• Confirm scope alignment and ethics compliance
• Select reviewers with appropriate expertise
• Provide clear decision letters and revision guidance
• Document rationale for complex decisions

Initial checks include scope fit, ethics approval, data availability, and manuscript completeness.

Use at least two independent reviewers when possible, balancing clinical and methodological expertise.

• Accept with minor changes
• Major revision with clear required changes
• Reject with constructive rationale

Decision letters should be concise and align with reviewer feedback, highlighting the most critical revisions.

Decision letters should summarize key reviewer concerns and clarify required revisions. Provide a short decision summary that highlights critical changes.

Editors must disclose conflicts of interest and recuse themselves when necessary. Ethics concerns should be escalated to the editorial office.

Editors should manage review timelines and communicate delays promptly. Clear expectations for reviewers help maintain consistent decision cycles.

Invite reviewers with complementary expertise and avoid overreliance on a small pool. Provide concise review requests and confirm availability before assignment.

When revisions are submitted, verify that all major concerns have been addressed and that responses are complete. If critical issues remain unresolved, request additional clarification.

Provide respectful, clear communication to authors, especially when decisions require substantial revisions or rejection. Concise explanations help authors improve future submissions.

Maintain clear records of reviewer feedback, decision rationale, and key correspondence to support transparency and future audits.

When reviews conflict, provide a balanced decision based on evidence and request additional review when needed.

Escalate complex or sensitive cases to senior editors for guidance.

Consistent decisions strengthen author trust.