Peer Review

Abstract

Little information is available regarding how to review a plastic surgery manuscript. This vital responsibility ensures that publications meet an acceptable scientific standard. Thoughtful and thorough reviews are essential to protect patients and surgeons from unscientific practices and products. This discussion provides information for the reviewer, gained from the author's experience, including examples of a thorough review, likely to be useful to the editor, and a cursory one that is unhelpful. The first consideration is relevance. Prerequisites for publication include institutional review board approval, disclosure of financial conflicts, and discussion of the regulatory status of devices. Particular attention is needed to check for conflicts of interest, which are endemic in plastic surgery today. In view of the common practice of using computer-generated imaging, reviewers need to be especially vigilant for inauthentic “photoshopped” photographs. Examples of published images that have been digitally altered are provided. If data are available, it may be possible to check the statistical tests. Reviewers need to be aware of the practice of p-hacking. A quick literature search can identify relevant but unreferenced publications. The manuscript needs to be properly organized into sections. Minor points may be made regarding style. The study design and methodology need to be evaluated to be sure that the conclusions are well supported by data. Randomized studies are rarely feasible. Fortunately, well-done prospective observational studies in consecutive patients can be just as useful. Realistic complication rates are expected. Meta-analyses in plastic surgery are often subject to confounding variables. Comments should be available to the authors; confidential comments hidden from authors are discouraged. Like honesty, transparency is the best policy. Manuscripts should be evaluated solely for merit, not the identity of the author or institution. Timeliness of submission of the review is appreciated by authors. Evidence-based medicine is concerned solely with the facts. The 2 basic criteria are a solid scientific basis and reliable evidence of efficacy. Reviewers need to keep an open mind. Studies that challenge the status quo are often the most valuable ones and are needed for the advancement of the specialty.

Conflict of Interest and Plastic Surgery Journal Editors

“…Many journals, 1 and the International Committee of Medical Journal Editors 51 use an expiry date, such as 3 years, for a reporting a COI. Similar to the dollar value, no evidence supports a time limit for a COI 31 . It defies common sense to expect a quid pro quo to disappear in 3 years, especially COIs of the magnitude paid to plastic surgery journal editors (Table 1).…”

“…A multitude of products are promoted in plastic surgery, frequently without the benefit of an institutional review board approval or FDA clearance, but with plenty of COI. 31 Examples include acellular dermal matrix, implantable mesh, radiofrequency devices, electromagnetic treatments, cryolipolysis, and even the Allergan Keller funnel (a nylon sleeve for breast implant insertion). 32 Publication bias is endemic.…”

“…Similar to the dollar value, no evidence supports a time limit for a COI. 31 It defies common sense to expect a quid pro quo to disappear in 3 years, especially COIs of the magnitude paid to plastic surgery journal editors (Table 1 ).…”