peer reviewed journals research

Peer review guidance: a primer for researchers

Olena zimba.

1 Department of Internal Medicine No. 2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

Armen Yuri Gasparyan

2 Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, West Midlands, UK

The peer review process is essential for quality checks and validation of journal submissions. Although it has some limitations, including manipulations and biased and unfair evaluations, there is no other alternative to the system. Several peer review models are now practised, with public review being the most appropriate in view of the open science movement. Constructive reviewer comments are increasingly recognised as scholarly contributions which should meet certain ethics and reporting standards. The Publons platform, which is now part of the Web of Science Group (Clarivate Analytics), credits validated reviewer accomplishments and serves as an instrument for selecting and promoting the best reviewers. All authors with relevant profiles may act as reviewers. Adherence to research reporting standards and access to bibliographic databases are recommended to help reviewers draft evidence-based and detailed comments.

Introduction

The peer review process is essential for evaluating the quality of scholarly works, suggesting corrections, and learning from other authors’ mistakes. The principles of peer review are largely based on professionalism, eloquence, and collegiate attitude. As such, reviewing journal submissions is a privilege and responsibility for ‘elite’ research fellows who contribute to their professional societies and add value by voluntarily sharing their knowledge and experience.

Since the launch of the first academic periodicals back in 1665, the peer review has been mandatory for validating scientific facts, selecting influential works, and minimizing chances of publishing erroneous research reports [ 1 ]. Over the past centuries, peer review models have evolved from single-handed editorial evaluations to collegial discussions, with numerous strengths and inevitable limitations of each practised model [ 2 , 3 ]. With multiplication of periodicals and editorial management platforms, the reviewer pool has expanded and internationalized. Various sets of rules have been proposed to select skilled reviewers and employ globally acceptable tools and language styles [ 4 , 5 ].

In the era of digitization, the ethical dimension of the peer review has emerged, necessitating involvement of peers with full understanding of research and publication ethics to exclude unethical articles from the pool of evidence-based research and reviews [ 6 ]. In the time of the COVID-19 pandemic, some, if not most, journals face the unavailability of skilled reviewers, resulting in an unprecedented increase of articles without a history of peer review or those with surprisingly short evaluation timelines [ 7 ].

Editorial recommendations and the best reviewers

Guidance on peer review and selection of reviewers is currently available in the recommendations of global editorial associations which can be consulted by journal editors for updating their ethics statements and by research managers for crediting the evaluators. The International Committee on Medical Journal Editors (ICMJE) qualifies peer review as a continuation of the scientific process that should involve experts who are able to timely respond to reviewer invitations, submitting unbiased and constructive comments, and keeping confidentiality [ 8 ].

The reviewer roles and responsibilities are listed in the updated recommendations of the Council of Science Editors (CSE) [ 9 ] where ethical conduct is viewed as a premise of the quality evaluations. The Committee on Publication Ethics (COPE) further emphasizes editorial strategies that ensure transparent and unbiased reviewer evaluations by trained professionals [ 10 ]. Finally, the World Association of Medical Editors (WAME) prioritizes selecting the best reviewers with validated profiles to avoid substandard or fraudulent reviewer comments [ 11 ]. Accordingly, the Sarajevo Declaration on Integrity and Visibility of Scholarly Publications encourages reviewers to register with the Open Researcher and Contributor ID (ORCID) platform to validate and publicize their scholarly activities [ 12 ].

Although the best reviewer criteria are not listed in the editorial recommendations, it is apparent that the manuscript evaluators should be active researchers with extensive experience in the subject matter and an impressive list of relevant and recent publications [ 13 ]. All authors embarking on an academic career and publishing articles with active contact details can be involved in the evaluation of others’ scholarly works [ 14 ]. Ideally, the reviewers should be peers of the manuscript authors with equal scholarly ranks and credentials.

However, journal editors may employ schemes that engage junior research fellows as co-reviewers along with their mentors and senior fellows [ 15 ]. Such a scheme is successfully practised within the framework of the Emerging EULAR (European League Against Rheumatism) Network (EMEUNET) where seasoned authors (mentors) train ongoing researchers (mentees) how to evaluate submissions to the top rheumatology journals and select the best evaluators for regular contributors to these journals [ 16 ].

The awareness of the EQUATOR Network reporting standards may help the reviewers to evaluate methodology and suggest related revisions. Statistical skills help the reviewers to detect basic mistakes and suggest additional analyses. For example, scanning data presentation and revealing mistakes in the presentation of means and standard deviations often prompt re-analyses of distributions and replacement of parametric tests with non-parametric ones [ 17 , 18 ].

Constructive reviewer comments

The main goal of the peer review is to support authors in their attempt to publish ethically sound and professionally validated works that may attract readers’ attention and positively influence healthcare research and practice. As such, an optimal reviewer comment has to comprehensively examine all parts of the research and review work ( Table I ). The best reviewers are viewed as contributors who guide authors on how to correct mistakes, discuss study limitations, and highlight its strengths [ 19 ].

Structure of a reviewer comment to be forwarded to authors

Some of the currently practised review models are well positioned to help authors reveal and correct their mistakes at pre- or post-publication stages ( Table II ). The global move toward open science is particularly instrumental for increasing the quality and transparency of reviewer contributions.

Advantages and disadvantages of common manuscript evaluation models

Since there are no universally acceptable criteria for selecting reviewers and structuring their comments, instructions of all peer-reviewed journal should specify priorities, models, and expected review outcomes [ 20 ]. Monitoring and reporting average peer review timelines is also required to encourage timely evaluations and avoid delays. Depending on journal policies and article types, the first round of peer review may last from a few days to a few weeks. The fast-track review (up to 3 days) is practised by some top journals which process clinical trial reports and other priority items.

In exceptional cases, reviewer contributions may result in substantive changes, appreciated by authors in the official acknowledgments. In most cases, however, reviewers should avoid engaging in the authors’ research and writing. They should refrain from instructing the authors on additional tests and data collection as these may delay publication of original submissions with conclusive results.

Established publishers often employ advanced editorial management systems that support reviewers by providing instantaneous access to the review instructions, online structured forms, and some bibliographic databases. Such support enables drafting of evidence-based comments that examine the novelty, ethical soundness, and implications of the reviewed manuscripts [ 21 ].

Encouraging reviewers to submit their recommendations on manuscript acceptance/rejection and related editorial tasks is now a common practice. Skilled reviewers may prompt the editors to reject or transfer manuscripts which fall outside the journal scope, perform additional ethics checks, and minimize chances of publishing erroneous and unethical articles. They may also raise concerns over the editorial strategies in their comments to the editors.

Since reviewer and editor roles are distinct, reviewer recommendations are aimed at helping editors, but not at replacing their decision-making functions. The final decisions rest with handling editors. Handling editors weigh not only reviewer comments, but also priorities related to article types and geographic origins, space limitations in certain periods, and envisaged influence in terms of social media attention and citations. This is why rejections of even flawless manuscripts are likely at early rounds of internal and external evaluations across most peer-reviewed journals.

Reviewers are often requested to comment on language correctness and overall readability of the evaluated manuscripts. Given the wide availability of in-house and external editing services, reviewer comments on language mistakes and typos are categorized as minor. At the same time, non-Anglophone experts’ poor language skills often exclude them from contributing to the peer review in most influential journals [ 22 ]. Comments should be properly edited to convey messages in positive or neutral tones, express ideas of varying degrees of certainty, and present logical order of words, sentences, and paragraphs [ 23 , 24 ]. Consulting linguists on communication culture, passing advanced language courses, and honing commenting skills may increase the overall quality and appeal of the reviewer accomplishments [ 5 , 25 ].

Peer reviewer credits

Various crediting mechanisms have been proposed to motivate reviewers and maintain the integrity of science communication [ 26 ]. Annual reviewer acknowledgments are widely practised for naming manuscript evaluators and appreciating their scholarly contributions. Given the need to weigh reviewer contributions, some journal editors distinguish ‘elite’ reviewers with numerous evaluations and award those with timely and outstanding accomplishments [ 27 ]. Such targeted recognition ensures ethical soundness of the peer review and facilitates promotion of the best candidates for grant funding and academic job appointments [ 28 ].

