ATS -- Guidelines for Reviewers (and Authors)

Purpose of Peer Review

The purpose of peer review for The Annals of Thoracic Surgery is twofold. One is to evaluate objectively the science of the submitted paper and the other is to provide a constructive critique indicating how the paper could be or could have been improved by the authors. Critiques are primarily directed to authors and secondarily to the editor. In all instances reviewers should respect the authors’ efforts and avoid disparaging or unpleasant comments. Reviewers are not asked to copyedit papers, but should comment if language editing is needed. Reviewers are reminded that the submitted manuscript is a privileged communication owned by the authors.

Acceptance of a Manuscript for Review

Reviewers should accept the assignment to review manuscripts that are within their sphere of expertise and which they plan to review within the 21 day deadline. Reviewers should decline to review manuscripts for which an intellectual or financial conflict exists between the reviewer and authors or between the reviewer and commercial products that are integral to the content of the article.

Category of the Manuscript

The broad categories of papers for which peer review is undertaken are original scientific articles; new technology papers; case reports, how to do it articles; and images; editorials; surgical heritage articles and review articles. The criteria for publication differ between categories of manuscripts. The editor and/or associate and feature editors review correspondence, invited commentaries, editorials, surgical heritage submissions and ethical and statistical papers.

General Requirements for Publication

The paper should conform to the format and formatting restrictions for the category to which it belongs and be written in good, readable English. The paper should address an important or interesting subject and provide new and original information. When human or animal subjects are studied, manuscripts must include statements indicating compliance with protective laws and guidelines. Illustrative material should be well chosen and of good quality.

Original Scientific Article

Original scientific articles should address an important question and provide new, reliable information that is relevant to the science and practice of cardiac and general thoracic surgery. The reviewer should assess the articles’ interest to readers; strengths and weaknesses; originality; clarity of text, tables, illustrations and figure legends; presentation; analysis of results; credibility of results; importance of the findings; depth of scholarship; relationship of the results to the existing literature; and presence of marginally relevant or unnecessary archival material. Ethical issues, such as scientific misconduct; prior publication of all or part of the data; plagiarism; transgression of human or animal rights; or dishonesty should be noted, if detected.

Original scientific articles can be of several different types, but the three most common types are prospective, retrospective, and observational. For prospective studies the protocol of the study is planned before data are collected. The most common form is the ‘Prospective, randomized controlled trial’, which is well suited for many experimental animal studies and some human trials. Retrospective studies use data recorded before the study protocol was designed. Most original scientific articles in clinical disciplines, particularly surgery, are retrospective, but modern statistical models are now available to analyze objectively retrospective data using a variety of statistical methods. Observational studies record observations of one or more groups of patients. These studies may record changes in various laboratory or biochemical tests in response to procedures or other therapy or determine the indications, efficacy and safety of a new procedure or laboratory or diagnostic test.

The following topics are offered to help guide the reviewer’s assessment of an original scientific article. Not all topics are relevant to every article.

‘Title’ should reflect the content of the article and be concise and clear
‘Abstract’ should indicate the purpose of the study, subjects and methods used, most important results and the main conclusions, which the data support.
‘Introduction’ should indicate the rationale and focus of the study and state the purpose or hypothesis.
‘Methods’ should present the design of the study; fully describe the number of subjects and the exclusion and inclusion criteria; indicate whether subjects were enrolled consecutively; state whether institutional regulatory boards reviewed study protocols and whether human subjects gave consent; describe how comparison groups were assembled (eg. randomization scheme, matching, etc); describe methods used to gather data, including follow-up data; state the primary outcome variable; identify secondary outcome variables; indicate whether or not observers were blinded with respect to group assignment; describe how outcome measurements were made and validated; describe the statistical design of the study; and indicate the statistical methods used to analyze the outcome data.
‘Results’ should concisely present the most important findings in text and relegate to tables data of lesser importance, but generally should not appear in both sections. Data should be reported as means or medians with appropriate indicators of variance and exact p values in tables and text. Figures should be well selected to highlight important findings and should not be used to present data of lesser significance. Survival and event curves should indicate specified confidence limits or subjects at risk at appropriate intervals. Regression diagrams should include the regression equations, regression coefficient and exact p value in the figure legend. Figure legends should adequately and clearly describe the important information illustrated.
‘Comment’ should not repeat results, but should point out the significance and conclusions of the new data, integrate the authors’ new data with that in the prior literature, draw inferences and conclusions regarding the question or purpose addressed by the study and point out the limitations of the study. The ‘Comment’ section should not be a review of the literature.
References should be selected, properly cited, reasonably current, accurate and in proper format. Important omissions should be noted.

