The "Revista de Saúde Pública" and the refereeing process



Oswaldo Paulo ForattiniI; Maria Teresinha Dias de AndradeII

IChairman, Board of Editors
IIMember, Board of Editors



The Board of Editors of the "Revista de Saúde Pública" has continually sought to perfect the refereeing process used for the articles submitted for publication. This process, based on the judgment of specialists, the so-called referees, constitues one of the most important aspects of the publication of a scientific journal, as this judgement becomes an indication of the quality of that which is published, and, therefore, of the journal itself.

The adoption of the refereeing process for the selection of articles for publication in the "Revista de Saúde Pública" has a double purpose:

I — The selection of articles of the highest quality and the perfecting of others.

II — The presentation of suggestions to the author for the improvement of his article, as well as the suggestion of the methods to be followed in the elaboration of future works, in the case of an article's not being accepted.

Since the "Revista de Saúde Pública" was first published in 1967 it has adopted the refereeing process for the evaluation of articles and has been continually perfecting it throughout these more than 20 years. The process adopted is to be found, in a summary form, in the part "Information for Contributors" on the cover of every issue published. However, we suppose that this process is imperfectly known not only by the referees, but also and perhaps especially by the authors who submit their work for appreciation, as well as by readers. For this reason it was decided that this Editorial should furnish the details of this process for the information of those interested (referees, authors and readers).


The process of evaluation, in the beginnings of the "Revista de Saúde Pública", was restricted to the assessment carried out by the members of the Board of Editors themselves. Occasionally an article might be submitted to another referee, according to the judgment of the Editors Board. However, with the increase in the number of articles and the growing diversification of themes covered it was decided to institute a group of "consultant members", composed of specialists in the various fields related to Public Health. From that point on each article submitted for publication was assessed by two referees, either consultant members or members of the Board of Editors. The list of these members' names was published in every issue of the Journal.

Once again the growth in the number of articles received caused the Board of Editors to seek the assistance of other specialists who did not belong to the group of consultant members. As a result a parallel group was formed, of a larger number, whose names were published in the last issue of each year. Recently, in 1985, the Board of Editors decided to replace the group of "consultant members" by another, also permanent, formed of a small number of Brazilian and foreign specialists and called "Advisors". The purpose of this group is to advise the Board of Editors in the taking of decisions on controversial recommendations from referees and also, in certain cases, themselves to act as referees. The Board of Editors also maintains a varying group of referees, the specialists of which are chosen in accordance with the themes of the articles submitted. Maximum diversification is also sought in the attempt to avoid an overload of work for those specialists in whose fields certain themes tend to produce a larger quantity of articles.

The Refereeing Process: Procedures

Each article submitted for publication is entered on a "control sheet", which gives all the relevant details, as well as all the phases relation to the process of evaluation editing and publishing.

Every copy of the article, with the name(s) of the author(s) omitted, is passed on, by the Editor-in-chief to one of the members of the Board of Editors responsible for one of the larger areas within the Public Health field. This member, denominated "Associate Editor", choses at least two referees, who are specialists in the specific area to which the article is related. This procedure is followed with al articles, with the exception of those which are "Notes" or are destined for the section of "Actualities". For these kinds of contribution either the Editor-in-chief, or one of its members, may decide on the acceptance or not of the contribution.

Once the two more referees have been chosen, the Editor-in-chief passes a copy of the article on to each of them.

Each article is accompanied by a form, in quadruplicate, containing guidance as to the referee's general and specific comments addressed to the author.

Each referee has a period of 20 days to make his assessment, and he is asked to return the article immediately if this recommendation cannot be fulfilled. The period established for the return of the article is considered important in view of the fact that delays are prejudicial to the process of assessment, to the interests of the authors and also to the spread of information and thus, consequently, to scientific development. It must be understood that after an article is written there is a delay of six months, even in the most favorable circunstances, before publication.

Once the referee's recommendation has been received an article is passed on to the respective Associate Editor who makes his assessment and proposes either: acceptance with no modifications; acceptance with modifications; rejection with the possibility of representation and refusal. On this occasion the Editor may offer a further opinion containing observations not given by the referees but judged to be valid, or justifying total or partial refusal of the recommendation received, or even their total rejection when they are controversial.

The decisions of the Board of Editors are always taken by in session so that they shall be as consistent as possible. The evaluation by the team is also intended to maintain all the members informed about all the recommendations made as well as to receive relevant suggestions.

