications were associated with the use of extended field radiotherapy and radical radiation in non-cervical primary cases. CONCLUSIONS: An on-demand peer review system was feasible and resulted in clinically meaningful, major modifications in the target volumes for 53% of patients. ADVANCES IN KNOWLEDGE: Gynaecological cancers require ongoing peer review to ensure quality of care in radiotherapy. A flexible on-demand system not only ensures that patient treatment start is not delayed but also has an important educational role for junior trainees.

Event-Based Learning and Improvement: Radiology's Move From Peer Review to Peer Learning.

Over the past 15 years, the radiology community has made great progress moving from a system of score-based peer review to one of peer learning. Much has been learned along the way. In peer learning, cases in which learning opportunities are identified are reviewed solely for the purpose of fostering learning and improvement. This article defines peer learning and peer review and emphasizes the difference; looks back at the 20-year history of score-based peer review and transition to peer learning; outlines the problems with score-based peer review and the key elements of peer learning; discusses the current state of peer learning; and outlines future challenges and opportunities.

Implementation and Efficacy of a Large-Scale Radiation Oncology Case-Based Peer-Review Quality Program across a Multinational Cancer Network.

PURPOSE: With expansion of academic cancer center networks across geographically-dispersed sites, ensuring high-quality delivery of care across all network affiliates is essential. We report on the characteristics and efficacy of a radiation oncology peer-review quality assurance (QA) system implemented across a large-scale multinational cancer network. METHODS AND MATERIALS: Since 2014, weekly case-based peer-review QA meetings have been standard for network radiation oncologists with radiation oncology faculty at a major academic center. This radiotherapy (RT) QA program involves pre-treatment peer-review of cases by disease site, with disease-site subspecialized main campus faculty members. This virtual QA platform involves direct review of the proposed RT plan as well as supporting data, including relevant pathology and imaging studies for each patient. Network RT plans were scored as being concordant or nonconcordant based on national guidelines, institutional recommendations, and/or expert judgment when considering individual patient-specific factors for a given case. Data from January 1, 2014, through December 31, 2019, were aggregated for analysis. RESULTS: Between 2014 and 2019, across 8 network centers, a total of 16,601 RT plans underwent peer-review. The network-based peer-review case volume increased over the study period, from 958 cases in 2014 to 4,487 in 2019. A combined global nonconcordance rate of 4.5% was noted, with the highest nonconcordance rates among head-and-neck cases (11.0%). For centers that joined the network during the study period, we observed a significant decrease in the nonconcordance rate over time (3.1% average annual decrease in nonconcordance, P = 0.01); among centers that joined the network prior to the study period, nonconcordance rates remained stable over time. CONCLUSIONS: Through a standardized QA platform, network-based multinational peer-review of RT plans can be achieved. Improved concordance rates among newly added network affiliates over time are noted, suggesting a positive impact of network membership on the quality of delivered cancer care.

Strategies for Developing Journal Peer Reviewers: A Scoping Review.

AIM: This scoping review examined development strategies for preparing reviewers to critically appraise the content of manuscripts submitted to peer-reviewed journals. BACKGROUND: The journal peer review process is the crux of building the science of nursing education to inform teaching and learning. METHOD: Using the Joanna Briggs Institute procedure for scoping reviews, five databases were searched for articles published in English in peer-reviewed health sciences journals between 2012 and 2022 that included strategies for developing journal peer reviewers. RESULTS: Of the 44 articles included in the review, a majority were commentaries (52%) published by medicine (61%), followed by nursing (9%) and multidisciplinary journals (9%). Reviewer development strategies aligned with three themes: pedagogical approaches, resources, and personal practices. CONCLUSION: Although multiple disciplines addressed peer reviewer development, a comprehensive and effective approach was not reported in the reviewed literature. The findings can inform a multilevel reviewer development program led by academic nurse educators.

Challenges and Controversies in Peer Review: JACC Review Topic of the Week.