Also, large publishers and learned societies issue certificates of excellence in reviewing which may include Continuing Professional Development (CPD) points [ 29 ]. Finally, an entirely new crediting mechanism is proposed to award bonus points to active reviewers who may collect, transfer, and use these points to discount gold open-access charges within the publisher consortia [ 30 ].

With the launch of Publons ( http://publons.com/ ) and its integration with Web of Science Group (Clarivate Analytics), reviewer recognition has become a matter of scientific prestige. Reviewers can now freely open their Publons accounts and record their contributions to online journals with Digital Object Identifiers (DOI). Journal editors, in turn, may generate official reviewer acknowledgments and encourage reviewers to forward them to Publons for building up individual reviewer and journal profiles. All published articles maintain e-links to their review records and post-publication promotion on social media, allowing the reviewers to continuously track expert evaluations and comments. A paid-up partnership is also available to journals and publishers for automatically transferring peer-review records to Publons upon mutually acceptable arrangements.

Listing reviewer accomplishments on an individual Publons profile showcases scholarly contributions of the account holder. The reviewer accomplishments placed next to the account holders’ own articles and editorial accomplishments point to the diversity of scholarly contributions. Researchers may establish links between their Publons and ORCID accounts to further benefit from complementary services of both platforms. Publons Academy ( https://publons.com/community/academy/ ) additionally offers an online training course to novice researchers who may improve their reviewing skills under the guidance of experienced mentors and journal editors. Finally, journal editors may conduct searches through the Publons platform to select the best reviewers across academic disciplines.

Peer review ethics

Prior to accepting reviewer invitations, scholars need to weigh a number of factors which may compromise their evaluations. First of all, they are required to accept the reviewer invitations if they are capable of timely submitting their comments. Peer review timelines depend on article type and vary widely across journals. The rules of transparent publishing necessitate recording manuscript submission and acceptance dates in article footnotes to inform readers of the evaluation speed and to help investigators in the event of multiple unethical submissions. Timely reviewer accomplishments often enable fast publication of valuable works with positive implications for healthcare. Unjustifiably long peer review, on the contrary, delays dissemination of influential reports and results in ethical misconduct, such as plagiarism of a manuscript under evaluation [ 31 ].

In the times of proliferation of open-access journals relying on article processing charges, unjustifiably short review may point to the absence of quality evaluation and apparently ‘predatory’ publishing practice [ 32 , 33 ]. Authors when choosing their target journals should take into account the peer review strategy and associated timelines to avoid substandard periodicals.

Reviewer primary interests (unbiased evaluation of manuscripts) may come into conflict with secondary interests (promotion of their own scholarly works), necessitating disclosures by filling in related parts in the online reviewer window or uploading the ICMJE conflict of interest forms. Biomedical reviewers, who are directly or indirectly supported by the pharmaceutical industry, may encounter conflicts while evaluating drug research. Such instances require explicit disclosures of conflicts and/or rejections of reviewer invitations.

Journal editors are obliged to employ mechanisms for disclosing reviewer financial and non-financial conflicts of interest to avoid processing of biased comments [ 34 ]. They should also cautiously process negative comments that oppose dissenting, but still valid, scientific ideas [ 35 ]. Reviewer conflicts that stem from academic activities in a competitive environment may introduce biases, resulting in unfair rejections of manuscripts with opposing concepts, results, and interpretations. The same academic conflicts may lead to coercive reviewer self-citations, forcing authors to incorporate suggested reviewer references or face negative feedback and an unjustified rejection [ 36 ]. Notably, several publisher investigations have demonstrated a global scale of such misconduct, involving some highly cited researchers and top scientific journals [ 37 ].

Fake peer review, an extreme example of conflict of interest, is another form of misconduct that has surfaced in the time of mass proliferation of gold open-access journals and publication of articles without quality checks [ 38 ]. Fake reviews are generated by manipulating authors and commercial editing agencies with full access to their own manuscripts and peer review evaluations in the journal editorial management systems. The sole aim of these reviews is to break the manuscript evaluation process and to pave the way for publication of pseudoscientific articles. Authors of these articles are often supported by funds intended for the growth of science in non-Anglophone countries [ 39 ]. Iranian and Chinese authors are often caught submitting fake reviews, resulting in mass retractions by large publishers [ 38 ]. Several suggestions have been made to overcome this issue, with assigning independent reviewers and requesting their ORCID IDs viewed as the most practical options [ 40 ].

Conclusions

The peer review process is regulated by publishers and editors, enforcing updated global editorial recommendations. Selecting the best reviewers and providing authors with constructive comments may improve the quality of published articles. Reviewers are selected in view of their professional backgrounds and skills in research reporting, statistics, ethics, and language. Quality reviewer comments attract superior submissions and add to the journal’s scientific prestige [ 41 ].

In the era of digitization and open science, various online tools and platforms are available to upgrade the peer review and credit experts for their scholarly contributions. With its links to the ORCID platform and social media channels, Publons now offers the optimal model for crediting and keeping track of the best and most active reviewers. Publons Academy additionally offers online training for novice researchers who may benefit from the experience of their mentoring editors. Overall, reviewer training in how to evaluate journal submissions and avoid related misconduct is an important process, which some indexed journals are experimenting with [ 42 ].

The timelines and rigour of the peer review may change during the current pandemic. However, journal editors should mobilize their resources to avoid publication of unchecked and misleading reports. Additional efforts are required to monitor published contents and encourage readers to post their comments on publishers’ online platforms (blogs) and other social media channels [ 43 , 44 ].

The authors declare no conflict of interest.

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• What Is Peer Review? | Types & Examples

What Is Peer Review? | Types & Examples

Published on December 17, 2021 by Tegan George . Revised on June 22, 2023.

Peer review, sometimes referred to as refereeing , is the process of evaluating submissions to an academic journal. Using strict criteria, a panel of reviewers in the same subject area decides whether to accept each submission for publication.

Peer-reviewed articles are considered a highly credible source due to the stringent process they go through before publication.

There are various types of peer review. The main difference between them is to what extent the authors, reviewers, and editors know each other’s identities. The most common types are:

• Single-blind review
• Double-blind review
• Triple-blind review

Collaborative review

Open review.

Relatedly, peer assessment is a process where your peers provide you with feedback on something you’ve written, based on a set of criteria or benchmarks from an instructor. They then give constructive feedback, compliments, or guidance to help you improve your draft.

Table of contents

What is the purpose of peer review, types of peer review, the peer review process, providing feedback to your peers, peer review example, advantages of peer review, criticisms of peer review, other interesting articles, frequently asked questions about peer reviews.

Many academic fields use peer review, largely to determine whether a manuscript is suitable for publication. Peer review enhances the credibility of the manuscript. For this reason, academic journals are among the most credible sources you can refer to.

However, peer review is also common in non-academic settings. The United Nations, the European Union, and many individual nations use peer review to evaluate grant applications. It is also widely used in medical and health-related fields as a teaching or quality-of-care measure.

Peer assessment is often used in the classroom as a pedagogical tool. Both receiving feedback and providing it are thought to enhance the learning process, helping students think critically and collaboratively.

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Depending on the journal, there are several types of peer review.

Single-blind peer review

The most common type of peer review is single-blind (or single anonymized) review . Here, the names of the reviewers are not known by the author.

While this gives the reviewers the ability to give feedback without the possibility of interference from the author, there has been substantial criticism of this method in the last few years. Many argue that single-blind reviewing can lead to poaching or intellectual theft or that anonymized comments cause reviewers to be too harsh.

Double-blind peer review

In double-blind (or double anonymized) review , both the author and the reviewers are anonymous.

