A critical justification for the strengths and weaknesses of a manuscript depends not only on the clinical expertise in a given subject area and the time available for the review but also on the use of standard guidelines during the revision process.
Without a standard and systematic revision, there is a risk of missing important parts of a manuscript. The consequence can be a superficial review, with no real justification and support for the editor’s decision.
Most journal reviewers acquire the skills and knowledge to perform a manuscript review through their clinical expertise and their own experience in critically appraising the literature. If an individual performs an inadequate review, it is likely that his or her service will not be requested again. Sometimes an inadequate review is not the reviewer’s fault, but is due to insufficient formal training provided by the journals to establish standard methods to analyze the manuscript, or due to lack of information. Even if the reviewers analyze the manuscript as though they themselves were submitting it, sometimes there is a lack of a comprehensive set of guidelines for all aspects of the review process, leading to an unsupported decision 1).