In 2022, JSS reviewers continue to make outstanding contributions to the peer review process. They demonstrated professional effort and enthusiasm in their reviews and provided comments that genuinely help the authors to enhance their work.
Hereby, we would like to highlight some of our outstanding reviewers, with a brief interview of their thoughts and insights as a reviewer. Allow us to express our heartfelt gratitude for their tremendous effort and valuable contributions to the scientific process.
M. Burhan Janjua, Washington University, USA
Ana P. Johnson, Queen's University, Canada
Cameron Kia, Rush Medical Center, USA
Sunil Manjila, Insight Institute of Neurosurgery & Neuroscience, USA
Albert Thomas Anastasio, Duke University Health Center, USA
Rafael De la Garza Ramos, Albert Einstein College of Medicine, USA
Pravesh S. Gadjradj, Weill Cornell Medicine, USA
Lindsay Orosz, National Spine Health Foundation, USA
Stefano M. Priola, Northern Ontario School of Medicine University, Canada
Hossein Elgafy, University of Toledo, USA
Mark J. Lambrechts, Rothman Orthopaedic Institute, USA
M. Burhan Janjua
Dr. M. Burhan Janjua, MD FICS, is the Assistant Professor of Neurosurgery, Washington University School of Medicine, USA. His research focus is on brain and spinal tumors, neurovascular pathologies, neurotrauma, craniocervical anomalies, and spinal pathologies, spinal deformity, and clinical outcome registry-based studies. His recent projects entail research on adult spinal deformity, cerebellar AVMs, and carotid endarterectomy. You may follow Dr. Janjua on Instagram here.
Peer review is a critical aspect of scientific research. With new surgical approaches on horizon, evidence-based medicine, and latest research, Dr. Janjua believes that we are bound to perform a thorough peer review to enhance the validity of the treatment. Nonetheless, it is vital to grow as a surgeon scientist in the midst of latest innovations to help improve patient care.
However, during the review process, Dr. Janjua reiterates one thing that reviewers should always bear in mind – A review must be free of any bias. Objectively assessing the data presented and being critical to the presented research is the key to reviewing.
“Through peer reviewing, I learn from other’s contributions. It also helps guide others and enhance my scientific teaching. It is quite of a nourishment to a surgeon scientist soul,” says Dr. Janjua.
(By Brad Li, Eunice X. Xu)
Ana P. Johnson
Dr. Ana P. Johnson is the Professor of Public Health Sciences at Queen's University, Kingston, Canada. She received her undergraduate training in economics from Nottingham University in England, her master’s in economics from University of Houston, and PhD in Health Economics/Health Services Research from University of Texas Health Science Centre, School of Public Health, Houston. She was Assistant Professor at the Centre for AIDS Intervention Research, Medical College of Wisconsin. At McMaster University, she obtained a Career Award. At Queen's University, as Canada Research Chair in Health Policy, she is the former site Director of the Institute for Clinical Evaluative Sciences (ICES) Queen's Health Services Research. Dr. Johnson's research interests include economic evaluations of health care programs, uncertainty in cost-effectiveness analysis, decision-making, resource allocation, public health, and health technologies. Her projects include the economic evaluation of various health programs and analysis of uncertainty in cost-effectiveness analysis using classical and Bayesian methods. Decision analytic projects have concentrated on prioritization and resource allocation. For more information, please visit Dr. Johnson’s homepage here.
Dr. Johnson considers that a healthy review system entails and keeps the anonymity of reviewers as well as of authors, ideally, in order to avoid any biases. Constructive criticisms would be desired following questions posed by the journal. Besides, she believes it would be great if reviewers had incentives to review papers, monetarily or otherwise. She adds, “I understand there is a push to make the names of reviewers known. I do not necessarily agree with this. I believe most of the effort ought to be placed in the speed with which reviews are conducted, which could be addressed by providing incentives (monetarily or otherwise, as mentioned above).”
