Addressing Reviewers’ Comments and Revising Manuscripts After Peer Review

1. Addressing Reviewers’ Comments and Revising Manuscripts After Peer Review Moyses Szklo Editor-in-Chief American Journal of Epidemiology

2. Peer Review Process in the American Journal of Epidemiology Changes his mind and agrees: paper is rejected Disagrees Editor believes it should go to external reviewers Agrees EIC believes it should be rejected out of hand (low priority) Disagrees 2nd editor Disagrees Agrees: paper is rejected Outside reviews Paper reviewed by EIC

3. Primary Prevention • In a case-based case-control study, odds ratios instead of beta coefficients • In a cross-sectional study or when calculating cumulative incidence ratio without adjustment for time-to-event, prevalence ratio regression • Presentation of p values, 95% confidence limits and standard errors simultaneously is often redundant • Be careful when comparing association strengths • Stratified data instead of interaction terms (the latter are useful for statistical testing and for predictive equations)

4. Primary Prevention • In a case-based case-control study, odds ratios instead of beta coefficients • In a cross-sectional study or when calculating cumulative incidence ratio without adjustment for time-to-event, prevalence ratio regression • Presentation of p values, 95% confidence limits and standard errors simultaneously is often redundant • Be careful when comparing association strengths • Stratified data instead of interaction terms (the latter are useful for statistical testing and for predictive equations)

5. Primary Prevention • In a case-based case-control study, odds ratios instead of beta coefficients • In a cross-sectional study or when calculating cumulative incidence ratio without adjustment for time-to-event, prevalence/incidence ratio regression • Presentation of p values, 95% confidence limits and standard errors simultaneously is often redundant • Be careful when comparing association strengths • Stratified data instead of interaction terms (the latter are useful for statistical testing and for predictive equations)

6. (Spiegelman D, Hertzmark E, Am J Epidemiol 2005;162:199-200)

7. Primary Prevention • In a case-based case-control study, odds ratios instead of beta coefficients • In a cross-sectional study or when calculating cumulative incidence ratio without adjustment for time-to-event, prevalence/incidence ratio regression • Presentation of p values, 95% confidence limits and standard errors simultaneously is often redundant • Be careful when comparing association strengths • Stratified data instead of interaction terms (the latter are useful for statistical testing and for predictive equations)

8. Primary Prevention • In a case-based case-control study, odds ratios instead of beta coefficients • In a cross-sectional study or when calculating cumulative incidence ratio without adjustment for time-to-event, prevalence/incidence ratio regression • Presentation of p values, 95% confidence limits and standard errors simultaneously is often redundant • Be careful when comparing association strengths • Stratified data instead of interaction terms (the latter are useful for statistical testing and for predictive equations)

9. Primary Prevention • In a case-based case-control study, odds ratios instead of beta coefficients • In a cross-sectional study or when calculating cumulative incidence ratio without adjustment for time-to-event, prevalence/incidence ratio regression • Presentation of p values, 95% confidence limits and standard errors simultaneously is often redundant • Be careful when comparing association strengths • Stratified data instead of interaction terms (the latter are useful for statistical testing and for predictive equations)

10. Association of Center for Epidemiologic Studies Depression Scale (CES-D) scores (ln(CES-D + 1) with bereavement and baseline CES-D scores at 1 and 12-month interviews, adjusted for health and social network variables§, widowed and married women aged 65-74 yrs, Washington Co., MD, 1979-83 * §Self-reported health status, level of physical activity, family size and friendship size; ¶ p<0.0001; §p<0.001

11. Center for Epidemiologic Studies Depression Scale (CES-D) Mean Baseline and Follow-up Scores According to Whether Bereavement Occurred, Women Ages 65-75 Years, Washington County, MD, 1979-1983 Title: informative CES-D Score Time post-bereavement *Adjusted for self-reported health status, level of phys. activity, family size and friendship size; Test for interaction between status and difference [1 month – baseline]: p<0.001.

