You already know that research papers submitted for publication in medical journals are first subject to peer review before a final decision to accept the paper is made. Peer review is a time-honoured way to evaluate scientific or academic papers by others working in the same field. But The British Medical Journal, the world’s oldest, has launched a unique initiative to include patient review of submitted studies as well. Here’s how BMJ explains this project:
“The BMJ has committed to improve the patient centredness of its research, education, and analysis articles by asking patients to comment on them. Patient peer review is a new initiative for The BMJ. We are taking the lead here, and hope other publishers will follow.“
Tessa Richards, a senior editor at the BMJ, adds that patients tend to raise different and often insightful points. With over 300 patient reviewers already in place, she reminds physicians that improving healthcare depends on health professionals having a better understanding of the burdens of illness and treatment and of the difficulties and dangers that patients encounter while navigating fragmented delivery systems.
And it gets better!
Authors of research papers submitted for publication to this journal are now asked to state if, and how, they involved patients when choosing their research question, study design, and outcome measures and in implementing and disseminating study results. Tessa Richards concludes:
“In future we are likely to consider clinical research papers only if the authors can demonstrate partnership with patients in their study.”
My own BMJ debut as a brand new patient reviewer for heart-related studies happened last month! I described that experience to BMJ readers like this:
Carolyn Thomas: My experience of patient peer review
Published in The British Medical Journal, October 16, 2014
“I’ve finally hit the Submit button on my patient review of a research paper submitted to The BMJ—and in time for its deadline. Hurray!
“This is the first project of this type I’ve ever been involved in, and at first blush I wondered if I would have anything at all meaningful to contribute—as a non-scientist who wouldn’t know a Hosmer-Lemeshow test from my left elbow at the best of times.
“Once I started reading the paper, the pressure to come up with something profound seemed to grow exponentially, especially given that The BMJ is among those journals leading the way in even considering the inclusion of patient reviewers in this process. I also knew that, unless a patient review is meaningful or useful, why bother? Would my clearly non-professional input be used to explain trashing the entire patient peer review initiative? (‘We tried patient reviewers, but they just didn’t pan out . . . ‘)
“And then I decided to carefully re-read The BMJ‘s patient reviewer guidelines. The first question of the guidelines is:
“Is this an issue that matters to you, other patients, and carers?”
“I was suddenly able to take a nice deep breath and remind myself that The BMJ already has real scientists and healthcare professionals to offer peer review input, so I needn’t lose sleep over methodology minutiae. This first question reminded me as well that the particular focus of the paper I was reviewing did matter to me. In fact, I’d already written – from a patient’s perspective – about the very same issues surrounding controversial cardiovascular risk calculators that were discussed in the paper up for review.
“This experience has turned out to be far less stressful than I’d first anticipated, thanks to the helpful patient reviewer guidelines.
“I appreciate The BMJ‘s brave and generous offer to grant patients the opportunity to participate in what matters to us.”
Carolyn Thomas is a heart attack survivor, women’s health activist, and blogger at Heart Sisters.
Competing interests: I declare that I have read and understood BMJ policy on declaration of interests and I have no relevant interests to declare.
Read Carolyn Thomas’s previous BMJ post: Why physicians must stop saying: “We are all patients”
Are you a patient, patient advocate or caregiver interested in volunteering to be a patient reviewer for The British Medical Journal?
If so, read the patient reviewer guidelines that I mentioned above. Near the bottom of the guidelines are listed a number of published patient review examples (FYI, mine is #3). If you decide to sign up as a reviewer, you’ll be asked about medical conditions you have had or for which you are a patient advocate (for example, cancer, heart disease, diabetes).
You’ll also be asked if you have a special interest or expertise in topics like advancing patient partnership through shared decision-making, promoting self-management and patient leadership, etc.
Here’s more from BMJ editors about this unique opportunity:
“Don’t worry, you don’t need to have any medical or scientific training, because we’ll be asking you to consider a slightly different set of questions about the paper you’ll be reviewing than the traditional peer reviewers.
“As a patient reviewer, we’d like you to answer questions like:
- Is this an issue that matters to you, other patients and carers?
- Are there any areas relevant to patients and carers that are missing or should be highlighted?
- If the article is a research paper looking at a new intervention of treatment, say if you think it will really work in practice? What challenges might patients face?
- Are the outcomes measured and issues discussed in the article the ones that are important to patients? Are there others that should have been considered?
- Do you have any suggestions which might help the author/s strengthen their paper to make it more useful for doctors to share and discuss with patients?
“By answering these questions, you will be giving the editors your perspective on the patient-focused aspects of selected manuscripts, drawing on your experience of a particular topic, condition or intervention.
“You will also gain a unique insight into how medical research is conducted and the way educational articles are published for doctors. It’s your opportunity to have a real voice in shaping the way researchers and clinicians act, and to further their understanding on what is most important to, and of benefit to patients.”
Intrigued? Find out more about how you can get involved as a BMJ patient reviewer – and please forward this on to any other patients you know who might also be keen on getting involved like this.
Q: What do you make of The British Medical Journal taking this step towards “patient centredness”?
- My email to the BMJ’s Dr. José Merino – which turned into this BMJ blog post about my own experience as a patient reviewer for the journal
- The BMJ short (2:42) video tutorial on how to become a patient reviewer
- Guidance for BMJ Patient Reviewers
- My blog posts previously published by The BMJ, including Why Physicians Must Stop Saying ‘We Are All Patients’ , Yet Another Cardiac Risk Calculator? and What I Wish I’d Known Before My Hospital Discharge