Transparency of manuscript reviewing is important and therefore some journals have started to use open review.

In all the medical BMC journals, reviewers are asked to sign their reviews and the pre-publication history of each paper is posted on the web with the published article.
http://www.biomedcentral.com/info/about/peerreview/

The comments of reviewers, and the replies by the authors may be informative for the readers of the published paper. All relevant considerations cannot be included in the final report, for example, because of space limitations. Therefore the reviewer comments and replies by authors are of additional interest to those readers who are seriously interested in the topic.

However, in the case of rejection the BMC policy is semi-transparent. Although the reviewer comments are made available as net versions (below), the refutations of the reviewer comments are not.

Since the comments of reviewers and the replies by authors are important when considering the validity of a scientific paper, I am briefly describing the reviewer comments and their counter-comments for the paper below.

************************************

In April 2009, I submitted my manuscript
“Zinc lozenges may shorten the duration of colds: a systematic review”
to the journal “BMC Infectious Diseases”

I received three reviewer comments:

Referee 1:
http://www.biomedcentral.com/imedia/1286410906279031_comment.pdf
Referee 2:
http://www.biomedcentral.com/imedia/3538566202829538_comment.pdf
Referee 3:
http://www.biomedcentral.com/imedia/1956627467294205_comment.pdf

The manuscript was rejected on the basis of these three reviewer comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/BMC_InfectDis_Reject.pdf

Since reviewer 1 did not point out any flaws in my manuscript, and reviewers 2 and 3 did not point out problems that could not be corrected or replied to, I revised the text and wrote replies addressing the reviewer concerns:

Replies to Reviewer 1 comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/BMC_InfectDis_Reviewer_1.pdf
Replies to Reviewer 2 comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/BMC_InfectDis_Reviewer_2.pdf
Replies to Reviewer 3 comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/BMC_InfectDis_Reviewer_3.pdf

Thus, these comments and replies describe which kinds of issues have been explicitly considered in addition to the text published in the final paper. The rejection letter stated “Please note that this decision applies across the BMC-series of journals. Therefore, if you were to submit your revised manuscript to another journal within the BMC-series, your submission should also be accompanied by a full covering letter.”


On 18 August 2009, I asked the BMC Ear, Nose and Throat Disorders journal to look at my replies (above) and consider my manuscript. On 7 October 2009, I received a rejection letter, but the letter suggested that I should make some changes and they were ready to assess the manuscript again. On 21 October 2009, I resubmitted the manuscript to BMC ENT Disorders, but since I could not get information about the status of my manuscript, I finally withdrew it on 19 Nov 2009. The process with BMC took 7 months.

Then I submitted the manuscript to PLoS ONE, which rejected it without any reviewer comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/PLoSONE_Reject_1.pdf

However, the arguments of PLoS ONE editor were not valid:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/PLoSONE_Replies_1.pdf

Although I pointed out the errors in the arguments, the PLoS ONE editor did not accept my manuscript for a reconsideration. So, I used the possibility to appeal and the manuscript was sent to a second PLoS ONE editor. The second PloS ONE editor also rejected the manuscript but suggested ways to improve it:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/PLoSONE_Reject_2.pdf

I improved the manuscript and wrote replies to the second PLoS ONE editor comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/PLoSONE_Replies_2.pdf

However, the editor rejected the manuscript with the main reason that I was the only author of the paper (“my main worry remains the decision to carry out a systematic review with no co-reviewer”):
http://www.mv.helsinki.fi/home/hemila/PPH/OR/PLoSONE_Reject_3.pdf

However, I had already replied to this issue in my Replies_2 above, yet the editor did not present any counter-comments to my replies.

Then I submitted my manuscript to Clinical Epidemiology of the DOVE press, which rejected it on the basis of 3 reviewer comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinEpidemiol_Reject.pdf

However, the reviewers did not point out problems that could not be corrected or replied to, and so I submitted the manuscript to another journal of the DOVE press - Clinical Pharmacology – with replies to the Clinical Epidemiology reviewers:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinEpidemiol_Replies_1.pdf
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinEpidemiol_Replies_2.pdf
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinEpidemiol_Replies_3.pdf
Clinical Pharmacology rejected the manuscript on the basis of 2 new reviewer comments:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinPharmacol_Reject_1.pdf

The editor wrote that “provided that these points are satisfactorily addressed, we would be happy to consider your manuscript for publication.”

One reviewer simply stated that there was no novelty, without giving any reference where similar ideas had been previously reported:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinPharmacol_Replies_1.pdf

The second reviewer commented on some other manuscript, not my manuscript:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinPharmacol_Replies_2.pdf

However, my manuscript was rejected without the editor giving any reasons for his dissatisfaction to my replies to reviewers:
http://www.mv.helsinki.fi/home/hemila/PPH/OR/ClinPharmacol_Reject_2.pdf

When I asked the DOVE Press production coordinator about these puzzling reviewer comments, I received an email stating that the reviewer 2 comment (above) indeed did not appear to be related to my manuscript, and he promised to find out what was the actual reason for rejection by the Clinical Pharmacology editor.

***
“Dear Dr. Hemila,
Thank you very much. You're right, the reviewer comment does not appear to be related to your paper. I have asked my colleague to look into how this has happened. She will also write to that reviewer and ask for the original comments specific to your paper. I have also written to Prof. Frankel and asked him to revisit your manuscript in the light of these details and if the paper is still to be rejected, to let me know what the reason was so that I may inform you. At this time we are unlikely to have an answer until early January. Merry Christmas!
Sincerely, Peter Fogarty, Production Coordinator, Dove Medical Press Ltd”
***
However, January began and ended, and so did February etc. but I did not get any information about the rejection of my manuscript.


My manuscript was finally published:
Hemilä H.
Zinc lozenges may shorten the duration of colds: a systematic review.
Open Respiratory Medicine Journal 2011;5:51-58
http://dx.doi.org/10.2174/1874306401105010051
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136969
Supplementary files:
http://benthamscience.com/open/tormj/articles/V005/supplementary-material/2011_00000005_00000001_51TORMJ.zip
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136969/bin/TORMJ-5-51_SD1.zip
List of references with links to the references if such are available:
http://www.mv.helsinki.fi/home/hemila/Zn/TORMJ_Refs.htm

Although the paper above shows strong evidence that zinc lozenges can shorten the duration of colds,
most of the zinc lozenges on market are not effective.
Either they contain too little zinc or they contain additives such as citric acid which bind zinc.
See an analysis of the zinc lozenges on market in the USA:
http://coldcure.com/html/zinc-lozenges.html
Column “Zinc compound (mg) expected after reacting with other lozenge ingredients & mg iZn” shows the amount of expected free zinc.


Harri Hemilä
harri.hemila@helsinki.fi