Peer Review Week 2021: Interview with Craig S. Anderson

As part of Peer Review Week 2021, we interviewed the Editor-in-Chief of Cerebrovascular Diseases and Cerebrovascular Diseases Extra, Prof. Craig S. Anderson, to discuss the topic of “Identity in peer review”. As both a practicing clinician and researcher, Prof. Anderson combines these two perspectives when evaluating a manuscript submission. We discuss how both identities inform and influence the peer review process in these journals.

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What is your philosophy or approach when it comes to peer review for a manuscript?

I'm looking for high-quality science that is clinically relevant. I am also looking for findings that are novel and are going to advance scientific knowledge and clinical practice in the broad sense. I want to ensure that a submission gets a fair and constructive review on those merits. I consider the topic area, the size of the health issue and the relevance of that knowledge in terms of potential change or advancement. With study design, there is a grading of quality. Something that is single-center, small and retrospective is lower quality, whereas something that's multi-center, large and prospective is higher quality. Then there are randomized controlled trials, which are the highest quality in terms of study design.

How does your role as a clinician influence or inform this philosophy?

I'm actively engaged in clinical practice. Cerebrovascular Diseases and Cerebrovascular Diseases Extra are predominantly clinical science journals, so being a clinician-scientist directly allows me to know what the current hot topics are, what issues are challenging clinicians, and to some extent, what issues are challenging patients as the end-users of research. If a journal is focused on a discipline, having an Editor-in-Chief active in that field is good for peer review as there is natural engagement. There is an advantage in knowing what is clinically relevant. As an editor or reviewer, you know it is possible to get P values for statistical significance, but I ask in peer review “Does it really matter in terms of fulfilling good science, which is meaningful? Does it have direct application to clinical practice?”. Clinical research is more applied than discovery research, so I think we're a little bit more conservative as to the relevance of the topic.

What do you think is the main benefit for the manuscript of the integration of your role as a clinician and scientist in the peer review process?

In 2021, Cerebrovascular Diseases is celebrating its 30th anniversary and we are celebrating this with the publication of some articles which I'm very optimistic will be well received by the community. There is ongoing debate in the field about whether peer review should be fully open, single-blind, double-blind, or other variants. In my opinion, I think there is merit in it being open, which ensures a degree of credibility. My main role is around the science and quality of articles, but as Editor-in-Chief, I also have a leadership role for the journal which involves, in part, attracting and engaging people to come to the journal as authors and peer reviewers. Performing peer review can be an arduous task for the community. As an editor, I invite appropriate persons that are relevant to the subject to review, and I can do this with some influence as I am engaged in the stroke community as a clinician and researcher.

How do you think the peer review process in Cerebrovascular Diseases and Cerebrovascular Diseases Extra particularly improves manuscripts authored by less experienced researchers or those who have not had many training opportunities?

In these journals, we have a global focus, so I'm particularly interested in having a global reach. There's no doubt that submissions from lower-resource settings and non-English speakers require greater input from peer reviewers. There may be good science to find but it is not always clearly presented. We have to balance maintaining a quality standard, but at the same time allowing new researchers to present and publish. When I advise on how to do good research, I always say that it starts with a good idea, good science, good undertaking, good analysis, and then finishes with a presentation in a very professional manner. When a manuscript goes through peer review in Cerebrovascular Diseases and Cerebrovascular Diseases Extra, if the idea is good, we will do what we can to improve the paper to give the authors the chance to grow and improve the manuscript. Even if it is not published in our journal, we aim to improve the quality of the presentation of the research to be publishable elsewhere.

Are there any voices that you feel are underrepresented in peer review in your community?

There are aspects of research that are becoming very important, but still haven't received mainstream acceptability. These include aspects of translational research or how to drive change in the health sector. These areas use a different methodology, more incremental, qualitative in-person interviews, and is ‘softer’ research. I don't think we've been able to harness that area of research particularly well yet in Cerebrovascular Diseases, but it is important to do it from the point of view of change in the health sector, so more work needs to be done here.

What one thing would you change to make peer review practices more diverse, equitable and inclusive?

I think the best thing is to make sure that your editorial board is representative. What I did when I took over my role as Editor-in-Chief is to ensure that the editorial board is representative in terms of reach, discipline expertise, gender, and career expertise. I think we could be a little bit more active in helping to improve the quality of the science undertaken and submitted. While that is not really a journal's responsibility, it could be part of the engagement with the community.

Finally, are there issues facing peer review in the journal that you what to highlight?

I think plagiarism and falsification of the data are still big issues for us as a journal because there's so much pressure on people to publish for their career and respect within their hospital and country. I think the challenge for editors and reviewers is in making sure that the quality of the science is there. There was a discussion at the recent European Stroke Organization conference about checklist completion, such as CONSORT, as a requirement for manuscripts. This is used by editors and reviewers as an indicator of the quality of a study. However, a drawback of this approach is that it can help people make their research look better than it is, and thus make it even harder for editors and reviewers to pick up on plagiarism and falsification of data. It's like a menu for someone to go through and make their science look good when it may not be so. It is counter-intuitive that we've put the checklist and guidelines there to help us in peer review, but it could also be a way in which we're making it harder to spot falsification because manuscripts are helped to look good artificially. A benefit of me being active as a clinician in the field is that it is easier for me to spot problems or irregularities because I’m dealing with practice tools to allow me to pick up on areas where ‘that doesn't sound right’ or ‘I've never seen that before’.

The above conversation has been edited for clarity.