Arguments for double-blind review highlight that this mitigates any risk of prejudice on the side of the reviewer, while protecting the nature of the process. In theory, it also leads to manuscripts being published on merit rather than on the reputation of the author.

Triple-blind peer review

While triple-blind (or triple anonymized) review —where the identities of the author, reviewers, and editors are all anonymized—does exist, it is difficult to carry out in practice.

Proponents of adopting triple-blind review for journal submissions argue that it minimizes potential conflicts of interest and biases. However, ensuring anonymity is logistically challenging, and current editing software is not always able to fully anonymize everyone involved in the process.

In collaborative review , authors and reviewers interact with each other directly throughout the process. However, the identity of the reviewer is not known to the author. This gives all parties the opportunity to resolve any inconsistencies or contradictions in real time, and provides them a rich forum for discussion. It can mitigate the need for multiple rounds of editing and minimize back-and-forth.

Collaborative review can be time- and resource-intensive for the journal, however. For these collaborations to occur, there has to be a set system in place, often a technological platform, with staff monitoring and fixing any bugs or glitches.

Lastly, in open review , all parties know each other’s identities throughout the process. Often, open review can also include feedback from a larger audience, such as an online forum, or reviewer feedback included as part of the final published product.

While many argue that greater transparency prevents plagiarism or unnecessary harshness, there is also concern about the quality of future scholarship if reviewers feel they have to censor their comments.

In general, the peer review process includes the following steps:

• First, the author submits the manuscript to the editor.
• Reject the manuscript and send it back to the author, or
• Send it onward to the selected peer reviewer(s)
• Next, the peer review process occurs. The reviewer provides feedback, addressing any major or minor issues with the manuscript, and gives their advice regarding what edits should be made.
• Lastly, the edited manuscript is sent back to the author. They input the edits and resubmit it to the editor for publication.

In an effort to be transparent, many journals are now disclosing who reviewed each article in the published product. There are also increasing opportunities for collaboration and feedback, with some journals allowing open communication between reviewers and authors.

It can seem daunting at first to conduct a peer review or peer assessment. If you’re not sure where to start, there are several best practices you can use.

Summarize the argument in your own words

Summarizing the main argument helps the author see how their argument is interpreted by readers, and gives you a jumping-off point for providing feedback. If you’re having trouble doing this, it’s a sign that the argument needs to be clearer, more concise, or worded differently.

If the author sees that you’ve interpreted their argument differently than they intended, they have an opportunity to address any misunderstandings when they get the manuscript back.

Separate your feedback into major and minor issues

It can be challenging to keep feedback organized. One strategy is to start out with any major issues and then flow into the more minor points. It’s often helpful to keep your feedback in a numbered list, so the author has concrete points to refer back to.

Major issues typically consist of any problems with the style, flow, or key points of the manuscript. Minor issues include spelling errors, citation errors, or other smaller, easy-to-apply feedback.

Tip: Try not to focus too much on the minor issues. If the manuscript has a lot of typos, consider making a note that the author should address spelling and grammar issues, rather than going through and fixing each one.

The best feedback you can provide is anything that helps them strengthen their argument or resolve major stylistic issues.

Give the type of feedback that you would like to receive

No one likes being criticized, and it can be difficult to give honest feedback without sounding overly harsh or critical. One strategy you can use here is the “compliment sandwich,” where you “sandwich” your constructive criticism between two compliments.

Be sure you are giving concrete, actionable feedback that will help the author submit a successful final draft. While you shouldn’t tell them exactly what they should do, your feedback should help them resolve any issues they may have overlooked.

As a rule of thumb, your feedback should be:

• Easy to understand
• Constructive

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Below is a brief annotated research example. You can view examples of peer feedback by hovering over the highlighted sections.

Influence of phone use on sleep

Studies show that teens from the US are getting less sleep than they were a decade ago (Johnson, 2019) . On average, teens only slept for 6 hours a night in 2021, compared to 8 hours a night in 2011. Johnson mentions several potential causes, such as increased anxiety, changed diets, and increased phone use.

The current study focuses on the effect phone use before bedtime has on the number of hours of sleep teens are getting.

For this study, a sample of 300 teens was recruited using social media, such as Facebook, Instagram, and Snapchat. The first week, all teens were allowed to use their phone the way they normally would, in order to obtain a baseline.

The sample was then divided into 3 groups:

• Group 1 was not allowed to use their phone before bedtime.
• Group 2 used their phone for 1 hour before bedtime.
• Group 3 used their phone for 3 hours before bedtime.

All participants were asked to go to sleep around 10 p.m. to control for variation in bedtime . In the morning, their Fitbit showed the number of hours they’d slept. They kept track of these numbers themselves for 1 week.

Two independent t tests were used in order to compare Group 1 and Group 2, and Group 1 and Group 3. The first t test showed no significant difference ( p > .05) between the number of hours for Group 1 ( M = 7.8, SD = 0.6) and Group 2 ( M = 7.0, SD = 0.8). The second t test showed a significant difference ( p < .01) between the average difference for Group 1 ( M = 7.8, SD = 0.6) and Group 3 ( M = 6.1, SD = 1.5).

This shows that teens sleep fewer hours a night if they use their phone for over an hour before bedtime, compared to teens who use their phone for 0 to 1 hours.

Peer review is an established and hallowed process in academia, dating back hundreds of years. It provides various fields of study with metrics, expectations, and guidance to ensure published work is consistent with predetermined standards.

• Protects the quality of published research

Peer review can stop obviously problematic, falsified, or otherwise untrustworthy research from being published. Any content that raises red flags for reviewers can be closely examined in the review stage, preventing plagiarized or duplicated research from being published.

• Gives you access to feedback from experts in your field

Peer review represents an excellent opportunity to get feedback from renowned experts in your field and to improve your writing through their feedback and guidance. Experts with knowledge about your subject matter can give you feedback on both style and content, and they may also suggest avenues for further research that you hadn’t yet considered.

• Helps you identify any weaknesses in your argument

Peer review acts as a first defense, helping you ensure your argument is clear and that there are no gaps, vague terms, or unanswered questions for readers who weren’t involved in the research process. This way, you’ll end up with a more robust, more cohesive article.

While peer review is a widely accepted metric for credibility, it’s not without its drawbacks.

• Reviewer bias

The more transparent double-blind system is not yet very common, which can lead to bias in reviewing. A common criticism is that an excellent paper by a new researcher may be declined, while an objectively lower-quality submission by an established researcher would be accepted.

• Delays in publication

The thoroughness of the peer review process can lead to significant delays in publishing time. Research that was current at the time of submission may not be as current by the time it’s published. There is also high risk of publication bias , where journals are more likely to publish studies with positive findings than studies with negative findings.

• Risk of human error

By its very nature, peer review carries a risk of human error. In particular, falsification often cannot be detected, given that reviewers would have to replicate entire experiments to ensure the validity of results.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Measures of central tendency
• Chi square tests
• Confidence interval
• Quartiles & Quantiles
• Cluster sampling
• Stratified sampling
• Thematic analysis
• Discourse analysis
• Cohort study
• Ethnography

Research bias

• Implicit bias
• Cognitive bias
• Conformity bias
• Hawthorne effect
• Availability heuristic
• Attrition bias
• Social desirability bias

Peer review is a process of evaluating submissions to an academic journal. Utilizing rigorous criteria, a panel of reviewers in the same subject area decide whether to accept each submission for publication. For this reason, academic journals are often considered among the most credible sources you can use in a research project– provided that the journal itself is trustworthy and well-regarded.

In general, the peer review process follows the following steps: 

• Reject the manuscript and send it back to author, or 
• Send it onward to the selected peer reviewer(s) 
• Next, the peer review process occurs. The reviewer provides feedback, addressing any major or minor issues with the manuscript, and gives their advice regarding what edits should be made. 
• Lastly, the edited manuscript is sent back to the author. They input the edits, and resubmit it to the editor for publication.

