Introduction of Patient Review Alongside Traditional Peer Review at a General Medical Journal (The BMJ): A Mixed Methods Study

Sara Schroter,1 Amy Price,1,2 Rosamund Snow,1,3 Tessa Richards,1 Sam Parker,1 Elizabeth Loder,1 Fiona Godlee1

Objective To evaluate the feasibility of incorporating patient reviews into the traditional peer review process at The BMJ.

Design This was a mixed methods study including a comparison of acceptance and completion rates and timeliness to review between patient reviewers and traditional reviewers for articles sent for peer review in 2016. We also surveyed the patient reviewers and research editors on their views of the value of patient reviews.

Results In 2016, 359 of 647 research articles (55%) sent for review had at least 1 patient reviewer invitation. For review invitations in 2016, the agreement rate for patient reviewers was 287 of 677 (42%) and the completion rate was 224 of 287 (78%); for traditional reviewers, the agreement rate was 2649 of 6998 (38%) and the completion rate was 2217 of 2649 (84%). Patient reviewers took a mean (SD) of 10.5 (5.9) days to complete a review after agreement compared with 13.4 (7.7) days for traditional reviewers. Overall, 122 of 164 patient reviewers (74%) responded to a survey, and 100 of those patient reviewers (82%) would recommend being a patient reviewer for The BMJ to other patients and carers. One hundred seven of the patient reviewers who responded to a survey (88%) think more journals should adopt patient review, and 98 (80%) did not have any concerns about doing open review. Of the 20 patient reviewers who reviewed papers that were returned to the authors for revisions, 15 agreed or strongly agreed that the authors addressed their points, and 15 agreed that the authors were courteous when addressing their points. Twelve patient reviewers who reviewed papers that were returned to the authors for revisions felt they included points important to patients that were not raised by the traditional reviewers. Seven of 8 research editors responded to the editor survey; 5 of 7 reported patient reviews currently add “a little” value to research papers; and 2 of 7 believed patient reviews add “a lot” of value to research papers. However, 5 of 7 research editors found it difficult to identify appropriate patient reviewers, and 5 of 7 experienced difficulty communicating with patient reviewers about articles. All editors reported patient reviewers “occasionally” include insights not raised by other reviewers; 6 of 7 editors “occasionally” and 1 of 7 editors “frequently” find patient reviewers' comments helpful when advising authors on revisions to manuscripts. Four editors felt that other journals should adopt patient review, and 3 were unsure.

Conclusions Patient review of research is feasible alongside a standard peer review process and is considered beneficial by some editors and important by patients and carers. Further qualitative research should capture the value of the changes made to manuscripts as a result of patient reviews.

1The BMJ, London, UK, sschroter@bmj.com; 2Department of Continuing Education, University of Oxford, Oxford, UK; 3University of Oxford Medical School, Oxford, UK

Conflict of Interest Disclosures: Dr Schroter, Dr Richards, Mr Parker, Prof Loder, and Dr Godlee are employees of The BMJ; Dr Snow was also an employee of The BMJ. Dr Godlee is a member of the Peer Review Congress Advisory Board but was not involved in the review or decision for this abstract. Dr Price is a Research Fellow at The BMJ.

Acknowledgments: We thank all the patient reviewers for completing the survey and all those who have given their time to review articles for The BMJ and helped us improve our guidance. We also thank The BMJ editors for embedding patient review into their daily work flow.

Additional Information: Dr Rosamund Snow is deceased.

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