Data sharing is prevalent in scientific writing in recent years. In Dr. Johnson’s opinion, it would be important and ideal for researchers to share data as well as any aspects related to different stages of data acquisition, cleaning and analysis, especially with regards to troubles and tribulations that pertain to data collection, analysis and dissemination. Rather than viewing data as proprietary (barring taking into account confidentiality and anonymity precautions), she views data as an extension of the published, open access (ideally) text and results that accompany the data.
“What motivates me the most to conduct reviews is to learn about new and exciting research from my peers first hand and to feel like I get to contribute to the pool of reviewers, placing myself in the authors’ purview and one does,” says Dr. Johnson.
(By Brad Li, Eunice X. Xu)
Dr. Cameron Kia is an orthopaedic surgeon specializing in minimally invasive and complex spine surgery as an incoming fellow at Rush Medical Center, USA. He is a graduate of the University of Connecticut Orthopaedic Surgery Program. Research has always been a critical part of his training, which he strongly believes to be fundamental to better care towards patients. You may follow Dr. Kia on LinkedIn. A list of his publications is available here.
A healthy peer review system, in Dr. Kia’s opinion, is one where there is open communication between authors and reviewers. The point of such system is to not just accept or deny the article, but critically review the authors’ work so that they can optimize the work for the betterment of others.
Nevertheless, the current peer review system is not without shortcomings. One of the biggest limitations, according to Dr. Kia, is the limited number of peer reviewers compared to submitting authors. He believes clinical researchers need to promote reviewing articles and at the same time be rewarded for taking the time to help make research better.
On the importance of conflicts of interest (COI) disclosure, Dr. Kia reckons that it is very important for authors to let readers know what potential COI they have. Even as authors, we need to acknowledge that bias can exist and can have an unknowing impact on a research.
“I am beyond grateful for the researchers who devote their time and efforts toward scientific progress. As a clinician, we should rely on evidence-based care to help guide us towards the best treatment option for our patients,” says Dr. Kia.
(By Brad Li, Eunice X. Xu)
Sunil Manjila MD
Dr. Sunil Manjila is a neurosurgeon working with the Department of Neurosurgery, Insight Institute of Neurosurgery & Neuroscience (IINN), Flint, Michigan, the United States. He also works at the Insight Surgical Hospital (ISH, Warren, Michigan) and directs neurosurgical research at the Insight Research Institute in Flint, Michigan. He has been trained in neurosurgery residencies twice, the first one in Christian Medical College Vellore (India) and again at University Hospitals Case Medical Center in Cleveland, Ohio (USA). He has been an avid researcher and a published author with over 100 PubMed-indexed neurosurgical manuscripts and 2000+ Google scholar citations. He has co-authored a textbook on Lumbar Interbody Fusions (Elsevier, UK) and many textbook chapters. He has performed original research in both cranial and spinal surgical areas involving surgical techniques and technologies using cadaver studies. Currently, his clinical research focuses on minimally invasive spine and brain surgery, AI in spine and brain surgery, and neurosurgical robotics in brain and spine. You may get to know more about Dr. Manjila’s research through IINN's Instagram and Facebook.
A peer reviewer, according to Dr. Manjila, is an expert referee who is selected by the journal based on his/her proficiency in the submitted area of research in the manuscript. He/she would help evaluate and analyze the content and merit of a manuscript that eventually leads to its acceptance as such, with minor or major amendments or get a publication denied. The reviewer also heavily aids in empowering evidence-based medicine to prevent the dissemination of erroneous and misleading information among the scientific communities. The reviewer based on his/her wholesome domain experience and expertise would thoroughly read and critique scientific manuscripts before granting acceptance, ensuring the protection of scientific integrity.