Peer review can stop obviously problematic, falsified, or otherwise untrustworthy research from being published. It also represents an excellent opportunity to get feedback from renowned experts in your field. It acts as a first defense, helping you ensure your argument is clear and that there are no gaps, vague terms, or unanswered questions for readers who weren’t involved in the research process.

Peer-reviewed articles are considered a highly credible source due to this stringent process they go through before publication.

Many academic fields use peer review , largely to determine whether a manuscript is suitable for publication. Peer review enhances the credibility of the published manuscript.

However, peer review is also common in non-academic settings. The United Nations, the European Union, and many individual nations use peer review to evaluate grant applications. It is also widely used in medical and health-related fields as a teaching or quality-of-care measure. 

A credible source should pass the CRAAP test  and follow these guidelines:

• The information should be up to date and current.
• The author and publication should be a trusted authority on the subject you are researching.
• The sources the author cited should be easy to find, clear, and unbiased.
• For a web source, the URL and layout should signify that it is trustworthy.

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Reviews of Peer-Reviewed Journals in the Humanities and Social Sciences

We give you the scuttlebutt on academic journals—aiding you in selecting the right journal for publication—in reviews that are sometimes snarky, sometimes lengthy, always helpful. Written by Princeton University graduate students and Wendy Laura Belcher.

• Journal Article Prize Competitions
• Journal Disciplines
• Journals Reviewed
• Journals Ranking

Identifying the best journal to publish in is not easy. However, it is essential to select correctly, since you can only send your article to one journal at a time, never simultaneously. Based on the advice in Writing Your Journal Article in Twelve Weeks: A Guide to Academic Publishing Success ,  below are some of the ways to find the information you need to make your decision. Here’s how you can find out about:

All journals in your field or discipline.  For brief, online, up-to-date information about journals,  Ulrich’s Periodicals Directory  is the most comprehensive. Do not use the search on the home page, but go to advanced search, select the limiters “Active,” “Journal,” “Academic/Scholarly,” and “ Refereed / Peer-reviewed”   and then enter your keyword (e.g., film, gender, African history). A list of peer-reviewed journals will appear. Under each journal, you can find such information as the journal’s website, publisher, frequency, and a brief review from Magazines for Libraries . Unfortunately, this directory is not free; your library needs to own a subscription to access it.

Journal efficiency (or, gossip about journals) . For detailed information about individuals’ experiences with submitting articles to various journals, including comments on length of backlog and turnaround time, editorial promptness, and peer reviewer helpfulness, see the excellent Humanities Journal Wiki . Not all journals are there, but many are. The entries have to be read with a grain of salt (like any comment system, it is biased toward the negative), but trends in the behavior of the journal can become visible if enough scholars comment.

Journal prestige . Statistical information about which humanities journals are considered better than other journals is not easy to find and is not especially trustworthy. However, two places you can check rankings are the European Reference Index for the Humanities (ERIH)  and the ranking of journals in  JStor alone. You can also check out the meta-list of rankings, Harzing’s  Journal Quality List  (the Harzing 2015 list specifically). which includes many of the websites that provide rankings of journals: outside the United States, many universities compile their own rankings. Academics generally hate humanities lists, see the Guardian article on the topic. The ranking of social science journals can be found in a variety of places, including SCImago , ISI  Journal Citation Reports , and so on.

Journal impact . For information on journals that are cited frequently, use Harzing’s Publish or Perish software. It’s outstanding and free. To find a specific journal’s most cited articles, find its ISSN and insert it in “the Phrase” field.

Acceptance rates . Information about acceptance rates and circulation for peer-reviewed journals in the humanities is often tough to find at their websites. The best source of this information on literary scholarship journals is the MLA Directory of Periodicals , which provides a wealth of other information as well. However, since the information there about acceptance rates and circulation are reported by the journal, these are often slightly inflated. That is, they say their circulation rate is higher than it is and their acceptance rate is lower than it is. MLA doesn’t provide an acceptance rate directly; you have to calculate it by dividing the number of accepted submissions by the number of total submissions (e.g., 40 articles accepted for publication/ 100 articles submitted, equals 40 percent acceptance rate).

Topic trends . The following article analyzed 21,367 scholarly articles in literary journals from 1889–2013 to depict trends in topics over time. “ The Quiet Transformations of Literary Studies: What Thirteen Thousand Scholars Could Tell Us ” by Andrew Goldstone and Ted Underwood in New Literary History (summer 2014).

Our rankings. Using Harzing’s Publish or Perish software, we found the most highly cited articles in specific journals and list those articles on the journal page. We would like to post something here about which journals, therefore, are the most cited, but we haven’t done that yet. It is interesting to note that perhaps the most cited article in the humanities published since 2010 is Homi Bhabha’s two-page (!) introduction to the Simone de Beauvoir special issue in French Politics, Culture and Society , which has been cited 1,182 times.

Questions? Email the webmaster Wendy Laura Belcher.

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Peer Review: An Introduction: Where to Find Peer Reviewed Sources

• Why not just use Google or Wikipedia?
• Where to Find Peer Reviewed Sources
• Where to Get More Help

Need More Help?

Have more questions? Contact Scholarly Communication and Publishing at [email protected]   for more information and guidance.

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Why is it so hard to find Peer-Reviewed Sources?

It isn't hard to find peer-reviewed sources: you just need to know where to look!  If you start in the right place, you can usually find a relevant, peer-reviewed source for your research in as few clicks as a Google search, and you can even use many of the search techniques you use in Google and Wikipedia.

The easiest way to find a peer-reviewed article is by using one of the Library's numerous databases. All of the Library's databases are listed in the Online Journals and Databases index. The databases are divided by name and discipline.

Departmental libraries and library subject guides have created subject-focused lists of electronic and print research resources that are useful for their disciplines. You can search the library directory  for links to the departmental libraries at the University of Illinois Library, or search library websites by college  if you're not sure which departmental library serves your subject.

Peer-Reviewed Resources for Disciplinary Topics

There are numerous print and digital resources for specific disciplines, areas of study, and specialist fields.  To find research resources and databases for your area, consult the comprehensive directory of LibGuides , the websites of specialist libraries, and above all, contact a librarian for help !

Here are a few major databases for finding peer-reviewed research sources in the humanities, social sciences, and sciences:

• MLA International Bibliography This link opens in a new window Indexes critical materials on literature, languages, linguistics, and folklore. Proved access to citations from worldwide publications, including periodicals, books, essay collections, working papers, proceedings, dissertations and bibliographies. Use MLA International Bibliography in the NEW EBSCO user interface . more... less... Alternate Access Link
• Web of Science (Core Collection) This link opens in a new window Web of Science indexes core journal articles, conference proceedings, data sets, and other resources in the sciences, social sciences, arts, and humanities.

A scholarly, multidisciplinary database providing indexing and abstracts for over 10,000 publications, including monographs, reports, conference proceedings, and others. Also includes full-text access to over 5,000 journals. Offers coverage of many areas of academic study including: archaeology, area studies, astronomy, biology, chemistry, civil engineering, electrical engineering, ethnic & multicultural studies, food science & technology, general science, geography, geology, law, mathematics, mechanical engineering, music, physics, psychology, religion & theology, women's studies, and other fields. 

Alternate Access Link  

• IEEE Xplore This link opens in a new window Provides full-text access to IEEE transactions, IEEE and IEE journals, magazines, and conference proceedings published since 1988, and all current IEEE standards; brings additional search and access features to IEEE/IEE digital library users. Browsable by books & e-books, conference publications, education and learning, journals and magazines, standards and by topic. Also provides links to IEEE standards, IEEE spectrum and other sites.
• Scopus This link opens in a new window Scopus is the largest abstract and citation database including peer-reviewed titles from international publishers, Open Access journals, conference proceedings, trade publications and quality web sources. Subject coverage includes: Chemistry, Physics, Mathematics and Engineering; Life and Health Sciences; Social Sciences, Psychology and Economics; Biological, Agricultural and Environmental Sciences.
• Business Source Ultimate This link opens in a new window Provides bibliographic and full text content, including indexing and abstracts for scholarly business journals back as far as 1886 and full text journal articles in all disciplines of business, including marketing, management, MIS, POM, accounting, finance and economics. The database full text content includes financial data, books, monographs, major reference works, book digests, conference proceedings, case studies, investment research reports, industry reports, market research reports, country reports, company profiles, SWOT analyses and more. Use Business Source Ultimate in the NEW EBSCO user interface . more... less... Alternate Access Link
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• Last Updated: Jun 20, 2024 1:47 PM
• URL: https://guides.library.illinois.edu/peerreview

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Evaluating Resources: Peer Review

What is peer review.

