Trust in Peer Review

by Robin W. Coleman

Trust is at the core of scholarly endeavor, of how we communicate scholarship, and it’s also at the heart of public health. Now, more than ever, we can draw straight lines between all of these. As the editor for Public Health at Johns Hopkins University Press I’m in a good position to see how trust is both a tool and an aim of work across fields. It would be easy, for Peer Review Week (September 21 to 25, 2020), to point out that most public health publishing takes place in peer-reviewed journals and books, and therefore we know it’s reliable. But these days the connection between peer review, trust, and our day-to-day lives is outlined in neon so bright that it leaves afterimages when I close my eyes. I haven’t had an interaction with anyone outside my household in the last six months without considering public health knowledge and the trustworthiness of the evidence that’s kept me from having lunch with friends for half a year with no end in sight.

Let’s look at it this way: more than 200,000 Americans have died due to the COVID-19 pandemic, and a significant proportion of those deaths can be attributed to poor understanding. Many people have gotten sick because someone believed bad information or disbelieved good information. It’s not hard to see why. Peter Hotez, author of Preventing the Next Pandemic, has been forcefully calling out the White House for running what amounts to a campaign of misinformation. Given recent revelations from recordings of President Trump that make it clear that he knew in early February how deadly and transmissible COVID-19 is, some people have argued that it has in fact been a disinformation campaign. With wrong information so plentiful and even being pushed from the very top of the US government, how can we know who and what to trust? As guidance from the CDC has waffled—first, don’t wear masks, then do; they say it’s spread by droplets, then that it’s by aerosol, before rescinding that announcement 24 hours later—we’ve all had to wonder who it is that’s doing quality control. Is it still the experts at the CDC? Most people wouldn’t immediately think of this as a peer review issue, but that’s exactly what it is.

Publishers of scholarly material—books and journals most prominently—have used different forms of review for a long time. As disciplines have grown more specialized the importance of having experts weigh in on the work of their peers accomplishes a couple of vital goals. It can be additive, making the work better; and it can prevent misinformation from getting out. In the end, peer review is good for scholarship, but also for the public who have a sense that they can trust what they find from those sources.

How does trust—or its lack—play out? We need people to wear masks, but some Americans have responded to masks as if they are a form of tyranny. The divide between mask wearers and mask abjurers seems so starkly partisan that it’s almost too easy to tag it as a Political Determinant of Health. It is notable that after we were advised to wear masks, social media was flooded with claims that wearing a mask could actually endanger the wearer by restricting oxygen. That was news to all the health care workers who spend all day in masks, and it squandered the time and effort that experts put into debunking those claims.

Soon we’ll need as many people as possible to take a vaccine. Scientists at pharmaceutical companies have outdone themselves, getting numerous candidate vaccines into phase 3 trials in record time. Thanks to their tireless work, we’ll all be able to get a dose of COVID-19 vaccine by . . . when, exactly? CDC director Redfield said on September 16 that it will be “generally available” by the third quarter of 2021. Drs. Tony Fauci and Peter Hotez seem to agree. So why has Operation Warp Speed been pushing as if they’ll announce a vaccine by November 1, 2020? Just kidding—we all know why. More like Operation Warped Expectations.

When a vaccine is finally ready, will there be any trust left for the system that produced it? Setting aside ongoing attempts to push ahead for political reasons, we’re living with the legacy of misinformation against vaccines that started when a doctor in the United Kingdom published a fraudulent study that (didn’t really) show a link between the MMR vaccine and autism. Following discoveries made by Brian Deer, an investigative reporter (described in his book The Doctor Who Fooled the World), the article was retracted by The Lancet and the doctor’s license was revoked. But the damage was done. Partly because the initial publication was in a prestigious peer-reviewed journal, a fear had been planted. It’s not hard to see why those fears found fertile ground and gave rise to detailed conspiracy theories. In Viral BS, Dr. Seema Yasmin analyzes medical myths both humorous and hideous. The US was saved from the ravages of the drug Thalidomide thanks to the conscientious work of one woman at the FDA. And beyond the need to preserve trust in our drug approval process, we also need to acknowledge our long history of medical research that abused Black Americans. Trust is hard to earn back after atrocities like the Tuskegee Syphilis study. Now we see vaccine safety and efficacy trials happening, some of which have been slow to enroll Black participants. What does that mean for the process, and what does it mean for the eventual uptake of the vaccine that results?

Trust is hard to earn and easy to abuse. It’s easy, when managing the peer review process, to wish for fewer Reviewer 2s. I’m sure my authors would agree. But remembering why we open the door to critique in the first place—to be trustworthy in everything we publish—keeps me moving forward and looking for the silver lining. That’s what so much of our work at University Presses supports: the manufacture of trust. We talk about our impact on the quality of work, contribution to scholarship, author platforms, and boosting the reputation of our universities. But what we really do is build our culture of trustworthiness into every book we touch and then send it out into the world by the hundred or thousand. It’s like our superpower. Is that still a thing people say?

Robin W. Coleman is acquisitions editor at Johns Hopkins University Press, acquiring books in public health and health policy. He is on Twitter at @RobinWColeman. This blog post is published in recognition of Peer Review Week 2020, whose theme is "Trust in Peer Review."