12. Primary Prevention • Read carefully the Instructions to Authors (focus on maximum number of pages, other rules of presentation  e.g., AjE requires aa to plot ratio-based measures on a log scale) • Do not submit the same or similar publications to different journals • Avoid abbreviations • Description of results in text should follow the same order as in table • Avoid the word, “effect”, when reporting observational results • Make sure text, tables and figures match. When a result is presented only in the text, add parenthetically something like “not shown in table/figure”

13. Primary Prevention • Read carefully the Instructions to Authors (focus on limit on number of pages, other rules of presentation  e.g., AjE requires aa to plot ratio-based measures on a log scale) • Avoid abbreviations • Description of results in text should follow the same order as in table • Avoid the word, “effect”, when reporting observational results • Make sure text, tables and figures match. When a result is presented only in the text, add parenthetically something like “not shown in table/figure”

14. Primary Prevention • Read carefully the Instructions to Authors (focus on limit on number of pages, other rules of presentation  e.g., AjE requires aa to plot ratio-based measures on a log scale) • Avoid abbreviations • Description of results in text should follow the same order as in table • Avoid the word, “effect”, when reporting observational results • Make sure text, tables and figures match. When a result is presented only in the text, add parenthetically something like “not shown in table/figure”

15. (1) (2) (3) Table and text: same order Relative Risk Factor Unit 1.6 5 years Age Current vs. never Smoking 3.2 Total cholesterol 200+ Vs. <200 mg/dL 2.5 “Relative risks for total cholesterol, age and current smoking are shown in the table. Current smoking was associated with an approximately 3-fold increase in risk. The relative risk for total cholesterol levels of 200 mg/dL or higher was 2.5, whereas that related to a 5-year age increase…”

16. Primary Prevention • Read carefully the Instructions to Authors (focus on limit on number of pages, other rules of presentation  e.g., AjE requires aa to plot ratio-based measures on a log scale) • Avoid abbreviations • Description of results in text should follow the same order as in table • Avoid the word, “effect”, when reporting observational results • Make sure text, tables and figures match. When a result is presented only in the text, add parenthetically something like “not shown in table/figure”

17. (Wang N et al, Am J Epidemiol 2009 [Epub ahead of print])

18. Primary Prevention • Read carefully the Instructions to Authors (focus on limit on number of pages, other rules of presentation  e.g., AjE requires aa to plot ratio-based measures on a log scale) • Avoid abbreviations • Description of results in text should follow the same order as in table • Avoid the word, “effect”, when reporting observational results • Make sure text, tables and figures match. When a result is presented only in the text, add parenthetically something like “not shown in table/figure”

19. Primary Prevention • Focus on trends, not just on testing or precision • Do not repeat results in the text that are clearly shown in tables • Discuss the study’s limitations • Paper should be as short as possible

20. Primary Prevention • Focus on trends, not just on testing or precision • Discuss the study’s limitations • Paper should be as short as possible

21. Primary Prevention • Focus on trends, not just on testing or precision • Discuss the study’s limitations • Paper should be as short as possible

22. Avoiding wordiness (Friedman, AJE 1990;132:591) Other investigations exploring the association between multiparity and scleroderma have obtained information on multiparity using surrogate measures. The amount of money spent on diapers, without consideration of inflation, has been used as a proxy by several groups of investigators, and all have reported that no significant differences were observed once the data were stratified by age at last full term pregnancy. Similar results were found in the analysis and reported here. (73 words) Shortened: Other investigators have used surrogate multiparity measures, such as amount spent on diapers, without inflation adjustment; as with our study, no significant differences were identified in data stratified by age at last full term pregnancy.(35 words)

23. Alleged letter from Mark Twain to a friend Dear … I am sorry that I have written you such a long letter. I did not have any time to write you a short one…

24. Secondary Prevention: Responding to Reviewers’ Comments • In your cover letter, answer each critique/comment made by reviewers. • Highlight in the revised paper the changes made as a result of the reviewers’ comments. • Be courteous. A good idea is to start your response with, “I thank the reviewer for this thoughtful suggestion…” (that is, if you think it is thoughtful…) • Try to consider carefully each suggestion or comment. • If you disagree somewhat with the request for a change, but it is easy to implement it and it does not affect the science…do it! • If you disagree entirely with a criticism and believe it is scientifically sound, explain why.

25. Secondary Prevention: Responding to Reviewers’ Comments • In your cover letter, answer each critique/comment made by reviewers. • Highlight in the revised paper the changes made as a result of the reviewers’ comments. • Be courteous. A good idea is to start your response with, “I thank the reviewer for this thoughtful suggestion…” (that is, if you think it is thoughtful…) • Try to consider carefully each suggestion or comment. • If you disagree somewhat with the request for a change, but it is easy to implement it and it does not affect the science…do it! • If you disagree entirely with a criticism and believe it is scientifically sound, explain why.