The term peer review can be confusing, since in some of your courses you may be asked to review the work of your peers. When we talk about peer-reviewed journal articles, this has nothing to do with your peers!

Peer-reviewed journals, also called refereed journals, are journals that use a specific scholarly review process to try to ensure the accuracy and reliability of published articles. When an article is submitted to a peer-reviewed journal for publication, the journal sends the article to other scholars/experts in that field and has them review the article for accuracy and reliability.

Find out more about peer review with our Peer Review Guide:

• Peer Review Guide

Types of peer review

Single blind.

In this process, the names of the reviewers are not known to the author(s). The reviewers do know the name of the author(s).

Double blind

Here, neither reviewers or authors know each other's names.

In the open review process, both reviewers and authors know each other's names.

What about editorial review?

Journals also use an editorial review process. This is not the same as peer review. In an editorial review process an article is evaluated for style guidelines and for clarity. Reviewers here do not look at technical accuracy or errors in data or methodology, but instead look at grammar, style, and whether an article is well written.

What is the difference between scholarly and peer review?

Not all scholarly journals are peer reviewed, but all peer-reviewed journals are scholarly.

• Things that are written for a scholarly or academic audience are considered scholarly writing.
• Peer-reviewed journals are a part of the larger category of scholarly writing.
• Scholarly writing includes many resources that are not peer reviewed, such as books, textbooks, and dissertations.

Scholarly writing does not come with a label that says scholarly . You will need to evaluate the resource to see if it is

• aimed at a scholarly audience
• reporting research, theories or other types of information important to scholars
• documenting and citing sources used to help authenticate the research done

The standard peer review process only applies to journals. While scholarly writing has certainly been edited and reviewed, peer review is a specific process only used by peer-reviewed journals. Books and dissertations may be scholarly, but are not considered peer reviewed.

Check out Select the Right Source for help with what kinds of resources are appropriate for discussion posts, assignments, projects, and more:

• Select the Right Source

How do I locate or verify peer-reviewed articles?

The peer review process is initiated by the journal publisher before an article is even published. Nowhere in the article will it tell you whether or not the article has gone through a peer review process.

You can locate peer-reviewed articles in the Library databases, typically by checking a limiter box.

• Quick Answer: How do I find scholarly, peer reviewed journal articles?

You can verify whether a journal uses a peer review process by using Ulrich's Periodicals Directory.

• Quick Answer: How do I verify that my article is peer reviewed?

What about resources that are not peer-reviewed?

Limiting your search to peer review is a way that you can ensure that you're looking at scholarly journal articles, and not popular or trade publications. Because peer-reviewed articles have been vetted by experts in the field, they are viewed as being held to a higher standard, and therefore are considered to be a high quality source. Professors often prefer peer-reviewed articles because they are considered to be of higher quality.

There are times, though, when the information you need may not be available in a peer-reviewed article.

• You may need to find original work on a theory that was first published in a book.
• You may need to find very current statistical data that comes from a government website.
• You may need background information that comes from a scholarly encyclopedia.

You will want to evaluate these resources to make sure that they are the best source for the information you need.

Note: If you are required for an assignment to find information from a peer-reviewed journal, then you will not be able to use non-peer-reviewed sources such as books, dissertations, or government websites. It's always best to clarify any questions over assignments with your professor.

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Articles: Finding (and Identifying) Peer-Reviewed Articles: What is Peer Review?

• What is Peer Review?
• Finding Peer Reviewed Articles
• Databases That Can Determine Peer Review

Peer Review in 3 Minutes

What is "Peer-Review"?

What are they.

Scholarly articles are papers that describe a research study. 

Why are scholarly articles useful?

They report original research projects that have been reviewed by other experts before they are accepted for publication, so you can reasonably be assured that they contain valid information. 

How do you identify scholarly or peer-reviewed articles?

• They are usually fairly lengthy - most likely at least 7-10 pages
• The authors and their credentials should be identified, at least the company or university where the author is employed
• There is usually a list of References or Works Cited at the end of the paper, listing the sources that the authors used in their research

How do you find them? 

Some of the library's databases contain scholarly articles, either exclusively or in combination with other types of articles. 

Google Scholar is another option for searching for scholarly articles. 

Know the Difference Between Scholarly and Popular Journals/Magazines

Peer reviewed articles are found in scholarly journals.  The checklist below can help you determine if what you are looking at is peer reviewed or scholarly.

• Both kinds of journals and magazines can be useful sources of information.
• Popular magazines and newspapers are good for overviews, recent news, first-person accounts, and opinions about a topic.
• Scholarly journals, often called scientific or peer-reviewed journals, are good sources of actual studies or research conducted about a particular topic. They go through a process of review by experts, so the information is usually highly reliable.

• Next: Finding Peer Reviewed Articles >>
• Last Updated: May 21, 2024 8:45 AM
• URL: https://libguides.usu.edu/peer-review

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Peer Review in Scientific Publications: Benefits, Critiques, & A Survival Guide

Affiliations.

• 1 Clinical Biochemistry, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto , Toronto, Ontario, Canada.
• 2 Clinical Biochemistry, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada; Chair, Communications and Publications Division (CPD), International Federation for Sick Clinical Chemistry (IFCC), Milan, Italy.
• PMID: 27683470
• PMCID: PMC4975196

Peer review has been defined as a process of subjecting an author's scholarly work, research or ideas to the scrutiny of others who are experts in the same field. It functions to encourage authors to meet the accepted high standards of their discipline and to control the dissemination of research data to ensure that unwarranted claims, unacceptable interpretations or personal views are not published without prior expert review. Despite its wide-spread use by most journals, the peer review process has also been widely criticised due to the slowness of the process to publish new findings and due to perceived bias by the editors and/or reviewers. Within the scientific community, peer review has become an essential component of the academic writing process. It helps ensure that papers published in scientific journals answer meaningful research questions and draw accurate conclusions based on professionally executed experimentation. Submission of low quality manuscripts has become increasingly prevalent, and peer review acts as a filter to prevent this work from reaching the scientific community. The major advantage of a peer review process is that peer-reviewed articles provide a trusted form of scientific communication. Since scientific knowledge is cumulative and builds on itself, this trust is particularly important. Despite the positive impacts of peer review, critics argue that the peer review process stifles innovation in experimentation, and acts as a poor screen against plagiarism. Despite its downfalls, there has not yet been a foolproof system developed to take the place of peer review, however, researchers have been looking into electronic means of improving the peer review process. Unfortunately, the recent explosion in online only/electronic journals has led to mass publication of a large number of scientific articles with little or no peer review. This poses significant risk to advances in scientific knowledge and its future potential. The current article summarizes the peer review process, highlights the pros and cons associated with different types of peer review, and describes new methods for improving peer review.

Keywords: journal; manuscript; open access; peer review; publication.

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Overview of the review process

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How a peer review evaluates a manuscript

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Types of peer review.

Peer review is “a process where scientists (“peers”) evaluate the quality of other scientists’ work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already know.” This quote comes from an explainer on The Conversation, which you can read here . 

Peer review brings academic research to publication in the following ways:

• Evaluation – Peer reviewing research helps publications select the highest quality articles.
• Integrity – Peer review ensures the integrity of the publishing process and the scholarly record.
• Quality – The filtering process and revision advice offered by verified experts within the academic field improves the quality of the final article, as well as providing the author with new insights into their research.