New Technology

Articles describing new technology are necessarily descriptive and do not pose or test a hypothesis. These articles evaluate new devices, systems, machines, equipment, instruments, monitors, implantable material and similar technology designed for improving patient care and outcomes. The reviewer is asked to evaluate the efficacy, safety and indications of the new technology and the rigor, completeness and objectivity of the evaluation study. The reviewer should also assess compliance with the New Technology format and the format of the structured abstract, which differs from that of original scientific articles.

Topics which the reviewer should consider include:

Probable importance or usefulness of the technology.
Problem or task that the technology addresses.
Newness and innovation of the technology.
How well the technology is described and illustrated.
Protocol used for evaluation.
Methods used to test the technology; and the results obtained.
Reasons for selecting the methods of testing and evaluation.
Whether all studies used in the evaluation are included in the report.
Ease and difficulties in application including successes and failures.
Advantages and complications of the new technology.
Whether late adverse events are included or should be included in the evaluation. The conclusion section should summarize the indications, deficiencies and drawbacks. The article should have an objective, dispassionate tone and avoid the enthusiasm of an advertisement or endorsement.

The reviewer needs to inspect the ‘Disclosure statement’ after the text, before References. This statement should disclose the source of funds used for the evaluation study and whether or not the product was purchased, borrowed or donated by the manufacturer or inventor. Conflicts of interest statements for individual authors are managed by the editorial staff.

Case Reports, How to Do It, Images

These feature articles are a popular and instructive part of The Annals. Case reports describe interesting presentations of disease and innovative management of the patient’s or patients’ problem. How to Do It articles emphasize innovations in the operative management of technical challenges and new ways of doing things. Images, which must fit on one printed page, are graphics of interesting presentations of disease within the chest.

The primary criteria for review are interest to readers; uniqueness or innovation of the case, cases or procedure; and instructional value. Reviewers should evaluate the clarity and completeness of the case or procedure descriptions and the selection and quality of the illustrative material. Reviewers should also note whether or not the paper adheres to the format restrictions enumerated in “Information for Authors”. The reference list should be selective rather than inclusive.

Review Article

Reviewers should assess the importance of the subject matter, need for the review and probable interest to readers. Reviews of very rare and unusual diseases are discouraged; subject matter should be sufficiently broad to have instructional and practical value for readers. Reviewers should note if authors have respected the format and restrictions of this category as stated in “Information for Authors”.

The ‘Introduction’ should provide the rationale for reviewing the subject matter and provide the outlines of what is included and not included in the review. In the ‘Methods’ section reviewers should assess the methods used to search for articles, including search words and databases probed. The body of the review should be well organized with well chosen topical headings arranged in logical order. The organization, choice of topics, logical progression of topics and overall clarity and completeness of the text are important criteria for assessment. Within each topical heading the material should be presented in an integrated, comprehensive, objective manner. Statements should be referenced accurately. Reviewers should look for a brief “summing up” of the topical content before the author proceeds to the next topic. Reviewers should reject topical presentations consisting of “one sentence précis of referenced articles” arranged serially.

The review should provide a general overview of the subject matter assessing progress, pointing out deficiencies in present management and indicating opportunities and directions of future work. The reviewer should also assess the selection of references and note important absences or trivial inclusions.

Footnote. This editor carefully reads all reviews and respects the time and effort that each reviewer has expended on behalf of the author and all readers of The Annals. The reviewer remains anonymous; there is no reward beyond listing on the annual thank you list and the inner reward of service to our profession and to specific colleagues who are trying to contribute to our collective knowledge. The reviewer should direct his or her critique in a respectful manner to the authors in the style and format that suits them best. The recommendation to the editor regarding publication is made separately with or without additional comments.