Navigating Peer Review: Responding to Reviewer Feedback with Confidence

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The peer review process is a fundamental step in medical publishing, ensuring that research meets rigorous scientific and ethical standards. For new authors, receiving peer review feedback can feel intimidating, but understanding the process and how to respond effectively can make a significant difference in getting your article published.

This guide will break down the types of peer review, explain what reviewers evaluate, and provide practical strategies for responding to critiques constructively and professionally.

Understanding the Peer Review Process

Before giving a response to reviewer comments, it's important to understand how peer review works and why it’s essential in medical publishing.

What Is Peer Review?

Peer review feedback is the evaluation of a manuscript by experts in the same field before it is published. It ensures that the research is accurate, credible, and not misleading or dangerous.

Types of Peer Review

Different journals use different types of peer review:

• Single-blind peer review – Reviewers know who the author is, but the author doesn’t know who the reviewers are. Cureus utilizes single-blind peer review.
• Double-blind peer review – Neither the author nor the reviewers know each other's identities.
• Open peer review – Both the author and reviewers know each other’s identities.
• Post-publication peer review – The paper is published first, and peer review feedback is collected from the scientific community afterward. This is most commonly found in preprint servers.

Tip: Check the journal’s policies to understand which peer review model they use.

What Do Peer Reviewers Look for?

Reviewers assess manuscripts based on several key factors. Understanding these criteria will help you preemptively strengthen your submission and provide an appropriate response to reviewer comments.

• Scientific validity – Is the research question clear? Are the study design, methods, and statistical analyses appropriate?
• Clarity and organization – Is the manuscript well-structured and easy to follow?
• Relevance and contribution – Does the study contribute to existing literature?
• Ethical considerations – Have conflicts of interest, ethical approvals, and patient consent been properly disclosed?
• References and citations – Are sources properly cited? Is the literature review comprehensive?

Check out our Reviewer Guide for more information about our peer review feedback process.

Tip: Reviewers are not looking to reject papers—their goal is to help authors improve their work!

How to Approach Reviewer Feedback

Receiving feedback, especially critical feedback, can feel overwhelming, but providing a response to the peer review and making revisions is a normal part of the process.

Step 1: Read the Feedback with an Open Mind

• Don’t react emotionally. Peer review is not personal, but an opportunity to refine your work.
• Read the entire review carefully before making any changes.
• Classify the comments into major and minor revisions.

Step 2: Categorize the Comments

• Major revisions – These include methodological concerns, missing data, or major restructuring of the manuscript.
• Minor revisions – These focus on grammar, clarity, or formatting issues.
• Editorial suggestions – Requests for changes in style, citations, or references to align with journal guidelines.

Tip: Keep a positive mindset when reading peer review feedback and composing a response to reviewer comments—most manuscripts go through at least one round of revision before acceptance!

Responding to Reviewer Comments

When submitting your revised manuscript to Cureus, you’ll be required to respond to each peer review comment and then provide the editor with a brief explanation of your revisions. (Some journals instead require a formal response letter to the peer review comments.) This is your opportunity to demonstrate professionalism and commitment to improving your work.

Acknowledge and Appreciate Constructive Criticism

It’s important to remain courteous and respectful, even if you disagree with a reviewer’s comments: "We appreciate the reviewers’ thoughtful feedback and have addressed all concerns accordingly."

Provide Justifications for Disagreements

If you disagree with a peer reviewer’s feedback, explain your reasoning with evidence:

Reviewer Comment: "Consider reanalyzing your data using a different statistical method."

Your Response to Reviewer Comments: "We appreciate this suggestion. However, after consulting with a statistician, we believe our chosen method remains the most appropriate due to [specific reason]. To clarify, we have added a justification for our approach in the Methods section."

Tip: Never ignore a reviewer’s comment—if you cannot make the suggested change, explain why.

Implementing Revisions Effectively

Keep Track of Your Changes

• Work in Google Docs with tracked changes enabled when applying the peer review feedback.
• While you won’t be submitting tracked changes to Cureus, this will make the collaborative process of revision much easier for all authors.

Double-Check Consistency

• Ensure that revised sections flow well and do not contradict other parts of the manuscript.
• Update tables, figures, and references accordingly.

Tip: If you made major revisions, re-read the entire manuscript to ensure coherence and clarity.

Submitting the Revised Manuscript

After giving your response to peer review comments and before submitting for final publication, go through this final checklist:

• All reviewer comments have been addressed in detail, and the manuscript has been revised in response to reviewer comments.
• Your message to the editors is clear, concise and informative.
• Proofread the revised manuscript to eliminate errors.
• All additional supporting documents (e.g., ethical approvals) are included.

Tip: If possible, ask a colleague or mentor to review the revisions you made based on the peer review feedback before submission.

What Happens After Submitting the Revised Version?

The editor will evaluate your manuscript. If the revisions fully address concerns, the manuscript is accepted for publication. If further changes are needed, you may receive another round of revisions. If concerns are not adequately addressed after multiple opportunities, the article may be rejected. If this happens, your best option is to revise and submit to another journal.

Tip: Even top researchers go through multiple rounds of peer review—persistence is key!

Key Takeaways: How to Make Peer Review Work for You

• Be open to feedback – View revisions as an opportunity to improve.
• Respond professionally – Keep responses to peer review comments clear, concise, and respectful.
• Make thoughtful revisions – Your response and revisions should address every reviewer’s comment systematically.
• Seek clarification if needed – If a comment is unclear, don’t hesitate to ask the editor.

By approaching peer review feedback with confidence, professionalism, and a commitment to improvement, you’ll increase your chances of publication success while growing as a researcher and writer.