Types of peer review

• Single-anonymized  – The name of the reviewer is hidden from the author.
• Double-anonymized  – Names are hidden from reviewers and authors.
• Triple-anonymized  – Names are hidden from authors, reviewers, and the publication’s editor.
• Open peer review – At Sage we offer open peer review on some journals through our Transparent Peer Review program , whereby reviews are published alongside articles. The names of the reviewers may also be published, depending on the reviewers’ preference.
• Post publication peer review  – This involves an ongoing discussion of the research conducted via an open forum between the scientific community. It is the least common type of peer review and is not appropriate in all fields.

To learn more about the different types of peer review, see page 14 of Peer Review: The Nuts and Bolts of Peer Review , from Sense about Science.

A full list of Sage’s journals can be found here . Each journal will have its own set of instructions and submission guidelines for authors, so please double check the manuscript submission guidelines of the journal you are reviewing for in order to ensure that you understand the method of peer review being used.

• Journal Author Gateway
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What are Peer-Reviewed Journals?

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• What are Peer-reviewed Articles and How Do I Find Them? From Capella University Libraries

Introduction

Peer-reviewed journals (also called scholarly or refereed journals) are a key information source for your college papers and projects. They are written by scholars for scholars and are an reliable source for information on a topic or discipline. These journals can be found either in the library's online databases, or in the library's local holdings. This guide will help you identify whether a journal is peer-reviewed and show you tips on finding them.

What is Peer-Review?

Peer-review is a process where an article is verified by a group of scholars before it is published.

When an author submits an article to a peer-reviewed journal, the editor passes out the article to a group of scholars in the related field (the author's peers). They review the article, making sure that its sources are reliable, the information it presents is consistent with the research, etc. Only after they give the article their "okay" is it published.

The peer-review process makes sure that only quality research is published: research that will further the scholarly work in the field.

When you use articles from peer-reviewed journals, someone has already reviewed the article and said that it is reliable, so you don't have to take the steps to evaluate the author or his/her sources. The hard work is already done for you!

Identifying Peer-Review Journals

If you have the physical journal, you can look for the following features to identify if it is peer-reviewed.

Masthead (The first few pages) : includes information on the submission process, the editorial board, and maybe even a phrase stating that the journal is "peer-reviewed."

Publisher: Peer-reviewed journals are typically published by professional organizations or associations (like the American Chemical Society). They also may be affiliated with colleges/universities.

Graphics:  Typically there either won't be any images at all, or the few charts/graphs are only there to supplement the text information. They are usually in black and white.

Authors: The authors are listed at the beginning of the article, usually with information on their affiliated institutions, or contact information like email addresses.

Abstracts: At the beginning of the article the authors provide an extensive abstract detailing their research and any conclusions they were able to draw.

Terminology:  Since the articles are written by scholars for scholars, they use uncommon terminology specific to their field and typically do not define the words used.

Citations: At the end of each article is a list of citations/reference. These are provided for scholars to either double check their work, or to help scholars who are researching in the same general area.

Advertisements: Peer-reviewed journals rarely have advertisements. If they do the ads are for professional organizations or conferences, not for national products.

Identifying Articles from Databases

When you are looking at an article in an online database, identifying that it comes from a peer-reviewed journal can be more difficult. You do not have access to the physical journal to check areas like the masthead or advertisements, but you can use some of the same basic principles.

Points you may want to keep in mind when you are evaluating an article from a database:

• A lot of databases provide you with the option to limit your results to only those from peer-reviewed or refereed journals. Choosing this option means all of your results will be from those types of sources.  
• When possible, choose the PDF version of the article's full text. Since this is exactly as if you photocopied from the journal, you can get a better idea of its layout, graphics, advertisements, etc.  
• Even in an online database you still should be able to check for author information, abstracts, terminology, and citations.
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Peer Reviewed and Scholarly Articles

What are they? Peer-reviewed articles, also known as scholarly or refereed articles are papers that describe a research study. 

Why are peer-reviewed articles useful? They report on original research that have been reviewed by other experts before they are accepted for publication, so you can reasonably be assured that they contain valid information. 

How do you find them?  Many of the library's databases contain scholarly articles! You'll find more about searching databases below.

Watch: Peer Review in 3 Minutes

Why watch this video?

We are often told that scholarly and peer-reviewed sources are the most credible, but, it's sometimes hard to understand why they are credible and why we should trust these sources more than others. This video takes an in depth approach at explaining the peer review process. 

Hot Tip: Check out the Reading Scholarly Articles page for guidance on how to read and understand a scholarly article.

Using Library Databases

What Are Library Databases? 

Databases are similar to search engines but primarily search scholarly journals, magazines, newspapers and other sources. Some databases are subject specific while others are multi-disciplinary (searching across multiple fields and content types). 

You can view our most popularly used databases on the Library's Home Page , or view a list of all of our databases organized by subject or alphabetically at  U-M Library Databases .

Popular Multidisciplinary Databases

Many students use ProQuest , JSTOR , and Google Scholar for their initial search needs. These are multi-disciplinary and not subject-specific, and they can supply a very large number of  search results.

Subject-Specific Databases

Some popular subject-specific databases include PsycINFO for psychology and psychiatry related topics and  PubMed for health sciences topics. 

Why Should You Use Library Databases?

Unlike a Google search, the Library Databases will grant you access to high quality credible sources. 

The sources you'll find in library databases include:

• Scholarly journal articles
• Newspaper articles
• Theses & dissertations
• Empirical evidence

Database Filters & Limits Most databases have Filters/Limits. You can use these to narrow down your search to the specific dates, article type, or population that you are researching.

Here is an example of limits in a database, all databases look slightly different but most have these options:

Keywords and Starting a Search

What are Keywords?

• Natural language words that describe your topic 
• Allows for a more flexible search - looks for anywhere the words appear in the record
• Can lead to a broader search, but may yield irrelevant results

Keyword searching  is how we normally start a search. Pull out important words or phrases from your topic to find your keywords.

Tips for Searching with Keywords:

• Example: "climate change"
• Example:  "climate change" AND policy
• Example: comput* will return all words starting with four letters; computing, computer, compute, etc.  
• Example: wom?n will find both woman and women.

What are Subject Headings?

• Pre-defined "controlled vocabulary" that describe what an item is  about 
• Makes for a less flexible search - only the subject fields will be searched
• Targeted search; results are usually more relevant to the topic, but may miss some variations

Subject Terms and/or Headings are pre-defined terms that are used to describe the content of an item. These terms are a controlled vocabulary and function similarly to hashtags on social media. Look carefully at the results from your search. If you find an article that is relevant to the topic you want to write about, take a look at the subject headings. 

Hot Tip: Make a copy of this Google Doc to help you find and develop your topic's keywords.

More Database Recommendations

Need articles for your library research project, but not sure where to start? We recommend these top ten article databases for kicking off your research. If you can't find what you need searching in one of these top ten databases, browse the list of all library databases by subject (academic discipline) or title .

• U-M Library Articles Search This link opens in a new window Use Articles Search to locate scholarly and popular articles, as well as reference works and materials from open access archives.
• ABI/INFORM Global This link opens in a new window Indexes 3,000+ business-related periodicals (with full text for 2,000+), including Wall Street Journal.
• Academic OneFile This link opens in a new window Provides indexing for over 8,000 scholarly journals, industry periodicals, general interest magazines and newspapers.
• Access World News [NewsBank] This link opens in a new window Full text of 600+ U.S. newspapers and 260+ English-language newspapers from other countries worldwide.
• CQ Researcher This link opens in a new window Noted for its in-depth, unbiased coverage of health, social trends, criminal justice, international affairs, education, the environment, technology, and the economy.
• Gale Health and Wellness This link opens in a new window
• Humanities Abstracts (with Full Text) This link opens in a new window Covers 700 periodicals in art, film, journalism, linguistics, music, performing arts, philosophy, religion, history, literature, etc.
• JSTOR This link opens in a new window Full-text access to the archives of 2,600+ journals and 35,000+ books in the arts, humanities, social sciences and sciences.
• ProQuest Research Library This link opens in a new window Indexes over 5,000 journals and magazines, academic and popular, with full text included for over 3,600.
• PsycInfo (APA) This link opens in a new window Premier resource for surveying the literature of psychology and adjunct fields. Covers 1887-present. Produced by the APA.