The final decision, taken in session, may be:

1) Acceptance in its present form — in this case the article may be published without alterations, apart, that is, from normal correction of detail.

2) Acceptance, with some alterations — in this case the article may be published after the alternations have been made. The author receives his article together with a copy on which the alterations should be made. After the return of the article, the Associate Editor assesses the modifications. If agreement is reached, publication is authorized, otherwise the article is returned to the author.

3) Acceptance, conditional on reformulation. In this case the article, though accepted, must be submitted to the reformulation considered essential for publication. The manuscript is returned to the author, together with a copy. Should the author agree with and make the modifications deemed necessary, the article is presented then to the Editor who will undertake the evaluation of the modifications. If such a step be justified the article may again be submitted to the referees.

4) Rejection, but with the possibility of representation. In this case, though the article has been rejected, it may be presented again as a new article, on condition that this latter complies with the referees' recommendations — which are, generaly, of wide scope. Should the author rewrite the article this is submitted, in general, to the same referees and later assessed by the Associate Editor.

5) Rejection. In this case the article is rejected with no possibility of representation.

Criteria of Evaluation

For their assessment of articles the referees receive guidance on those aspects that are considered most important. This guidance is given on the form which accompanies each article and which is divided into three parts:

1) The referee's general commentary adressed to the author

In this part space is reserved for commentary, containing guidance for the referees, on: the objectives of the "Revista de Saúde Pública", a summary of the principal norms adopted number of pages, bibliographical references, tables, graphs, etc.), guidance for analysis, specifically for research studies.

This guidance to the referees (research articles) has to do with the following aspects:

"Introduction: Does the study contain sufficient information to justify the problem? Is the objective explicit? Is the objective suficiently precise and adequate? Are the concepts clearly presented?

Material and Methods: Is the description of the material studied and of the methods employed clear and precise? Do the instruments and the techniques employer guarantee the validity and the trustworthiness of the results? Is the purpose of the research well defined and clearly expounded? Is the sample adequate to the objective in view?

Results and Discussion: Are the results set out in an understandable and succint manner? Is the statistical analysis adequate? Have the data been sufficiently well exploited? Have the results been compared with those presented by other authors? Have the results been sufficiently well explained and compared as to be well grounded? Is the research repeatable?"

2) The referee's specific commentary addressed to the author

This part is set aside for abservations on specific parts of the article, with the indication of the page on which the error detected is to be found, as well as information about the title (adequate or otherwise), about summaries (if they contain sufficient information) and about bibliographical references (whether they are pertinent, up-to-date and sufficient).

3) Opinion as to the language in which the article should be published. The referee should, in this part, give his opinion as to whether the article should be published in Portuguese, English or Portuguese and English simultaneously. (See Editor Note — Rev. Saúde públ., 21(2): 69, 1987).

Whatever may be the decision of the Board of Editors, the Editor-in-chief informs the authors of the result of the evaluation, in writing, and this is accompanied by copies of the referees, recommendations (a 2nd copy of the referee's form) and of the final decision of the Board of Editors.

Communication to the Referees

Given the importance of the referees' role in the process of selection and of the need for them to have full knowledge of the final decision of the Board of Editors, as well as of the recommendations of the other referees with regard to the same article, each referee receives the following from the Editor-in-chief:

a) a letter informing of the Board Editors decision; and

b) a copy of the other referees' recommendations on the same article (the third copy of the referee's form).

The Publishing Committee understands that this procedure contributes to the perfecting of the educacional process. With this communication with the referees the cycle of communication is complete.

Authors Board of Editors Referees

The list of the names of the referees who collaborate with the Revista de Saúde Pública is published in the sixth issue, the last of each year, as a may of expressing the editor's thanks for the assistance thus given.



Relatório do Editor da Revista de Saúde Pública para 1983. Rev. Saúde públ., S. Paulo, 18:67-8. 1984.

SARACEVIC, T. The refereeing process at information processing & management. Inf. Proc. Manag., 22:1-3, 1986.

Vigésimo aniversário da Revista de Saúde Pública. Rev. Saúde públ, S. Paulo, 20:409-10, 1986.

Faculdade de Saúde Pública da Universidade de São Paulo São Paulo - SP - Brazil
E-mail: revsp@org.usp.br