The process of peer review has been the gold standard for evaluating medical science, but significant pressures from the recent COVID-19 pandemic, new methods of communication, larger amounts of research, and an evolving publication landscape have placed significant pressures on this system. A task force convened by the American College of Cardiology identified the 5 most significant controversies associated with the current peer-review process: the effect of preprints, reviewer blinding, reviewer selection, reviewer incentivization, and publication of peer reviewer comments. Although specific solutions to these issues will vary, regardless of how scientific communication evolves, peer review must remain an essential process for ensuring scientific integrity, timely dissemination of information, and better patient care. In medicine, the peer-review process is crucial because harm can occur if poor-quality data or incorrect conclusions are published. With the dramatic increase in scientific publications and new methods of communication, high-quality peer review is more important now than ever.

Author Guide for Addressing Animal Methods Bias in Publishing.

There is growing recognition that animal methods bias, a preference for animal-based methods where they are not necessary or where nonanimal-based methods may already be suitable, can impact the likelihood or timeliness of a manuscript being accepted for publication. Following April 2022 workshop about animal methods bias in scientific publishing, a coalition of scientists and advocates formed a Coalition to Illuminate and Address Animal Methods Bias (COLAAB). The COLAAB has developed this guide to be used by authors who use nonanimal methods to avoid and respond to animal methods bias from manuscript reviewers. It contains information that researchers may use during 1) study design, including how to find and select appropriate nonanimal methods and preregister a research plan, 2) manuscript preparation and submission, including tips for discussing methods and choosing journals and reviewers that may be more receptive to nonanimal methods, and 3) the peer review process, providing suggested language and literature to aid authors in responding to biased reviews. The author's guide for addressing animal methods bias in publishing is a living resource also available online at animalmethodsbias.org, which aims to help ensure fair dissemination of research that uses nonanimal methods and prevent unnecessary experiments on animals.

Potentially avoidable mortality after endoscopic retrograde cholangiopancreatography in Australia: an 8-year qualitative analysis.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly performed procedure worldwide. The aim of this study was to examine cases of mortality after ERCP to identify clinical incidents that are potentially preventable, to improve patient safety. METHODS: The Australian and New Zealand Audit of Surgical Mortality provides an independent and externally peer-reviewed audit of surgical mortality pertaining to potentially avoidable issues. A retrospective review of prospectively collected data within this database was performed for the 8-year audit period from 1 January 2009 to 31 December 2016. Clinical incidents were identified by assessors through first- or second-line review, and thematically coded into periprocedural stages. These themes were then qualitatively analysed. RESULTS: There were 58 potentially avoidable deaths following ERCP, with 85 clinical incidents. Preprocedural incidents were most common (n = 37), followed by postprocedural (n = 32) and then intraprocedural (n = 8). Communication issues occurred across the periprocedural period (n = 8). Preprocedural incidents included delay to procedure, inadequate resuscitative management, decision to perform procedure and inadequate assessment. Intraprocedural incidents comprised technical factors and inadequate support. Postprocedural incidents involved inappropriate treatment, delay in definitive surgical treatment or in recognizing complications, inappropriate second-line intervention and inadequate assessment. Communication incidents comprised inadequate documentation, failure to escalate care and poor inter-clinician communication. CONCLUSION: Causes of mortality following ERCP are wide-ranging, and reviewing clinical incidents associated with potentially avoidable mortality can serve to inform and educate practitioners. In collating a subset of cases in which procedure-related mortality was deemed avoidable, a series of cautionary tales about ERCP is presented that may provide cues to practitioners on improving patient safety and inform future surgical practice.

JACLP Guide for Manuscript Peer Review: How to Perform a Peer Review and How to Be Responsive to Reviewer Comments.

