Publication Scholarship: The Manuscript Reviewer

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Publication Scholarship The Manuscript Reviewer
Teaching Journal Club

• Henry Cohen, BS, MS, PharmD, FCCM, BCPP, CGP
• Professor of Pharmacy Practice
• Arnold Marie Schwartz College of Pharmacy and
  Health Sciences of Long Island University
• and
• Chief Pharmacotherapy Officer
• Director of Pharmacy Residency Programs (PGY-1
  PGY-2)
• Departments of Pharmacy and Medicine
• Kingsbrook Jewish Medical Center
• Brooklyn, New York

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Scholarship Defined

• The creation, discovery, advancement, or
  transformation of knowledge
• Composed in a manner that is subject to peer
  review and effective communication
• Assessed for quality by peer review and made
  public
• If an activity cannot be evaluated using
  universally recognized criteria, it will not be
  universally valued

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Standards to Assess Scholarship

• Clear goals
• Adequate preparation
• Appropriate methods
• Significant Results
• Effective presentation
• Reflective critique

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Relevance of Publication Scholarship

• Pharmacy
• Requirement of a healthcare profession
• Advance and improve patient care
• Societal contribution
• Clinical Pharmacists
• Establish improve relationships with medical
  and nursing staff
• Funding opportunities for department and hospital
• Fellowships, new equipment, stipends
• Enhance job satisfaction

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Relevance of Publication Scholarship

• Academicians
• Requirement for reappointment, promotion and
  tenure
• Tenure track faculty
• Nontenure track faculty
• Research positions
• Collaborative opportunities with other pharmacy
  disciplines
• Research and practice opportunities at
  university-based medical centers
• Teaching Opportunities
• Undergraduate and graduate

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Advantages of Serving as a Peer Reviewer for a
Journal

• Ensure robust, fair, non-bias, safe contributions
  to the literature
• Critique can enhance the manuscript and increase
  relevance
• Controversial publications
• Review cutting edge research
• Apply data to practice
• Provide ideas for research endeavors

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Advantages of Serving as a Peer Reviewer for a
Journal

• Scholarly activity
• Job requirement for reappointment promotion
• Professional notoriety
• Professional satisfaction
• Provides new opportunities
• Journal Editorial Board Member
• Journal Editor
• Publishing
• Educational

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What credentials do I need to be a Peer Reviewer?

• Training in area of expertise
• PharmD or advanced degree
• General Residency and Specialty Residency
• Practice in area of expertise
• Experience in area of expertise
• 3 5 Years minimum
• Research in area of expertise
• Fellowship
• Board Certified

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What credentials do I need to be a Peer Reviewer?

• Publish manuscripts
• Publish in peer reviewed journals
• Chapters in text books
• Web Chapters
• Lecture in area of expertise
• Invited presentations
• Board certification review courses
• Notoriety in area of expertise

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How can I be appointed to become a Peer Reviewer?

• Choose an area that you are competent
• Respond to peer review in a timely fashion
• Do not be an offensive Abstract reviewer
• Answer Journal call for peer reviewers
• Ask the Journal Editor
• Ask Journal Editorial Board Members for
  recommendations
• After publishing an article ask if
  opportunities exist

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How to Critically Evaluate Published Drug Therapy
Drug-Induced Case Reports

• Introduction relevance and brief literature
  review
• Establish a temporal and causal relationship
• Detect confounding variables
• Medications, OTCs, CAM, recreational drugs
• Doses of concomitant medications
• Medication compliance measurements
• Drug serum levels and laboratory data
• Drug and food interactions
• Nutrition status and compliance
• Comorbid diseases

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How to Critically Evaluate Published Drug Therapy
Drug-Induced Case Reports

• Was a comprehensive literature review provided?
• Focus on similarities and differences to the case
  report
• Was a summary table with salient data provided?
• Was the case validated with established criteria
• Naranjos Algorithm
• Conclusion
• Is the conclusion valid based on the case report?
• How can I apply the data from the report to my
  practice?
• Provide a prospectus to answer unanswered
  questions

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How to Critically Evaluate Published
Drug-Related Clinical Trials

• Hypothesis
• Objectives
• How many and are they attainable?
• Methodology
• Sample size was a power analysis completed?
• Blinding
• Length of study
• Exclusion criteria
• Medication source generic or brand
• Confounding variables (similar as with case
  reports)
• Compliance statistics

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How to Critically Evaluate Published
Drug-Related Clinical Trials

• Results Discussion
• Do the results answer the objectives
• Did the authors compare and contrast the results
  with similar trials, and provide explanations for
  the differences
• Conclusion
• Is the conclusion is based on study objectives
  and results?
• How can I apply the trial conclusions to my
  practice?
• Provide a prospectus to answer unanswered
  questions

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Reviewing Submitted Manuscripts as a Referee Vs
Reviewing Published Articles

• Minor flaws are acceptable
• Major flaws
• Fatal
• Recoverable
• Acceptable
• Uncontrollable
• Are the conclusions accurate?
• Do the conclusions have any value in advancing
  present practice?

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Correcting Diction, Grammar, and Spelling

• Diction
• Choice of words clear, correct and effective
• Grammar
• Syntax
• Spelling
• Reject based on poor diction, grammar, or
  spelling
• Choppy, lengthy, redundant, awkward sentencing
• Do not correct use of english
• Request medical writer to edit and rewrite

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• List the different Forest Classes for GI Bleeding
• List the troponin and CPK levels that were noted
  in patients who did develop an acute coronary
  syndrome
• In the clinical course section, sentence 1,
  shorter duration of symptoms refers to MI or GI
  symptoms please clarify?
• What medications were used to treat patients with
  GI bleed? Did patients receive medications prior
  to endoscopy?
• When providing mortality data provide the
  number in addition to the percentage.
• What strength of epinephrine was used for
  endoscopic injection hemostasis?
• The tables are not referenced in the text.

