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Many scientific journals use an external peer review process where manuscripts are reviewed by experts who are not members of the Editorial Board. These experts assess the merits and shortcomings of manuscripts and help the editor decide whether or not they should be published. They also help improve the quality of the manuscripts submitted. Although empirical evidence supporting this approach is still limited, there is some consensus that it is the best possible method of controlling the quality of scientific publications. If you would like to learn more about the merits and shortcomings of external peer review of manuscripts in the field of biomedical sciences, consult Godlee & Jefferson's book Peer review in health sciences, published by BMJ Books (London, 1999), or the website of the International Congress on Peer Review and Biomedical Publishing:

Although the debate about the suitability of the peer review process is far from over, all manuscripts submitted to Gaceta Sanitaria undergo external peer review. This is consistent with the approach used by all major national and international biomedical journals. Furthermore, Gaceta Sanitaria is continuously reviewing and improving the external peer review process in order to address its shortcomings and consolidate its strengths (see for example La revisión por pares: ¿buena, mala o todo contrario?, by Plasència et al., Gac Sanit. 2001;15(5):378-9; La calidad de las evaluaciones de manuscritos en Gaceta Sanitaria, by García et al., Gac Sanit. 2002;16(3):244-9; Autores parásitos o altruismo en el trabajo editorial. La importancia de que los/las autores/as también sean revisores/as, by Ruano-Raviña & Álvarez Dardet, Gac Sanit. 2014;28:354-5). With this same aim, the general guidelines to be followed by Gaceta Sanitaria's external peer reviewers are also included below.

1. Overview

  • External peer reviewers are volunteers. In recognition of their work, the names of the external reviewers who have provided this service each year are included on the journal's website. The Gaceta Sanitaria office can issue a document confirming the reviewer's contribution on request.
  • Reviewers are free to accept or decline a request to review a document. However, if they accept, they must return the reviewed manuscript by the stipulated deadline (usually 3 weeks after receipt). If they wish to decline, they must notify the Gaceta Sanitaria office immediately (within 48 hours). If a reviewer declines to review a manuscript, it would help the Editorial Board if he or she could put forward the name of another person or persons who could review the manuscript in question, although the editor will have the final say regarding the person(s) to whom the manuscript will be sent.
  • Reasons for declining an invitation to review a manuscript include: lack of time required to complete the work within the timeframe specified; lack of familiarity with or experience in the topic; or conflicts of interest which could compromise the required neutrality and rigour of the review process.
  • Until they are published, manuscripts are confidential documents. Their content or any aspect related to the review should not be discussed with any third party. The only people authorised to discuss any matters related to the review process are the Editor in Chief, Assistant Editor and other members of Gaceta Sanitaria's Editorial Board.
  • The review process is anonymous, i.e. the reviewer does not know who the author(s) is (are) or the names of the institutions where they work. Reviewers can also choose to remain anonymous, but can add their name to their feedback to the author(s) if they wish.
  • Once the external review is complete and feedback has been received, the decision regarding the manuscript (whether it is accepted, rejected pending changes or rejected outright) will be made by the relevant editor. The external reviewer will be notified and will also receive a copy of the feedback provided by the other peer reviewers, if applicable. The Editorial Board is ultimately responsible for the decision, which will be based on the feedback and suggestions of the peer reviewers and on the journal's own editorial requirements.

2. The review process

Peer reviewers must provide feedback divided into the following three sections:

a) A summary of the reviewer's overall assessment of the manuscript. This should include all relevant points in accordance with the nature and characteristics of the work. This section is not shown to the author(s) and is for internal use by the Gaceta Sanitaria Editorial Board only.

b) Comments for the Editorial Board. As with the previous section, this part of the review is not shown to the author(s).

c)Feedback for the author(s). This is the only section that is sent to the author(s). The reviewer's name will not be included unless he or she expressly requests it.

In order to complete the review correctly and provide all the documents detailed above, reviewers should follow the steps below:

  • Initial read-through of the manuscript, including the abstract, text, tables and figures, and bibliography, as if it were a published article. During this first read-through, it is useful to write notes on a separate piece of paper or on the manuscript itself. These should detail the study's main characteristics (e.g. specified objectives or key details of the method) and any potential problems (e.g. sentences that are difficult to follow or unsupported conclusions). The reviewer will be able to assess the manuscript in more detail during the second read-through.
  • n-depth review of the manuscript. Here the reviewer should consider some or all of the following, although the exact requirements depend on the type of manuscript under review:
    • Suitability for Gaceta Sanitaria's readership. The reviewer can suggest other more appropriate journals or target audiences if necessary, providing reasons for their suggestion(s).
    • Originality of the work, taking into account its contribution to the field of public health and health administration, citing relevant references if appropriate.
    • Quality of the title and abstract. The title should not be too vague or too long. If the study focuses on a specific population (only women/men, the elderly, immigrants, etc.), this should be mentioned in the title. There may be inconsistencies between the information in the abstract and that provided in the text and tables, or key details may be missing from the abstract (e.g. formulation of the study objective or presentation of numerical data, if applicable). Quite often the conclusions in the abstract are not completely consistent with the ones in the body of the text.
    • Formal aspects. Is the text easy to read? Are the sentences and paragraphs clear and easy to follow? Is the language used non-sexist? Are any sentences difficult to understand? Reviewers must check that the text follows the established structure, e.g. for an Original Article, they must check that the Introduction, Methods, Results and Discussion appear in the correct order. The tables and figures must be clear and easy to understand without referring back to the text. They should complement the information provided in the text, not repeat it. Reviewers should also assess the length of the text. If it is too long they should suggest which paragraphs or sections could be omitted. The manuscript should adhere to Gaceta Sanitaria's Guidelines for Authors, taking into account the specific requirements for the different article types (Original Articles, Field Notes, etc.).
    • Ethical aspects, including those related to the research itself (e.g. confidentiality of study subject data, informed consent or other ethical principles related to medical research in humans) as well as those related to its publication (e.g. repetition or potential conflicts of interest).
    • Recommendations about awareness of sex/gender in scientific publication as set out in Gaceta Sanitaria's Policy to Promote Gender Equality in Scientific Publication.
    • Content and validity of scientific information:

      Introduction and objective: Does this section provide a summary of the framework or motivation for the study, based on current literature relevant to the study objectives? If appropriate, is the reason why differences by sex/gender are expected explained? Is the aim of the study included at the end of the introduction and adequately defined?

      Methods: Does the study design allow the proposed objectives to be achieved? Do the authors explain how the sex of the study participants has been taken into account in the study design? Are the study setting, population and sample group described in enough detail? Does the sample group include enough members of each sex, and does the manuscript provide details of subjects lost to follow-up by sex? If applicable, is the reason why the study focuses on a particular population (only men, only women, young people, immigrants, etc.) adequately justified? Are the methods appropriate for the study objectives? Are the tools used to gather data described in sufficient detail? Are the tools appropriate for the study objectives? Is the statistical analysis performed appropriate? Does the study include an analysis stratified by sex?

      Results: Are they credible? Has the correct information to be presented been selected? Is the information presented relevant to the research question? Are unnecessary or superfluous data shown? Are the results stratified by sex where appropriate? Are subgroups of men and women analysed, allowing meta-analysis? Are interactions that allow differences by sex to be determined analysed?

      Interpretation and conclusions: Are the conclusions correct based on the data presented? Are the novel or relevant aspects and strengths of the study highlighted? Are the implications of the analysis comparing sexes or genders discussed where relevant? If it was not possible to carry out that analysis, are the resulting limitations discussed? Are the results of the study compared with those of other works? Are the limitations of the study and their potential effect on the interpretation of results discussed? Are the implications of the study results for future research in the field, as well as for healthcare policy and management, where relevant, discussed? Do the conclusions answer the questions set out in the study objectives?

      References: Are they relevant? Are they current? Are they cited correctly? Have any important references been omitted? Are there enough? Are there too many?

  • Writing the review report. As well as providing a summary of their review that includes all relevant aspects in accordance with the manuscript type, reviewers must provide comments for the editor and the author(s). The following guidelines apply::
    • In the comments for the Editorial Board, the reviewer can freely express his or her opinion about the manuscript, including any points that he or she believes the editors should know about. These comments do not need to be sent to the author(s). For example, it is best if the reviewer includes any recommendation about whether or not the manuscript should be published in this section. Any harsh criticism of the manuscript can be expressed more freely to the editor here, while it is more appropriate to tone down any criticism in the feedback that is sent to the author(s). Any serious conflict of interest detected should also be described in this section only. Reviewers may find that they cannot evaluate certain aspects of a manuscript properly because they lack the relevant knowledge or experience (e.g. an uncommon statistical analysis). In these cases, reviewers should also outline these issues in the comments for the Editorial Board only.
  • The feedback for the author(s) should begin with a paragraph briefly summarising the work (a maximum of one or two sentences) and evaluating its relevance and originality within the field of public health and its appropriateness for readers of Gaceta Sanitaria. In the review report itself, some reviewers prefer to divide their comments into major and minor ones. This is generally helpful for both the Editorial Board and the author(s). Major comments refer to important limitations in the study design or content, while minor comments should include more easily resolvable issues, such as problems with the structure of the text or the language.

    t is generally preferable to provide the comments in list format rather than writing long paragraphs referring to many different issues. Where relevant, reviewers should refer to the location in the text of the issues discussed, including the page number, paragraph and sentence where the problem can be found. It is much easier for the editor to assess the manuscript and for the author(s) to respond to feedback if comments are provided in a numbered list.