26. Secondary Prevention: Responding to Reviewers’ Comments • In your cover letter, answer each critique/comment made by reviewers. • Highlight in the revised paper the changes made as a result of the reviewers’ comments. • Be courteous. A good idea is to start your response with, “I thank the reviewer for this thoughtful suggestion…” (that is, if you think it is thoughtful…) • Try to consider carefully each suggestion or comment. • If you disagree somewhat with the request for a change, but it is easy to implement it and it does not affect the science…do it! • If you disagree entirely with a criticism and believe it is scientifically sound, explain why.

27. Secondary Prevention: Responding to Reviewers’ Comments • In your cover letter, answer each critique/comment made by reviewers. • Highlight in the revised paper the changes made as a result of the reviewers’ comments. • Be courteous. A good idea is to start your response with, “I thank the reviewer for this thoughtful suggestion…” (that is, if you think it is thoughtful…) • Try to consider carefully each suggestion or comment. • If you disagree somewhat with the request for a change, but it is easy to implement it and it does not affect the science…do it! • If you disagree entirely with a criticism and believe it is scientifically sound, explain why.

28. Secondary Prevention: Responding to Reviewers’ Comments • In your cover letter, answer each critique/comment made by reviewers. • Highlight in the revised paper the changes made as a result of the reviewers’ comments. • Be courteous. A good idea is to start your response with, “I thank the reviewer for this thoughtful suggestion…” (that is, if you think it is thoughtful…) • Try to consider carefully each suggestion or comment. • If you disagree with a request for a change, but it is easy to implement it and it does not affect the science…do it! • If you disagree entirely with a criticism and believe it is scientifically sound, explain why.

29. Secondary Prevention: Responding to Reviewers’ Comments • In your cover letter, answer each critique/comment made by reviewers. • Highlight in the revised paper the changes made as a result of the reviewers’ comments. • Be courteous. A good idea is to start your response with, “I thank the reviewer for this thoughtful suggestion…” (that is, if you think it is thoughtful…) • Try to consider carefully each suggestion or comment. • If you disagree with a request for a change, but it is easy to implement it and it does not affect the science…do it! • If you disagree entirely with a criticism and believe it is scientifically sound, explain why.

30. Tertiary Prevention Should authors request reconsideration if you paper has been rejected, and you believe that the reasons for rejection were not reasonable? I am sorry to inform you that after careful review, we are unable to accept your paper for publication. As you know, we can accept only a fraction of the meritorious manuscripts submitted to the American Journal of Epidemiology. I appreciate the considerable effort that you and your colleagues have put into this manuscript and am sorry to bring you this unfavorable news.The comments of the reviewers are enclosed for your consideration. I hope the information provided by the reviewers will be helpful if you decide to revise the manuscript for submission to another journal. Please keep in mind that our decisions regarding acceptance of manuscripts are based not only on the reviewers' comments to the authors, but also on the reviewers' comments to the editor, in-house evaluations by editors, and an assessment of the priority rating of the manuscript in relation to our many other submissions.On behalf of the Journal, I thank you for submitting your manuscript and hope that the outcome of this specific review will not discourage you from sending future papers to us.Sincerely

31. Decisions made for submissions to the AjE between 1/1/08 and 6/30/08

32. E-mail message from an European author upon receiving a rejection letter: Dr. Szklo, What could I expect from an american (sic) editor? I will no longer buy american (sic) products.

33. Reputed rejection slip from a Chinese economics journal We have read your manuscript with boundless delight. If we were to publish your paper, it would be impossible for us to publish any work of a lower standard. And, as it is unthinkable that, in the next one thousand years, we shall see its equal, we are, to our regret, compelled to return your divine composition, and to beg you a thousand times to overlook our short sight and timidity.

35. Adjusted* Risk (Hazard) Ratios of Coronary Heart Disease by Selected Factors, with 95% Confidence Intervals, Men 40-64 Yrs. Old at Baseline, 5-year Follow-up, 1975-79 *Each variable is simultaneously adjusted for all other variables seen in the table using Cox Proportional Hazards model

36. Relative Risk of Pancreatic cancer in Relation to Drinks per Day by Gender in the NIH-AARP Diet and Health Study, USA, 1995/1996-2003