The peer review (PR) system is considered an integral part of the process of evaluating scientific medical articles for publication in journals [1]. However, many authors are often frustrated or disappointed by critical feedback, and sometimes humiliated to be told by an anonymous reviewer that their paper is not good enough [2-4]. Sometimes the PR process can be emotionally stressful, especially when authors feel that the comments are ill-informed, biased, or malicious. However, the fact remains that the PR system helps authors improve their manuscripts in the long run, and mature authors understand and use this beneficial system.

As the editor-in-chief of Vascular Specialist International (VSI) journal, I have often seen authors responding inappropriately to reviewers’ comments. I think such reactions are a result of misunderstanding the PR system and lack of education about how to respond to reviewers. Therefore, I’d like to describe the PR system of VSI, and provide tips to authors regarding how to respond to reviewers’ comments.

When an article is submitted to VSI, a manuscript editorial service checks whether it is presented in the recommended format. If not, it is returned to the authors, and they are asked make relevant changes with regard to ethics or format. Once a manuscript passes this entry check, the editors carefully read it and decide whether to reject it or forward it to the PR system. For the PR, usually three reviewers from related fields are invited by the editors. Because VSI runs a double-blind review system, these peer reviewers do not know each other nor the authors. They usually volunteer their work as a gift to the society or science and medicine without any payment or reward. They are professionals who give critical comments to help improve the article, not to criticize the authors. The authors have the right to alter their manuscript as per reviewers’ recommendations or defend themselves against incorrect comments with sound scientific rationale. Authors must think from the reviewers’ perspective, communicate effectively, and persuade the reviewers with evidence that the manuscript is good enough for publication.

I would like to summarize simple but important tips to help authors respond appropriately to peer reviewers’ comments. Please note that there are many articles, online texts, and YouTube videos dealing with this topic [2-5].

1) Letter to the editor and reviewers

Please start the response letter with thanks to the editors and reviewers, and show that you have sincerely taken full account of all the reviewers’ comments. Provide an overview of the changes, new data, and new analyses performed in response to the most essential comments of all the reviewers. Then quote the full set of reviews.

2) Be polite and respectful

As an author, you do not have to agree with every feedback, but politeness will help obtain a favorable decision. It is likely that you have experience of reviewing articles written by other authors, therefore, take the opportunity to treat your reviewers the way you would like to be treated [2]. Although you might want to say: “My English writing skills are better than yours. Why are you complaining about my typos?”, you must say: “Our manuscript has been reviewed by a native English speaker, and revised to improve readability.” [2]. Do not attack the reviewers or question their motives, expertise, or intellectual aptitude. If the reviewer failed to understand something, it is most likely because you failed to explain it clearly. And if the reviewer had a problem, so will readers [4]. Rewrite the paragraphs in question to convey your point clearly.

Remember that you need to be polite, even when reviewers are rude. However, if you feel the reviewer has any conflict of interest, malicious intent, or discriminatory attitude, you can report that to the editor-in-chief in a separate letter. Fortunately, I have not received such a letter yet from VSI authors.

3) Respond point-by-point to each and every comment raised by all reviewers

Be polite, but do not repeat thanks in every response. As the old Korean proverb says, excessive politeness becomes rudeness. If you agree with the comment, acknowledge it and mention the changes you made. If you disagree with the reviewer’s suggestion, provide a reasonable explanation as to why you did not make the suggested change. If additional work or experiment is recommended, just do it if possible. Otherwise, tactfully explain why the additional work cannot be performed.

Author’s document with an overview of changes and point-by-point responses shows the editor that you carefully considered and addressed each criticism, and this aids the editor in making a final decision to accept your paper for publication.

4) Make the response self-contained

Show exactly how you revised the manuscript so that the reviewer does not need to go back to the manuscript. Make your changes standout by using different typefaces, colors, and indentations for the three different elements: the reviewer comment, your response, and the change made in the manuscript. This will help the reviewer navigate your response. Reviewers are busy, and sometimes they forget what they criticized. Therefore, highlight the changes for better understanding. Otherwise, you can show both the original and revised versions of the altered paragraph to make it easy for the editor to see how you dealt with the criticism.

5) Stay optimistic

If you feel that you received a harsh review, give yourself time to digest before attempting to respond. Read all the comments carefully before answering. Don’t send a letter in anger. They are professional volunteers to help you improve your research. You can vent your anger by first writing a scathing response (which you will not send), then write a more professional version without the hysterics [4]. If you find contradictory comments by different reviewers, stick with what you think is more appropriate. The reviewers are blind to each other. They are able to view other reviewers’ comments on your original manuscript only when they receive your response to the review, and then they may change the initial suggestion.

6) Check repeatedly for any mistakes

The best way to write a good manuscript is to rewrite repeatedly and ask other co-authors to cross-check the revised manuscript.

Seung-Kee Min has been the editor-in-chief of Vasc Specialist Int since 2019.