    • It is very important to provide justification for the comments, either by referring to specific content in the manuscript or to other information, such as evidence from previous studies. Where necessary, reviewers should include citations in their review to support the points made.
    • Finally, reviewers should always use a respectful, constructive tone in their comments. The reviewer's role is not just to influence the decision regarding whether or not the manuscript is accepted or rejected. A good review also plays an educational role and helps the author(s), some of whom are less experienced and who may benefit from the feedback and recommendations included in the review even if the journal decides not to publish the work. As such, wherever possible it is better to outline how a problem should be or could have been corrected rather than simply pointing out that there is a problem.

Basic Recommendations for the Publication of Qualitative Studies in Gaceta Sanitaria

Document written by the Gaceta Sanitaria editorial team with contributions from Erica Briones, Carmen de la Cuesta Benjumea, Isabel Goicolea, Daniel La Parra, Miguel Ángel Mateo, Clemente Penalva and María Luisa Vázquez

This document provides a series of basic recommendations for Gaceta Sanitaria's authors, reviewers and editors regarding the minimum information to be included in qualitative research studies.

NIt is not a guide to conducting qualitative studies, as it is aimed at experts in the field who wish to publish the results of their research and at reviewers and editors responsible for assessing the quality of the manuscripts submitted to Gaceta Sanitaria for possible publication.

These guidelines are based on two quality criteria for qualitative research: the relevance of the research topic and the validity of the study based on the information provided in the manuscript.

1. Relevance

This document provides a series of basic recommendations for Gaceta Sanitaria's authors, reviewers and editors regarding the minimum information to be included in qualitative research studies.

1.1 In the Introduction section

  • This section should include explicit statements clearly describing the study question and objectives and justifying the use of a qualitative approach. Reasons for the use of qualitative methods include: the study topic is an emerging one, the experience or point of view of the people involved or affected needs to be studied, or new research hypotheses need to be generated. A lack of published qualitative studies on the topic alone does not justify the use of these methods.

1.2 In the Discussion section

  • Here the author(s) should explain why the study contributes to our existing knowledge of the topic and describe what it adds or contributes to practice or policy.
  • t will be seen as positive if the analysis is linked to theory or practice.

2. Validity

This criterion refers to the information provided in the Methods, Results and Discussion sections.

2.1 In the Methods section

  • Identification of the sampling type (purposive, theoretical, etc.) and the reference text.
  • Description of the process used to select the study participants, situations observed and documents or analogues studied.
  • Identification of the information production techniques used and description of their application in the study (places, duration, profiles of interviewers and moderators). Description of the methods used to record that information (audio recorders, video cameras, notes, etc.).
  • Identification of the period in which the information was produced.
  • Description of the techniques used to process the qualitative data (if a computer program was used, name it and include it in the bibliography).
  • Description of the analysis methodology chosen, citing the relevant reference text where appropriate.
  • Description of the steps taken for the analysis.
  • Review of the consistency between the analysis methodology used and the terminology used.
  • Detailed explanation of the measures taken in each case to improve the study validity (this information is also relevant to the Discussion section in some cases).

2.2 In the Results section

  • The author(s) should make a clear distinction between the results obtained during the information production process and their own interpretation of those results.
  • The interpretation of results should be based on the sections of the documents, spoken words or images (photographs, audio, paintings, drawings, etc.) that best demonstrate the interpretation included in the Results section.
  • The use of semiotic squares, concept maps, diagrams, etc. is also recommended where relevant.
  • Use a homogeneous labelling system that guarantees anonymity in case they could be used to identify the contributions made by the study participants.
  • Check the plausibility and consistency of the results described in relation to the study objectives.
  • It will be seen as positive if a theoretical analysis has been carried out (concepts based on data and relationships).
  • It will be seen as positive if the theory is precise and complete (clarity, concision and theoretical saturation).

2.2 In the Discussion section
In addition to the content usually included in this section (see Guidelines for Authors), it is advisable to include reflections on the possible influence of the investigator on the contributions made by the participants (in studies based on this type of contribution).
It will be seen as positive if information is provided about the measures used to improve study validity (this should also be included in the Methods section where appropriate).