Prepublication review of medical ethics research: cause for concern

Although medical ethics research is frequently published in medical journals, little is known about the prepublication review such articles receive. The authors sought to describe the prepublication review of medical ethics research at major medical journals and medical ethics journals. They also sought to compare the ethics backgrounds of editors at both journal types and editors' attitudes concerning the training necessary for reviewers of ethics research.

In November 2006, the authors distributed a 19-item survey via the Internet and mail to editors of major medical journals, specialty medical journals, and medical ethics journals. The survey collected data on the use of peer review, importance of peer review, ethics training of editors, and editors' attitudes regarding the appropriate training for reviewers. Multiple-choice and open-response questions measured peer review use characteristics, and questions weighted with a five-point scale measured editor attitudes.

Medical journals and medical ethics journals almost always peer reviewed articles examining topics in medical ethics and considered this review important to enhancing the quality of published ethics research. However, medical journals were less likely to have an editor with advanced training in ethics as compared with medical ethics journals (7% versus 100%, P < .001), and their editors viewed specialized training in ethics as less important for a reviewer than did medical ethics journal editors (2.56 versus 3.88, P = .035).

Physicians should be aware that ethics articles in prominent medical journals may not have been appropriately reviewed by a reviewer with specialized training in ethics.