Research Methods: Peer-Reviewed Journal Articles

• Getting Started
• What Type of Source?
• Credible Sources
• Finding Background Information
• Library Databases
• Reference Books
• Electronic Books
• Online Reference Collections
• Databases Presenting Two Sides of an Argument
• Peer-Reviewed Journal Articles
• Writing Style Guides and Citing Sources
• Annotated Bibliographies

What is a Peer-Reviewed (Academic) Journal?

What Is a Peer-Reviewed Journal?

Peer Review is a process that journals use to ensure the articles they publish represent the best scholarship currently available. When an article is submitted to a peer reviewed journal, the editors send it out to other scholars in the same field (the author's peers) to get their opinion on the quality of the scholarship, its relevance to the field, its appropriateness for the journal, etc.

Publications that don't use peer review (Time, Cosmo, Salon) just rely on the judgement of the editors whether an article is up to snuff or not. That's why you can't count on them for solid, scientific scholarship. --University of Texas at Austin

Databases Containing Peer-Reviewed Journal Articles

Each database containing peer-reviewed journals has different content coverage and materials.  The databases listed in this Research Guide are available only to Truckee Meadows Community College students, faculty and staff. You will need your TMCC credentials (Username and Password) to access them off-campus.

When searching a database, a search term frequently will retrieve many articles.  Browse the article abstracts to find one or more relevant to your search.

Some of the databases provide citations for the articles.

Consult a librarian for assistance.

• Databases with peer-reviewed articles and content . This list can also be sorted by subject!

How to Read a Peer-Reviewed Journal Article

Tips for Reading a Research Article

Read the Abstract. It consists of a brief summary of the research questions and methods. It may also state the findings. Because it is short and often written in dense psychological language, you may need to read it a couple of times. Try to restate the abstract in your own nontechnical language.

• Read the Introduction. This is the beginning of the article, appearing first after the Abstract. This contains information about the authors' interest in the research, why they chose the topic, their hypothesis , and methods. This part also sets out the operational definitions of variables.
• Read the Discussion section. Skip over the Methods section for the time being. The Discussion section will explain the main findings in great detail and discuss any methodological problems or flaws that the researchers discovered.
• Read the Methods section. Now that you know the results and what the researchers claim the results mean, you are prepared to read about the Methods. This section explains the type of research and the techniques and assessment instruments used. If the research utilized self-reports and questionnaires, the questions and statements used may be set out either in this section or in an appendix that appears at the end of the report.
• Read the Results section. This is the most technically challenging part of a research report. But you already know the findings (from reading about them in the Discussion section). This section explains the statistical analyses that led the authors to their conclusions.
• Read the Conclusion. The last section of the report (before any appendices) summarizes the findings, but, more important for social research, it sets out what the researchers think is the value of their research for real-life application and for public policy. This section often contains suggestions for future research, including issues that the researchers became aware of in the course of the study.
• Following the conclusions are appendices, usually tables of findings, presentations of questions and statements used in self-reports and questionnaires, and examples of forms used (such as forms for behavioral assessments).

Modified from Net Lab

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• Last Updated: Apr 15, 2024 9:36 AM
• URL: https://libguides.tmcc.edu/researchmethods

• UConn Library
• Research Now
• Explore Information
• Understanding & Recognizing Peer Review

Explore Information — Understanding & Recognizing Peer Review

• Getting the Lay of the Land
• Why use Library Information?
• The Information Lifecycle
• Primary & Secondary Sources - Humanities & Social Sciences
• Primary & Secondary Sources - Sciences
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• Research Now Homepage

What Do You Mean by Peer Reviewed Sources?

(Source: NCSU Libraries)

What's so great about peer review?

Peer reviewed articles are often considered the most reliable and reputable sources in that field of study. Peer reviewed articles have undergone review (hence the "peer-review") by fellow experts in that field, as well as an editorial review process. The purpose of this is to ensure that, as much as possible, the finished product meets the standards of the field. 

Peer reviewed publications are one of the main ways researchers communicate with each other. 

Most library databases have features to help you discover articles from scholarly journals. Most articles from scholarly journals have gone through the peer review process. Many scholarly journals will also publish book reviews or start off with an editorial, which are not peer reviewed - so don't be tricked!

So that means I can turn my brain off, right?

Nope! You still need to engage with what you find. Are there additional scholarly sources with research that supports the source you've found, or have you encountered an outlier in the research? Have others been able to replicate the results of the research? Is the information old and outdated? Was this study on toothpaste (for example) funded by Colgate? 

You're engaging with the research - ultimately, you decide what belongs in your project, and what doesn't. You get to decide if a source is relevant or not. It's a lot of responsibility - but it's a lot of authority, too.

Understanding Types of Sources

• Popular vs. Scholarly
• Reading Scholarly Articles
• Check Yourself!

Popular vs. scholarly articles.

When looking for articles to use in your assignment, you should realize that there is a difference between "popular" and "scholarly" articles.

Popular  sources, such as newspapers and magazines, are written by journalists or others for general readers (for example, Time, Rolling Stone, and National Geographic).

Scholarly  sources are written for the academic community, including experts and students, on topics that are typically footnoted and based on research (for example, American Literature or New England Review). Scholarly journals are sometimes referred to as "peer-reviewed," "refereed" or "academic."

How do you find scholarly or "peer-reviewed" journal articles?

The option to select  scholarly or peer-reviewed articles is typically available on the search page of each database.  Just check the box or select the option . You can also search Ulrich's Periodical Directory  to see if the journal is Refereed / Peer-reviewed.  

Popular Sources (Magazines & Newspapers) Inform and entertain the general public.

• Are often written by journalists or professional writers for a general audience
• Use language easily understood by general readers
• Rarely give full citations for sources
• Written for the general public
• Tend to be shorter than journal articles

Scholarly or Academic Sources (Journals & Scholarly Books) Disseminate research and academic discussion among professionals in a discipline. 

• Are written by and for faculty, researchers or scholars (chemists, historians, doctors, artists, etc.)
• Uses scholarly or technical language
• Tend to be longer articles about research
• Include full citations for sources 
• Are often refereed or peer reviewed (articles are reviewed by an editor and other specialists before being accepted for publication)
• Publications may include book reviews and editorials which are not considered scholarly articles

Trade Publications Neither scholarly or popular sources, but could be a combination of both. Allows practitioners in specific industries to share market and production information that improves their businesses.

• Not peer reviewed. Usually written by people in the field or with subject expertise
• Shorter articles that are practical
• Provides information about current events and trends 

What might you find in a scholarly article?

• Title:  what the article is about
• Authors and affiliations:  the writer of the article and the professional affiliations. The credentials may appear below the name or in a footnote.
• Abstract: brief summary of the article. Gives you a general understanding  before you read the whole thing.
• Introduction: general overview of the research topic or problem
• Literature Review: what others have found on the same topic
• Methods:  information about how the authors conducted their research
• Results: key findings of the author's research
• Discussion/Conclusion: summary of the results or findings
• References: Citations to publications by other authors mentioned in the article
• Anatomy of a Scholarly Article This tutorial from the NCSU Libraries provides an interactive module for learning about the unique structure and elements of many scholarly articles.

