Guidance for peer reviewers

All unpublished manuscripts are confidential documents. If we invite you to review an article please do not discuss it even with a colleague: if you would like to pass it on to someone else to review please email first.

Open peer review

We ask reviewers to sign their reports and declare any competing interests on any manuscripts we send them. Reviewers advise the editors, who make the final decision (aided by an editorial manuscript committee meeting for some articles, including original research).

For research papers, The BMJ has fully open peer review. This means that every accepted research paper submitted from September 2014 onwards will have its prepublication history posted alongside it on

This prepublication history comprises all previous versions of the manuscript, the study protocol (submitting the protocol is mandatory for all clinical trials and encouraged for all other studies at The BMJ), the report from the manuscript committee meeting, the reviewers’ signed comments, and the authors’ responses to all the comments from reviewers and editors (read more in this editorial).

If you experience any adverse event arising from open peer review, or would like to tell us your views, please email

We provide a thank-you email once your review is complete, and a free one-year online subscription to We are not able to provide any additional documentation regarding your review.

As a reviewer you will be advising the editors, who make the final decision (aided by an editorial committee for all research articles and most analysis articles). We will let you know our decision. Authors - and readers too, if the paper is accepted and published - will see your signed report, so please do not make any comments that you are not prepared to stand by publicly. Even if we do not accept an article we would like to pass on constructive comments that might help the author to improve it.

Authors can now nominate other BMJ Journals that they would like their manuscript to go to automatically if it is rejected by the first journal. The system also passes on editors' comments and peer reviewers' reports relating to that manuscript, to facilitate the review process at the next BMJ Journal. This means that your review might be read by other editors within BMJ (the publishing group) in due course.


Writing your review

The BMJ's peer reviewers do not have to fill in standard appraisal forms. But we do ask all reviewers to consider this general guidance:

When you provide your review via our online editorial office we will ask you to declare any competing interest that might relate to the article.

Before writing your review you may find it helpful to browse our resources for authors, advice on The BMJ's article types, our transparency policy, and our training materials for peer reviewers. Patients are asked to review our articles from the patient perspective and it may be helpful to also see their training materials.

Please give detailed and constructive comments (with references, whenever possible) that will both help the editors to make a decision on the article and the authors to improve it.

For all articles

  • Is the article important?
  • Will it help our readers to make better decisions and, if so, how?
  • Will the article add enough to existing knowledge?
  • Does the article read well and make sense? Does it have a clear message?

For research articles

  • Originality — does the work add enough to what is already in the published literature? If so, what does it add? Please cite relevant references to support your comments on originality.
  • Importance of the work to general readers — does this work matter to clinicians, researchers, policymakers, educators, or patients? Will it help our readers to make better decisions and, if so, how? Is a general medical journal the right place for it?
  • Scientific reliability
    • Research question — clearly defined and appropriately answered?
    • Overall design of study — appropriate and adequate to answer the research question?
    • Participants — adequately described, their conditions defined, inclusion and exclusion criteria described? How representative were they of patients whom this evidence might affect?
    • Methods — adequately described? Main outcome measure clear? Is the study fully reported in line with the appropriate reporting statement or checklist (these are all collected and regularly updated at Was the study ethical (this may go beyond simply whether the study was approved by an ethics committee or IRB)?
    • Results — answer the research question? Credible? Well presented?
    • Interpretation and conclusions — warranted by and sufficiently derived from/focused on the data? Discussed in the light of previous evidence? Message clear?
    • References — up to date and relevant? Any glaring omissions?
    • Abstract/summary/key messages/what this paper adds — reflect accurately what the paper says?
    • Documents in the supplemental files eg checklists for reporting statements eg CONSORT, PRISMA, and STROBE (see for other examples and for extensions to existing statements); and the protocol for an RCT. Do these properly match what is in the manuscript? Do they contain information that should be better reported in the manuscript, or raise questions about the work?

Not all of these points will be relevant for non-research articles. Please use your discretion about the above list when reporting on other types of article.

Some types of article need more specific appraisal, and you may find it useful to look at our checklists.