RESUMO
BACKGROUND: There is a power imbalance between authors and reviewers in single-blind peer review. We explored how switching from single-blind to double-blind peer review affected 1) the willingness of experts to review, 2) their publication recommendations, and 3) the quality of review reports. METHODS: The Finnish Medical Journal switched from single-blind to double-blind peer review in September 2017. The proportion of review invitations that resulted in a received review report was counted. The reviewers' recommendations of "accept as is", "minor revision", "major revision" or "reject" were explored. The content of the reviews was assessed by two experienced reviewers using the Review Quality Instrument modified to apply to both original research and review manuscripts. The study material comprised reviews submitted from September 2017 to February 2018. The controls were the reviews submitted between September 2015 and February 2016 and between September 2016 and February 2017. The reviewers' recommendations and the scorings of quality assessments were tested with the Chi square test, and the means of quality assessments with the independent-samples t test. RESULTS: A total of 118 double-blind first-round reviews of 59 manuscripts were compared with 232 single-blind first-round reviews of 116 manuscripts. The proportion of successful review invitations when reviewing single-blinded was 67%, and when reviewing double-blinded, 66%. When reviewing double-blinded, the reviewers recommended accept as is or minor revision less often than during the control period (59% vs. 73%), and major revision or rejection more often (41% vs 27%, P = 0.010). For the quality assessment, 116 reviews from the double-blind period were compared with 104 reviews conducted between September 2016 and February 2017. On a 1-5 scale (1 poor, 5 excellent), double-blind reviews received higher overall proportion of ratings of 4 and 5 than single-blind reviews (56% vs. 49%, P < 0.001). Means for the overall quality of double-blind reviews were 3.38 (IQR, 3.33-3.44) vs. 3.22 (3.17-3.28; P < 0.001) for single-blind reviews. CONCLUSIONS: The quality of the reviews conducted double-blind was better than of those conducted single-blind. Switching to double-blind review did not alter the reviewers' willingness to review. The reviewers became slightly more critical.
RESUMO
The current knowledge regarding the prevalence and persistence of edematous changes postmeningioma surgery is limited. Our hypothesis was that peritumoral edema is frequently irreversible gliosis, potentially influencing long-term postoperative epilepsy. We conducted a systematic literature search in PubMed, Cochrane Library, and Scopus databases. We included studies with adult patients undergoing first supratentorial meningioma surgery, which reported pre- and postoperative peritumoral brain edema (T2WI and FLAIR hyperintensity on MRI). Risk of bias was assessed based on detailed reporting of five domains: (1) meningioma characteristics, (2) extent of resection, (3) postoperative radiation therapy, (4) neurological outcome, and (5) used MRI sequence. Our loose search strategy yielded 1714 articles, of which 164 were reviewed and seven met inclusion criteria. Persistent edema rates ranged from 39% to 83% with final follow-up occurring between 0, 14, and 157 months. Among patient cohorts exhibiting persistent edema, a smaller portion achieved seizure resolution compared to a cohort without persistent edema. Relatively reliable assessment of persistent T2/FLAIR hyperintensity changes can be made earliest at one year following surgery. All studies were classified as low quality of evidence, and therefore, quantitative analyses were not conducted. Persistent T2/FLAIR hyperintensity changes are frequently observed in MRI imaging following meningioma surgery. The term "edema," which is reversible, does not fully capture pre- and postoperative T2WI and FLAIR hyperintensity changes. Future studies focusing on peritumoral meningioma-related edema, its etiology, its persistence, and its impact on postoperative epilepsy are needed.