A key in peer review is whether it is conducted in an objective manner. To Dr. Manjila, an objective review is an unbiased, focused and evidence-based evaluation of the methodology and results presented in a manuscript, based on the existing body of literature, and applied logic. There are two key steps to make the review objective. Firstly, the anonymization of the submitted article to blind the authors’ names and their institutions from the reviewer is key to achieving objectivity. Secondly, the adoption of standardized and rigorous guidelines for manuscript review will culminate in publishing well-written articles devoid of scientific flaws and errors.
Viewing from a reviewer’s angle, Dr. Manjila strongly believes that seeking institutional review board (IRB) approval for research is important to primarily protect the subjects (i.e., study subjects who are being investigated) through an independent review process instituted by the governing body of the organization. IRB regularly monitors the research ethics and guidelines to protect both doctors and patients from any harm (clinical, legal, economic, and social) that the research might produce. IRB helps streamline the strategies, ensure anonymity, mitigate conflicts, and help intervene with midterm assessments to ensure patient safety. If this process is omitted, the above-mentioned scrutiny for ensuring “primum non nocere” will not happen. In such circumstances, biased approvals of unethical and unscientific research methodologies will get permitted and the patients would not get the best intervention or even the accepted standard of care.
“Peer reviewing is a huge responsibility which motivates me mainly to help, guide and facilitate authors from across the world. This would also help me stay abreast of the latest and greatest innovations in research areas of my interest and expertise. This holistic process also gives me the ability to comment on the novel research work and ideas proposed by others such as new treatment modalities, surgical approaches, and outcome analyses. While doing so, it also helps me improve my own scholarly skills, build a professional reputation, and take pride in getting acknowledged for playing a wage-less watch dog of scientific advancement,” says Dr. Manjila.
(By Brad Li, Eunice X. Xu)
Albert T. Anastasio
Dr. Albert Thomas Anastasio is a resident physician in orthopaedic surgery at Duke University Health Center, USA. He is a graduate of Emory University School of Medicine. His research interests are broad, across multiple specialties within orthopaedics including spine surgery, foot and ankle surgery, and total joint arthroplasty. His current research projects involve particular emphasis on outcomes after total ankle arthroplasty and insertional Achilles tendinopathy debridement. He is active within the peer review system, and enjoys contributing to the academic milieu in this way. You may take a look at his profiles here and here.
Maintaining active engagement in peer review is imperative, according to Dr. Anastasio, to ensure academic quality is maintained. Peer review serves not only as a check reign on quality, but also as a way for reviewers and authors to engage in constructive conversation to improve the future scientific efforts of both parties.
From Dr. Anastasio’s perspective, reviewers should have an understanding of statistical analytical methods, as he often finds errors in tests used or poor control for confounding variables. Potential author bias and conflict of interest should be considered. Perhaps most importantly, reviewers should provide their own review of the literature. He often finds, for example, review manuscripts that are very similar to other existing reviews or repeat studies which clutter the literature and add little value.
As a reviewer and author, Dr. Anastasio strongly believes that reporting guidelines such as TREND and CARE help standardize the literature. While this is important for stand-alone studies, adherence to the guidelines for all publications is most important when it comes to systematic review and metanalysis. Poorly standardized case series with loose follow up and lack of patient reported outcome scores plague the orthopaedic community and make definitive, evidence-based decisions difficult for many surgical pathologies.
“I find tremendous value from engaging in the peer-review process. Peer review sharpens my instincts when preparing my own manuscripts. It provides me with ideas for building on the existing literature, and it keeps me on the forefront of new developments in the field, which can improve my clinical practice,” says Dr. Anastasio.
(By Brad Li, Eunice X. Xu)
Rafael De la Garza Ramos
Dr. Rafael De la Garza Ramos, MD, is Chief Resident in the Department of Neurological Surgery at Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA. He has clinical and research interests in primary and metastatic tumors of the spine, cancer disparities, spinal deformity, complex reconstruction, and salvage procedures. He has over 170 published peer-reviewed manuscripts and numerous abstract presentations at national and international research meetings. His specific career goals include reducing disparities in spinal oncology and improving safety and outcomes of complex spine surgery via use of advanced surgical techniques and technologies, multidisciplinary collaborations, and research. You may connect with Dr. De la Garza Ramos on LinkedIn.