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• Define in every table in the key section, pre-
  and post- PES MI.
• Make some preventative recommendations should
  beta blockers be considered at patients with CAD
  risk?
• Conclusions regarding the duration of endoscopic
  examination may be premature, the differences are
  small please clarify.
• The author concludes that the method of
  hemostasis did not differ between patients who
  had an MI and those who did not - there are too
  few patients in all groups to make this
  conclusion.

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Methods for Submitting Review

• Web-based programs
• Electronic copy submitted via mail, E-mail or fax
• Generally cannot write comments on the manuscript
• Not-blinded to editor
• Blinded to author
• Comments to editor and author
• Comments to editor that are not viewable by author

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Reviewers Guidelines

• Ensure ethical and humane study
• Ensure Institutional Review Board Approval
• Ensure HIPPA rules are followed
• Appropriate use of references
• Ensure that assays scoring systems are
  validated
• Recommend review for statistical analysis
• Recommend Editorial Reply by an expert
• Recommend experts to the editor

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Reviewers Guidelines

• Critically review the manuscript
• Focus on scientific merit and value
• Provide constructive criticism
• Aim is to improve the quality
• Do not be destructive
• Judge each manuscript on its own merits
• Avoid personal comments and opinions

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Reviewers Guidelines The Final Decision

• Accept a manuscript
• Perfect manuscript
• Requires no changes
• Cannot accept but will reconsider if revisions
  are made
• Provide comments on scientific method
• Provide recommendations for substantive changes
• Reject
• Provide a paragraph describing the merits of your
  decision

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Reviewers Guidelines

• Choose only areas of expertise
• May ask a colleague to review
• Teaching tool for residents and new practitioners
• Inform editor that this is not your area of
  expertise
• Editors request 2 6 week deadlines
• Inform editor immediately when you cannot meet a
  deadline
• Review 2 6 manuscripts annually
• Estimated 20 50 hours per year
• Allow for busy-time, Vacations
• Recommend an alternative reviewer

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How to choose expert subjects for review

• List of Subjects
• Disease specific
• Organ specific
• Subject specific
• CNS
• Head Injury
• Cerebral Function
• Stroke
• Parkinsons Disease

• Pulmonary
• Pulmonary Edema
• Pulmonary Emboli
• Pulmonary Function Tests
• Hepatic
• Hepatic Failure
• Hepatic Drug Metabolism
• Hepatic Function Tests

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How does drug literature evaluation enhance the
skills necessary to publish case reports and
clinical trials?

• Developing excellent drug literature evaluation
  skills spawns similar applicability and strategy
  to preparing case reports, and designing research
  protocols
• Case reports are an excellent start for beginners
• Comprehensive evaluation of clinical trials is an
  advanced skill, and integral to success
• Repetition and experience is important to master
  this skill

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Teaching Drug Literature Evaluation Skills to
Pharmacy Students, Residents, and Pharmacists

• Journal Club Presentations
• Provide goals and objectives for evaluations and
  grading
• Present using slides, and a handout
• Teach a primer on basic presentation skills
• Encourage active participation from the audience
• Require the audience to read the article

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Teaching Drug Literature Evaluation Skills to
Pharmacy Students, Residents, and Pharmacists

• Design an outline for the presentation
• Faculty should review the outline BEFORE the
  student proceeds with the preparation of the
  presentation
• Establish time limitations based on the outline
• Case reports 20 minutes 20 minutes of QA
• Research Trials 30 40 minutes 30 minutes of
  QA
• 1 or 2 presentations every 4 8 weeks of
  clerkship

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Journal Club Evaluation CriteriaReview of
Article

• Accurately and concisely summarizes the
  introduction, study hypothesis, methodology,
  major points of results and discussion (if
  applicable) of the article.
• Accurately presents the conclusion of the study.
• Elaborates on any minor or major attributes or
  deficiencies of the study. If none are present,
  the presenter states such.

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Journal Club Evaluation Criteria Ability to
Answer Questions

• Answers questions in a logical fashion.
• Accurately answers and corresponds with the
  expected competency of the presenter.
• Thinks creatively and analytically. May
  theorize, if not sure of an answer, but
  identifies answer as such.

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Journal Club Evaluation CriteriaPresentation
Skills

• Visual aids are appropriate
• handouts and slides
• Room setup
• Establishes eye contact
• Pronunciations are correct
• Speaks with enthusiasm
• Correct use of vocabulary
• Not verbose or redundant
• Appropriate use of pointer

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Teaching Drug Literature Evaluation Skills to
Pharmacy Students, Residents, and Pharmacists

• Review and master the subject and background
• Read the article at least twice
• Provide a background to the subject matter
• Provide a checklist of plausible bias and
  confounding variables
• Verify the authors statistics or references
• Provide data from other case reports or trials
  beyond the data from the article

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Journal Club Evaluation CriteriaEvaluation with
faculty

• Ask presenter to perform self evaluation first
• Areas of strengths and weakness
• What strategy will they employ to improve their
  weaknesses?
• Consider a standard grading system
• Provide constructive criticism, and methods for
  improvement

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Conclusions

• The definition of a profession includes
  publication scholarship in peer reviewed journals
• Publication scholarship validates the role of the
  pharmacist and medication management
• Peer reviewers should have expertise
• Establishing concise goals and objectives are
  necessary to teach drug literature evaluation
• Mastering drug literature evaluation skills is
  necessary to develop publication skills

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Questions
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Thanks!