Responding to reviewers: Advice to young (and some older) authors

Reviewers give generously of their time and talent to improve the quality of medical journals, and the peer review process works best in an atmosphere of mutual respect and cooperation.•Interpret each comment as friendly advice. Do not become defensive.•Make appropriate changes in response to each comment, and include a point-by-point discussion of the changes in a cover letter. If the changes are straightforward, the editor can accept them without the need for further layers of review. If the issues are more complex, the manuscript is more likely to be returned to the reviewers for a second look.•You do not have to make every change requested by the reviewers, but be careful to explain why you feel the change is inappropriate or beyond the scope of the manuscript.•Be concise—adding paragraphs can result in a bloated discussion, and readers can get lost in the details. In most cases, necessary additions can be balanced by deletions of repetitive or unnecessary text. It can be frustrating when a reviewer does not seem to understand the relevance of your work, and authors have a right to appeal an editorial decision. Contact the journal office, editor, or deputy editor if you want to appeal a decision. Explain why you feel the decision was in error and the impact the article could have on clinical outcomes. Typically, the editor will assign a fresh set of reviewers, but take heed of the reviewers’ comments and make revisions where appropriate before resubmission. If basic flaws in the manuscript have not been addressed, the outcome is commonly unchanged. Remember, “insanity” has been described as taking the same actions again and again, expecting a different outcome. Perhaps the best way to learn how to respond to reviewers is to become a reviewer yourself. It can be satisfying to contribute to the vetting of scientific literature, and reviewing articles can make you a better author. If you want to perform reviews for the journal, visit http://www.editorialmanager.com/jaad and click on “Register Now” to register your areas of interest.