The peer-review process has been fundamental in scientific publishing. To Dr. De la Garza Ramos, it is a regulatory process that allows researchers and reviewers to learn from each other and to move the field forward. Researchers receive criticism and improve their work, or if needed, revise further before publishing.
In Dr. De la Garza Ramos’ opinion, constructive reviews are the ideal type of review. They offer guidance from reviewers and help the researchers improve their work. On the other hand, destructive reviews are just criticisms of the work without any suggestions or guidance, and such reviews should be avoided.
Seeing the prevalence of data sharing in recent decade, Dr. De la Garza Ramos reckons that it is important for research data to be transparent and thus he supports researchers to have their data available upon a reasonable request.
“Peer reviewing is essential in scientific publishing. Although it is non-profitable in most instances, it is a way to pay it forward. Being a researcher myself, I need peer reviewers to criticize my work and get their guidance and suggestions,” says Dr. De la Garza Ramos.
(By Brad Li, Eunice X. Xu)
Pravesh Shankar Gadjradj
Dr. Pravesh S. Gadjradj currently serves at Weill Cornell Medicine, New York, USA. He was born and raised in Rotterdam, the Netherlands, where he completed Medical School in 2018. In addition to his MD-degree, he also completed a PhD-program and MSc in Epidemiology at the Erasmus University Rotterdam and the Vu University of Amsterdam, respectively. For his PhD-program, he conducted the PTED-study under supervision of his mentors: a multicenter randomized controlled trial on full-endoscopic transforaminal discectomy versus conventional microdiscectomy for sciatica. Based on this study, full-endoscopic procedures became part of reimbursed care in the Netherlands. Currently, he is employed at Weill Cornell Medicine at which he will continue to focus on the minimally invasive treatment of degenerative spine conditions. He has published over 100 peer-reviewed publications and book chapters, and has won numerous awards for his research such as the Sanford Larson award (AANS), the Value Award (NASS) and Charlie Kuntz Scholar Award. You may connect with Dr. Gadjradj through LinkedIn and ResearchGate.
The biggest limitation of the existing peer review system, according to Dr. Gadjradj, is that authors, especially in the spine field, can submit their work to a lot of journals with comparable merits and comparable impact factors. But at the same time, their work can be rejected at half of them, while being praised and accepted at the other half. This difference in peer-review experience between journals is difficult to prevent from happening but it can sometimes be demotivating to submit work and get very different reactions on the same work.
As a reviewer, Dr. Gadjradj believes that the most important part of giving constructive criticisms is giving comments that the authors can actually use to improve their work with. No study is perfect and there are some open-door comments that a lot of reviewers can always give such as (1) no randomization; (2) no control group; (3) no complete follow-up, etc. To him, the best reviews are those that let authors acknowledge these flaws, but also focus on the merits the paper does have.
From a reviewer’s point of review, Dr. Gadjradj indicates that it is mandatory for authors to disclose Conflicts of Interest (COI) so that readers can judge certain works in the light of some bias. However, this is not a perfect system and there may always be some form of COI without it always being apparent. Yet, COI can definitely influence a research project, especially when the results of a study may not be entirely black and white.
“There are multiple reasons why I think it is important all researchers should spend time peer-reviewing the work of colleagues. For once, it is a form of ‘giving back’ as we ourselves also submit our work and receive quality comments to improve our work. Secondly, it gives me the opportunity to read the latest publications as one of the first ones while also being able to contribute to the success of the paper. Finally, I also learn a lot from reviewing others work,” says Dr. Gadjradj.