Recognizing that very few potential reviewers and authors receive formal training on peer review, we provide guidance on peer reviewing manuscripts and on being responsive to reviewer comments. Peer review provides benefits to all parties involved. Serving as a peer reviewer gives perspective on the editorial process, fosters relationships with journal editors, gives insights into novel research, and provides a means of demonstrating topical expertise. When responding to peer reviewers, authors have the opportunity to strengthen the manuscript, sharpen the message, and address areas of potential misunderstanding. First, we provide guidance on how to peer review a manuscript. Reviewers should consider the importance of the manuscript, its rigor, and clarity of presentation. Reviewer comments should be as specific as possible. They should also be constructive and respectful in tone. Reviews typically include a list of major comments focused on methodology and interpretation and may also include a list of minor comments that pinpoint specific areas of clarification. Opinions expressed as comments to the editor are confidential. Second, we provide guidance on being responsive to reviewer comments. Authors are encouraged to approach reviewer comments as a collaboration and to view this exercise as an opportunity to strengthen their work. Response comments should be presented respectfully and systematically. The author's goal is to signal that they have engaged directly and thoughtfully with each comment. In general, when an author has questions regarding reviewer comments or how to respond, they are invited to contact the editor to review.

A Decade of Prospective Peer Review: Impact on Safety Culture and Lessons Learned in a Multicenter Radiation Medicine Department.

PURPOSE: Quality assurance (QA) is critical to the success of radiation therapy (RT) for patients with cancer and affects clinical outcomes. We report longitudinal findings of a prospective peer review evaluation system implemented at a major academic health system as part of RT QA during a 10-year period. METHODS AND MATERIALS: All cases treated within our department undergo prospective multidisciplinary peer review and are assigned a grade (A, B, or C). "A" cases require no changes, "B" cases require minor modification, and "C" cases require major modification before treatment planning. The z-ratio test for the significance of the difference between the 5-year baseline (2012-2016) and follow-up (2017-2021) period was used to compare grades between the 2 periods. A 2-tailed P value <.05 was considered significant. RESULTS: Of the 20,069 cases, 15,659 (78%) were curative and were analyzed. The fraction of A cases decreased from 74.8% (baseline) to 64.5% (follow-up), whereas B cases increased from 19.4% to 35.4% and C cases decreased from 5.8% to 0.1%. Of the 9 treatment locations, the main hospital site had a higher percentage of A grades relative to community locations in the baseline (78.6% vs 67.8%; P < .002) and follow-up (66.9% vs 62.3%; P < .002) periods. There was a decrease in the percentage of A cases from the baseline to the follow-up period regardless of plan type (complex vs intermediate vs simple). There was a decrease in the percentage of A cases among specialists from baseline to follow-up (78.2% to 67.7%; P < .002) and among generalists from baseline to follow-up (69.7% to 61.7%; P < .002). CONCLUSIONS: Our 10-year experience in contour peer review identified increased opportunities in improving treatment plan quality over time. The drop in A scores and rise in B scores suggests increased scrutiny and findings-based improvements over time, whereas the drop in C scores indicates amelioration of "major failures" addressed in the startup years. Peer review rounds upstream of treatment planning provide valuable RT QA and should be considered by other departments to enhance the quality and consistency of RT.

Peer review of presentations through examination software.

BACKGROUND AND PURPOSE: Peer evaluations are often utilized to allow student pharmacists practice in giving and receiving feedback. In a small class setting, these can easily be completed and feedback distributed quickly. However, in the larger class setting, reviewing and disseminating peer feedback can be quite cumbersome, especially if using paper format. The purpose of this educational activity was to create a process for peer evaluations that allows for efficient collection and dissemination of peer feedback of presentations of student pharmacists and describe the student experience with this new format. EDUCATIONAL ACTIVITY AND SETTING: In Research Topics in Pharmacy II, an electronic peer-evaluation tool was created using electronic examination software to collect and distribute this peer review in a timely fashion during and after each class session. At the completion of this course, a survey was distributed to collect student pharmacists' perception of this electronic peer-review process. FINDINGS: A total of 63 of 91 students (69%) completed the survey. The majority of the students (98.4%) "strongly agreed" or "agreed" the peer-evaluation items made it easy to provide feedback to their peers and 79% preferred this electronic method of feedback vs. paper format. Overall, 93.6% of student pharmacists felt they were more engaged during the presentations as a result of providing electronic feedback. SUMMARY: Maximizing our resources by creating an electronic peer evaluation with our current examination software, allowed for an efficient means of obtaining and disseminating peer review that was timely and well-received by students.

