HOW TO REVIEW A PAPER FOR EUROPEAN UROLOGY

Stephen A. Boorjian, MD, FACSProfessor of UrologyDirector, Urologic Oncology FellowshipMayo ClinicRochester, MN

DISCLOSURES• Financial: none

• Intellectual: “this is how I do it”– Many approaches can be successful

OUTLINE FOR TALK• Section-by-section manuscript review tips

• Importance of serving as a manuscript reviewer

• Conclusions

HOW TO REVIEW A MANUSCRIPT FOR EUROPEAN UROLOGY

POINTS TO CONSIDER DURING REVIEW

• Originality of question/topic

• “Robustness” of dataset

• Appropriate methodology

• Importance of findings• Do the present data add in a meaningful and

significant way to the existing literature on the topic?

MANUSCRIPT TITLE

• Does the title accurately represent the data presented?

• Does the title sufficiently represent the data presented– “Catch the eye” of the casual reader

ABSTRACT

• Very important – often only part of manuscript read

• Can it be read as a stand-along representation of manuscript?– Critical methodology/data included– Conclusions supported by data provided

• Does it follow the EU guidelines?

INTRODUCTION

• Brief background to topic, citing relevant literature

• Key – does the Introduction “sell” the importance of the topic/need for the study?

• Are the objective(s) of the study clearly stated?

METHODS• Level of detail provided

– i.e. explain reasoning for select patients being excluded from study/provide demonstration that not biasing analyses in remaining cohort

• Critical – are the methods chosen appropriate

to address the question of interest?– Validated instrument for QoL assessment– i.e. Cox model vs logistic regression analysis

METHODS: REPORTING GUIDELINES

• Used to standardize reporting of clinical studies – Enhance research quality– Enhance transparency

• CONSORT (diagram) – for RCT• PRISMA – for systematic reviews + meta-

analysis

• EQUATOR websitehttp://www.equator-network.org/

RESULTS

• KEY SECTION OF MANUSCRIPT– “Non-fixable” with revisions

• (For clinical studies):– Size of dataset (power of analyses)– Duration of follow-up for endpoint of interest

and disease state being studied• 2 years ok to report mortality in mRCC• 2 years not ok for mortality in localized PCa

RESULTS

• Are relevant demographic details regarding study population and treatment provided?

• Are the outcome measures reported appropriate and sufficient?– i.e. text should not present p values only, but raw

numbers (%) provided as well

• Do the reported findings make sense? – RFS, CSS, OS congruous?

REVIEW OF MANUSCRIPT TABLES

• “Readability”– Too much/too little data provided to easily read

• Are all tables referenced in text?

• Do tables/text present duplicate data? Are conflicting data presented?

• Do the numbers in the table add-up?

REVIEW OF MANUSCRIPT TABLES

• Sequence/completeness of tables– Demographic data

– Univariate comparisons

– Multivariate models• HR, 95% CI, p values provided

REVIEW OF MANUSCRIPT FIGURES

• Are all the figures included necessary?– No duplication

• Is data presentation clear and not mis-labeled?– Appropriate axis/scales on graphs

• Can figures be read “stand-alone” (without accompanying text)?– For Kaplan-Meier curve:

• p values provided• Number of patients at risk at various timepoints provided

DISCUSSION SECTION

• Orderly flow– Summarize results

– Contextualize results = KEY!• In light of existing literature on the topic

• Explain discrepancies in findings from prior similar series

– Methodology, study population

• Offer why present study = unique

DISCUSSION SECTION• Paragraph detailing study limitations

• Conclusions (in this section or as stand-alone section)– Are the conclusions supported by the data

presented?– Does the manuscript leave you with a message

regarding the importance of the study?

REFERENCES: A WINDOW TO THE AUTHORS

• Reflects authors’ familiarity with subject matter– Marker of well-done paper

• I often read after abstract and before manuscript

• Review paper – absolutely critical (i.e. = “data”)– Comprehensive + contemporary

• Most recent series if multiple from one center– Will be reference basis for readers

REFERENCES: A WINDOW TO THE AUTHORS

• Original (non-review) paper – still essential– Inclusive of relevant series

• Largest• Contemporary• Best datasets

– Look at quality of journals cited – JAMA, JCO, Eur Urol

– Avoid over self-citation• But – appropriate referencing of one’s prior work

may reflect expertise in subject area

MISCELLANEOUS REVIEW COMMENTS

• Does the manuscript follow EU guidelines?– Length of abstract/manuscript– Number/format for references– Inclusion of all required sections (Take Home Message)– Is the paper clearly formatted for another journal?!!!

• Cover letter addressed to another editor!

• Writing style/presentation– If you found it hard to understand/read, so will target

audience

ORGANIZING YOUR REVIEW FOR SUBMISSION: COMMENTS TO AUTHORS

• 2-3 sentence summary of manuscript/critical findings

• Major concerns/suggested changes– Project concept, study design, study population– Methodologic/statistical concerns

• Minor concerns– References– Modifications to tables/figures– Formatting

ORGANIZING YOUR REVIEW FOR SUBMISSION: COMMENTS TO EDITOR

• Brief summary of decision recommended and key points to support– Originality of question– “Robustness” of dataset– Appropriate methodology– Importance of findings

• Do the present data add in a meaningful and significant way to the existing literature on the topic?

HOW TO GET BETTER AT MANUSCRIPT REVIEWS

• Practice, practice, practice

• Track disposition of manuscripts you review– Read other reviewers’ comments

ARE REVIEWERS EVER WRONG?

• Eur Urol process makes effort for consensus, but message/novelty of work may be missed

• Authors may appeal a decision– Submit (timely) letter to journal – Well-reasoned explanation of why author feels

reviewers’ assessment incorrect

– May (may not) lead to manuscript being sent for re-review to garner additional opinions

WHY IS MANUSCRIPT REVIEWING IMPORTANT TO DO FOR YOU?

BENEFITS OF SERVING AS A REVIEWER I: PERSONAL SKILL DEVELOPMENT

• Become more facile at critical review

• Become a better author – Types of analysis– Presentation of data

• Reviewing a manuscript ≈ writing a good manuscript

• Stay abreast of current literature – PubMed topic as part of review

BENEFITS OF SERVING AS A REVIEWER II: PROFESSIONAL DEVELOPMENT

• Critical part of important process– Currency of academics = peer-reviewed

publications

• Opportunity for academic recognition– Best Reviewer, Editorial Board positions

• Establishment of contacts– Editors get to “know the name”

• Letters for academic promotion

BENEFITS OF SERVING AS A REVIEWER III

• FUN!

• Opportunity for “first-look” at new/exciting data

• Opportunity to improve quality of publications

• Diversion from other clinical/academic responsibilities

CONCLUSIONS• Manuscript review should address:

– Originality of question– “Robustness” of dataset– Appropriate methodology– Importance of findings

• Personal + professional benefits to reviewing

• Enjoy the process – “academic hobby”

THANK YOU

Questions?