(By Brad Li, Eunice X. Xu)
Dr. Lindsay Orosz, MSPAC, is a recent graduate of Harvard Medical School’s Global Clinical Scholars in Research Training (GCSRT) program and is the Director of Research at the National Spine Health Foundation (NSHF) in Reston, Virginia, USA. NSHF is a patient-centered non-profit organization dedicated to helping spine patients navigate their treatment journey through patient education, research, and advocacy. As the Director of Research, she manages all aspects of research, including study design, investigator partnerships, data management, funding, and the dissemination of findings through abstract presentations and the publication of manuscripts. In addition to providing peer reviews, Dr. Orosz is also the Senior Editor of the Foundation’s patient-focused journal, The Spine Health Journal. All research topics are related to spinal healthcare, including: Enhanced Surgical Recovery (ESR) for spine surgery / opioid prescribing strategies after spine surgery, robotic-guided spine surgery, augmented reality-assisted spine surgery, artificial intelligence measuring various spinal parameters on xrays, intradiscal regenerative medicine injections to treat discogenic back pain, and artificial disc replacements / hybrid surgeries. Connect with Dr. Orosz on LinkedIn.
In Dr. Orosz’s opinion, peer reviewers should be knowledgeable about the topic, read the manuscript closely, and provide questions/comments that bring about changes that would enhance the presentation of the work. To her, it is important to realize that while many suggestions can be made to improve the delivery of the information provided so that it can be received by the reader in a clear manner, some suggestions to study design or execution simply cannot be changed and therefore should be limited by the reviewer.
From a reviewer’s perspective, Dr. Orosz highlights the importance for authors to follow reporting guidelines (e.g. STROBE, TREND and CARE), as these tools help authors streamline their manuscripts to include necessary information that would be asked for later if inadvertently excluded. And it can save time, for sure.
“As a researcher, I enjoy all aspects of the research process, particularly as it pertains to the publication process. Reading, editing, and reviewing are important aspects to the publication process and there are a variety of advantages to being on the giving and receiving ends of the peer-review process, though they are not public or profitable,” says Dr. Orosz.
(By Brad Li, Eunice X. Xu)
Stefano Maria Priola
Dr. Stefano M. Priola, MD, is Assistant Professor of Neurosurgery at the Northern Ontario School of Medicine University, Canada. He is a graduate of the University of Messina, Italy, where he has completed his Medical Degree and his Neurosurgical Residency. In 2016, he moved to Toronto, Canada, to complete clinical fellowships in “General Neurosurgery”, “Neuro-oncology and Skull Base Approaches”, and “Vascular and Endovascular Neurosurgery”. His research interests are broad and include neuro-oncology, vascular and endovascular neurosurgery and skull base surgery. Connect with Dr. Priola on LinkedIn.
Peer review plays a fundamental role in science, according to Dr. Priola, acting as an objective quality-control system. It allows for the presentation of new research ideas and their translation into a clinical setting. It is also the guarantor of the paper originality, ensuring that research has been properly conducted and would be of significant interest to the journal audience.
In Dr. Priola’s opinion, an objective review means an independent and unbiased assessment of the manuscript. To achieve that, the reviewer has to be impartial, and remain open to new ideas or different approaches. In addition to that, he believes reviewers should be blinded about the paper’s authors, so they keep their assessment immune from influence in one way or the other.
The Institutional Review Board (IRB) serves as an objective third party and oversight committee, with the purpose of protecting and managing risk to human participants involved in research. In view of this, Dr. Priola stresses that it is important for original research to apply to IRB to confirm that every precaution has been taken and that humans involved in research are not at risk. Omitting this process could lead to unregulated research projects with unpredictable and possible risks for the patients involved.
“Peer reviewing is a way to stay up to date on the most recent research trends and it also gives me the opportunity to find new ideas for my own research endeavors. Reviewing a paper helps me feel that I am somehow contributing to a brighter future for science, and thus the human race,” says Dr. Priola.