Open-access Mega-journals in Health and Life Sciences: What Every Researcher needs to know about this Publishing Model.

A mega-journal is a peer-reviewed scientific open-access journal designed to be much larger than a traditional classical journal. The low selectivity review criteria largely focused on the scientific soundness of the research methodology and ethical issues regardless of the importance and application of the results, the fast peer review, and a very broad scope usually covering a whole discipline, such as biomedicine or social science, are the major hallmarks. This publishing model was pioneered by PLOS One and was soon followed by other publishers. A few years ago, it was believed that the academic journal landscape would dominate by the mega-journals model, but a decline has been registered in the last few years. This editorial aimed at presenting the current state-of-the-art of the open-access mega-journals (OAMJs) in scientific publications.

Reviewer acknowledgment lists as data: Low-hanging fruit for analysis.

Many journals publish the names of reviewers in annual acknowledgement lists. For prestigious outlets, being named on such lists can constitute legitimation of expertise. Although designed to motivate service, this practice can be leveraged to address an important problem in the study of peer review-reliance on tightly held proprietary data. While certainly not without limitations, analysis of reviewer acknowledgement lists can help answer broad questions in the sociology of science concerning intra- and inter-disciplinary stratification. Results from a pilot study of publications in criminology and sociology are discussed.

Gender Affirming Surgery: A Comprehensive, Systematic Review of All Peer-reviewed Literature and Methods of Assessing Patient-centered Outcomes (Part 1: Breast/Chest, Face, and Voice).

OBJECTIVE: To perform the first systematic review of all available gender-affirming surgery (GAS) publications across all procedures to assess both outcomes reported in the literature and the methods used for outcome assessment. SUMMARY OF BACKGROUND DATA: Rapidly increasing clinical volumes of gender-affirming surgeries have stimulated a growing need for high-quality clinical research. Although some procedures have been performed for decades, each individual procedure has limited data, necessitating synthesis of the entire literature to understand current knowledge and guide future research. METHODS: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify all outcomes measures in GAS cohorts, including PCOs, complications, and functional outcomes. Outcome data were pooled to assess currently reported complication, satisfaction, and other outcome rates. RESULTS: Overall, 15,186 references were identified, 4162 papers advanced to abstract review, and 1826 underwent full-text review. After review, there were 406 GAS cohort publications. Of non-genitoplasty titles, 35 were mastectomy, 6 mammoplasty, 21 facial feminization, and 31 voice/cartilage. Although 59.1% of non-genitoplasty papers addressed PCOs in some form, only 4.3% used instruments partially-validated in transgender patients. Overall, data were reported heterogeneously and were biased towards high-volume centers. CONCLUSIONS: This study represents the most comprehensive review of GAS literature. By aggregating all previously utilized measurement instruments, this study offers a foundation for discussions about current methodologic limitations and what dimensions must be included in assessing surgical success. We have assembled a comprehensive list of outcome instruments; this offers an ideal starting basis for emerging discussions between patients and providers about deficiencies which new, better instruments and metrics must address. The lack of consistent use of the same outcome measures and validated GAS-specific instruments represent the 2 primary barriers to high-quality research where improvement efforts should be focused.

