By Gary Burd, SVP, Global Medical Director

There’s plenty of guidance out there on how to conduct good clinical research, write a manuscript reporting data from a clinical trial, submit a manuscript for a journal (e.g., The Lancet’s guidelines) and even peer review a manuscript. But, what should you do when you’re an author left holding fifty-odd comments from peer reviewers and have just days to turn your manuscript around? Distinctly lacking is advice on how to respond to make the editor’s and reviewers’ jobs easier.

Interpretation can be the most difficult first hurdle. Take the time to try and understand what the peer reviewers are actually asking for and why. Sometimes there are conflicting comments to navigate or requests for additional data analyses, which may not be available or appropriate to include. Infuriatingly, there may be requests to include more information, but they come with a warning not to go over the word count. All of these can be frustrating, but it’s important to stay calm and be methodical. Responding following the advice of Hywel Williams seems appropriate: respond completely, respond politely and respond with evidence.

Respond completely

Itemize and respond to all comments, including minor, major and even positive comments. If several comments are contained in a single paragraph, separate them and tackle each individually. Address comments sequentially by either numbering them or putting them in a table. Together, this can make the response easier for reviewers and editors to read, while typing out or paraphrasing reviewer comment forces you to listen to what was actually said, instead of what you thought was said.

Respond politely

Reviewers spend (unpaid) time reading your work and a long list of detailed comments is a substantial investment of time and effort with the ultimate goal of improving your manuscript. It’s important to thank your reviewers for their time, feedback and positive comments. Disagreeing with your reviewer is okay and expected, but do it politely – even if they weren’t.

Respond with evidence

When disagreeing with the reviewer’s comments, make sure you provide a rationale for your decision. If you are asked for data, provide it if you can; it can just be for their information and does not necessarily have to go in the manuscript. The goal is to reassure your reviewers that you have taken their comments seriously, respect their opinion and are attempting to address their concerns.

The most important thing is to make the editor’s and reviewers’ jobs easier by being clear in your response. For each comment, make sure you provide the following information:

  • What is your opinion of the comment?
  • What have you provided as additional information?
  • What have you changed in the manuscript?
  • Where can the change be found in the manuscript?

Finally, if you feel the need to, involve the editor if there are disagreements. They are there to help navigate the process too, and can advise you on how best to respond in challenging situations.

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