(By Brad Li, Eunice X. Xu)
Dr. Hossein Elgafy, MD, Mch, FRCSEd, FRCSC, MBA, is a tenured Professor of Orthopaedics and Chief of Spine at the University of Toledo, USA. He is an orthopaedic fellowship trained spine surgeon specializing in comprehensive surgical care of the spine. He completed his orthopaedic residency training at University of British Columbia, Vancouver, Canada, and one year of spine fellowship at the University of Washington Harborview Medical Center, Seattle, Washington. He is American Board Certified in orthopaedic surgery. He is a fellow of the Royal College of Physicians and Surgeons of Canada and the Royal College of Surgeons of Edinburgh, United Kingdom. In 2019, he completed a master’s degree in business administration from the University of Toledo. Find out more about Dr. Elgafy here and here.
Peer review, according to Dr. Elgafy, plays a role in science in ensuring the value, integrity, and sound methodology of research. It must be blinded, bias-free, constructive, and add to the value of the manuscript.
Speaking of the need to disclose Conflict of Interest (COI), Dr. Elgafy strongly agrees that authors should disclose their COI. It is very important for the integrity of research and ensures that the study under peer review is solely conducted to advance our knowledge on the subject without any biases influenced by personal benefit.
“Despite the fact that peer reviewing is often anonymous and non-profitable, it contributes to advancing research and knowledge that ultimately improves the method used to take care of our patients. Further, by conducting peer review, my knowledge gets updated,” says Dr. Elgafy.
(By Brad Li, Eunice X. Xu)
Mark J. Lambrechts
Dr. Mark J. Lambrechts is a clinical fellow at Rothman Orthopaedic Institute, USA and will be joining the spine team within the orthopaedics department at Washington University in St. Louis in August 2023. His research interests include degenerative spine disease and spine trauma with a particular interest in spinal cord injury research. His goal is to leverage outcomes-based research to minimize patient morbidity during spine surgery, while optimizing recovery postoperatively. A list of his research can be found here. You may also connect with Dr. Lambrechts on LinkedIn.
JSS: What role does peer review play in science?
Dr. Lambrechts: Peer review is an integral part of the scientific process. While peer reviewers in a sense serve as gatekeepers, only allowing sound science to be published for the possible consumption and adoption of future practices by other scientists and physicians, the peer-review process also accomplishes much more than this. Peer reviewers may have different backgrounds (statistician/methodology experts, clinician-based researchers, or basic scientists), which allows for significant improvements in the manuscript prior to publication. Incorporation of peer-review comments into the manuscript may then allow for the original idea to expand its impact prior to publication, which can be a huge benefit to authors. Of course, the reviewers themselves are also learning during this process as they gain valuable information and insight into how the authors chose to approach answering their questions.
JSS: What reviewers have to bear in mind while reviewing papers?
Dr. Lambrechts: It is my belief that reviewers (who may be experts in the field) should evaluate each paper with the intent to make it worthy of publication. This can take the form of improving the validity of the methodology, helping the authors introduce or discuss their findings in the context of the broader available literature, or helping the authors focus on the most pertinent results. In this manner, a reviewer should not only be judging whether the manuscript is suitable for publication, but their goal should be to guide the authors to obtain the best end-product possible and optimize the likelihood the manuscript will be accepted for publication and provide overall impact to the scientific community.
JSS: The burden of being a scientist/doctor is heavy. How do you allocate time to do peer review?
Dr. Lambrechts: Peer reviewing is a give and take. Any clinician/scientist who wishes to have their ideas evaluated by peer reviewers should also set aside time to peer review for their colleagues. While time is often difficult to come by during the work day, I usually set aside a couple of hours in the evening 2-3 days a week to spend time performing peer reviews.
JSS: Data sharing is prevalent in scientific writing in recent years. Do you think it is crucial for authors to share their research data?
Dr. Lambrechts: Data should be available upon reasonable request. Spine literature often has relatively low sample sizes, thus statistical significance can be found (type I error) when perhaps a real difference does not exist. Data sharing may be one avenue to allow for larger sample sizes, while also minimizing the risk of bias.
(By Brad Li, Eunice X. Xu)