Distribución geográfica y brecha de género en la revisión por pares de una revista científica biomédica en Latinoamérica / Geographic distribution and gender gap in the peer review of a Latin American biomedical scientific journal

La revisión por pares es un proceso importante al permitir tomar decisiones previas a la publicación de un artículo. Sin embargo, existe escasa información en revistas científicas de Latinoamérica sobre los profesionales que participan en estos procesos. Este trabajo se propuso determinar la distribución geográfica y de género en la revisión por pares realizada en la Revista Peruana de Medicina Experimental y Salud Pública. Se analizaron las listas de agradecimiento de quienes participaron en la revisión por pares de esta revista desde el año 2010 hasta el 2017. El país de procedencia se identificó a partir de la afiliación institucional, mencionada inicialmente por los revisores, y para la identificación del género se utilizaron los nombres. En caso de existir duda con el género se realizó una búsqueda de imágenes y de perfiles académicos públicos disponibles en Internet. Se encontraron 1 628 menciones de agradecimientos a profesionales que participaron en la revisión por pares; el 60,4 por ciento (n = 983) fueron procedentes del extranjero, principalmente de España, México, Chile, Colombia y Argentina. El 71,1 por ciento (n = 1158) fueron revisores hombres y el 28,9 por ciento (n = 470) revisoras. según la procedencia de las revisoras, el 35,0 por ciento (n = 344) fueron del extranjero y el 19,6 por ciento (n = 126) de Perú; y en los revisores hombres el 65,0 por ciento fueron del extranjero y el 80,6 por ciento de Perú. La revisión por pares en una revista científica biomédica en Perú fue realizada principalmente por profesionales de otros países de habla hispana. Existe una brecha de género que es mayor para la participación de revisoras de Perú(AU)

Peer review is an important process that makes it possible to take decisions before the publication of an article. However, little information is available in Latin American scientific journals about the professionals involved in this process. The purpose of the study was to determine the geographic and gender distribution of peer review in the Peruvian Journal of Experimental Medicine and Public Health. Data about peer reviewers were obtained from the acknowledgements sections of journal issues published from 2010 to 2017. The country of origin was identified from the institutional affiliation reported by peer reviewers, and gender was derived from their proper names. In the event of doubt about a reviewer's gender, a search was conducted for images and public academic profiles available on the Internet. A total 1 628 acknowledgement mentions were found, 60.4percent (n = 983) of which referred to overseas reviewers, mainly from Spain, Mexico, Chile, Colombia and Argentina. 71.1percent (n = 1 158) of the reviewers were male and 28.9percent (n = 470) were female. 35.0percent (n = 344) of the female reviewers were foreign and 19.6percent (n = 126) were from Peru, whereas 65.0percent of the male reviewers were foreign and 80.6percent were from Peru. Peer review in a Peruvian biomedical scientific journal was mainly conducted by professionals from other Spanish-speaking countries. A gender gap was observed which is wider for participation of Peruvian female reviewers(AU)

Transparency in peer review: Exploring the content and tone of reviewers' confidential comments to editors.

PURPOSE: Recent calls to improve transparency in peer review have prompted examination of many aspects of the peer-review process. Peer-review systems often allow confidential comments to editors that could reduce transparency to authors, yet this option has escaped scrutiny. Our study explores 1) how reviewers use the confidential comments section and 2) alignment between comments to the editor and comments to authors with respect to content and tone. METHODS: Our dataset included 358 reviews of 168 manuscripts submitted between January 1, 2019 and August 24, 2020 to a health professions education journal with a single blind review process. We first identified reviews containing comments to the editor. Then, for the reviews with comments, we used procedures consistent with conventional and directed qualitative content analysis to develop a coding scheme and code comments for content, tone, and section of the manuscript. For reviews in which the reviewer recommended "reject," we coded for alignment between reviewers' comments to the editor and to authors. We report descriptive statistics. RESULTS: 49% of reviews contained comments to the editor (n = 176). Most of these comments summarized the reviewers' impression of the article (85%), which included explicit reference to their recommended decision (44%) and suitability for the journal (10%). The majority of comments addressed argument quality (56%) or research design/methods/data (51%). The tone of comments tended to be critical (40%) or constructive (34%). For the 86 reviews recommending "reject," the majority of comments to the editor contained content that also appeared in comments to the authors (80%); additional content tended to be irrelevant to the manuscript. Tone frequently aligned (91%). CONCLUSION: Findings indicate variability in how reviewers use the confidential comments to editor section in online peer-review systems, though generally the way they use them suggests integrity and transparency to authors.