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• Last Updated: Aug 2, 2024 4:30 PM
• URL: https://guides.lib.uconn.edu/exploreinfo

• Open access
• Published: 26 August 2024

The association between ibuprofen administration in children and the risk of developing or exacerbating asthma: a systematic review and meta-analysis

• Luke Baxter 1 ,
• Maria M. Cobo 1 , 2 ,
• Aomesh Bhatt 1 ,
• Rebeccah Slater 1 ,
• Olutoba Sanni 3 &
• Nutan Shinde 4  

BMC Pulmonary Medicine volume  24 , Article number:  412 ( 2024 ) Cite this article

Metrics details

Ibuprofen is one of the most commonly used analgesic and antipyretic drugs in children. However, its potential causal role in childhood asthma pathogenesis remains uncertain. In this systematic review, we assessed the association between ibuprofen administration in children and the risk of developing or exacerbating asthma.

We searched MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus from inception to May 2022, with no language limits; searched relevant reviews; and performed citation searching. We included studies of any design that were primary empirical peer-reviewed publications, where ibuprofen use in children 0–18 years was reported. Screening was performed in duplicate by blinded review. In total, 24 studies met our criteria. Data were extracted according to PRISMA guidelines, and the risk of bias was assessed using RoB2 and NOS tools. Quantitative data were pooled using fixed effect models, and qualitative data were pooled using narrative synthesis. Primary outcomes were asthma or asthma-like symptoms. The results were grouped according to population (general, asthmatic, and ibuprofen-hypersensitive), comparator type (active and non-active) and follow-up duration (short- and long-term).

Comparing ibuprofen with active comparators, there was no evidence of a higher risk associated with ibuprofen over both the short and long term in either the general or asthmatic population. Comparing ibuprofen use with no active alternative over a short-term follow-up, ibuprofen may provide protection against asthma-like symptoms in the general population when used to ease symptoms of fever or bronchiolitis. In contrast, it may cause asthma exacerbation for those with pre-existing asthma. However, in both populations, there were no clear long-term follow-up effects.

Conclusions

Ibuprofen use in children had no elevated risk relative to active comparators. However, use in children with asthma may lead to asthma exacerbation. The results are driven by a very small number of influential studies, and research in several key clinical contexts is limited to single studies. Both clinical trials and observational studies are needed to understand the potential role of ibuprofen in childhood asthma pathogenesis.

Peer Review reports

Asthma is a noncommunicable disease affecting approximately 235 million people worldwide and is characterised by inflammation and narrowing of the small airways in the lungs, leading to any combination of cough, wheeze, shortness of breath, and chest tightness [ 1 ]. The prevalence of asthma has increased in many countries in recent decades, especially among children, making asthma a serious global public health problem [ 2 , 3 ]. The reason for increasing asthma prevalence in children is uncertain, but there is likely a complex interaction of multiple risk factors, including environmental (e.g., increased air pollution, changes to housing conditions) and lifestyle factors (e.g., decreased physical activity, changes in diet, increased childhood obesity) [ 4 ].

Increased early-life use of pharmacological agents, such as analgesics and antipyretics, could be causal factors in childhood asthma pathogenesis. Due to fears of a causal relationship between aspirin use and Reye’s syndrome [ 5 ] and the risk of aspirin-induced asthma [ 6 ], aspirin use in children has dramatically decreased in recent decades. Consequently, drugs such as ibuprofen and paracetamol have become increasingly popular for treating fever and pain in children. In the United Kingdom, the National Health Service describes both paracetamol and ibuprofen as safe for treating pain and high temperature in babies and children [ 7 ]. However, caution is advised for ibuprofen use in children with asthma [ 8 ], while no such warning is supplied for paracetamol [ 9 ], suggesting that ibuprofen may be linked to asthma development or exacerbation in those with pre-existing asthma.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that is frequently prescribed or administered over-the-counter (OTC) to treat fever and pain. Links between childhood ibuprofen use and asthma development or exacerbation are being investigated [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Ibuprofen’s inhibition of the cyclooxygenase system can lead to activation of the lipoxygenase system, resulting in bronchospasm [ 6 , 17 ], which could precipitate asthma. Additionally, empirical evidence exists demonstrating ibuprofen-induced asthma exacerbation in children with asthma and self-reported aspirin allergy [ 18 ].

Despite these points, two recent systematic reviews did not identify a risk difference between ibuprofen and paracetamol in asthma development or exacerbation in children [ 14 , 16 ]. However, one of these reviews limited the scope to randomised controlled trials (RCTs) [ 14 ], and the other to a relatively narrow age range of less than 2 years [ 16 ], restricting the generalisability of the findings.

We conducted a systematic review to assess the association between ibuprofen administration in children and the risk of developing or exacerbating asthma. The aim was to expand on previous reviews by looking across the entire age range of childhood from 0 to 18 years, including both interventional and observational studies, and assessing the association separately for clinically distinct paediatric subpopulations: general, asthmatic, and ibuprofen-hypersensitive.

Protocol development

We registered our review on PROSPERO on 8 July 2022 (CRD42022344838). The protocol was written according to PRISMA-P guidelines [ 19 , 20 ] and made publicly available on OSF prior to registration with PROSPERO. Further methodological details can be found in our online protocol ( https://doi.org/10.17605/OSF.IO/Z37KW ).

Eligibility criteria

A full list of eligibility criteria is provided in Supplementary Methods S1.1 (Supplementary Tables 1–2). The numeric results from studies included in our review were grouped by population for synthesis: (i) general population of children (i.e., studies not limiting eligibility to specific clinical subpopulations; however, some study-specific exclusion will always occur, for example, children with severe asthma, ibuprofen hypersensitivity, or other contraindications for safety reasons; children with conditions that could interfere with ibuprofen administration or absorption, such as inability to swallow or frequent vomiting; children receiving treatments that could interfere with the outcome assessment, such as leukotriene receptor antagonist and other anti-asthmatic treatments); (ii) children with asthma; and (iii) children with ibuprofen hypersensitivity.

Search strategy

We searched six bibliographic databases (MEDLINE, Embase, Cochrane Library, CINAHL, Web Of Science, Scopus) to identify records on 21-May-2022, and our searches were independently peer-reviewed using the PRESS Checklist [ 21 , 22 ] by an outreach librarian at the Bodleian Health Care Libraries, University of Oxford ( https://doi.org/10.17605/OSF.IO/R3AV6 ). All search strategies are provided in full in Supplementary Methods S1.2. Additional information sources included relevant reviews that were identified during screening [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ] and backwards citation searching using the citationchaser tool [ 23 ]. EPPI-Reviewer [ 24 ] was used for de-duplication, and screening was performed independently in duplicate, with disagreements settled by discussion between both reviewers.

Data extraction and bias assessment

Data extraction and bias assessment were performed by one reviewer and then verified by a second reviewer, with disagreements settled by discussion. Our primary outcomes of interest were asthma, asthma-like symptoms, or asthma exacerbation [ 2 ]. For risk of bias assessment, the Cochrane risk of bias tool (RoB2) was used for RCTs [ 25 ], and the Newcastle-Ottawa Scale (NOS) [ 26 ] was used for observational studies. The results from these assessments were used to decide which studies to include in primary syntheses (Supplementary Figs. 1–2). Our approach to assessing meta-biases (outcome reporting and publication biases) is detailed in Supplementary Methods S1.3.

Data synthesis

A narrative synthesis was performed when outcomes were too heterogeneous to synthesise quantitatively. Otherwise, meta-analysis was performed using the R package meta [ 27 ]. Given the sparsity of the data for quantitative synthesis, we report the common effect model results as primary results. For completion, we report additional analysis outputs, e.g., both odds and risk ratios; both common and random effects model effect sizes; I 2 , tau 2 , and chi 2 for heterogeneity. Due to the sparsity of the results, subgroup analyses were not performed.

For meta-analysis of dichotomous data, ORs were pooled using Peto’s method [ 28 ] due to zero events in some arms. Where multiple outcomes from a study were available, the primary analysis was performed by selecting the outcomes with the expected lowest risk of bias. To test the robustness of the primary analysis, sensitivity analyses were performed using alternative combinations of studies’ numeric results.

Study selection characteristics

Of the 820 records screened, 18 relevant studies were identified, with a further 6 from relevant reviews (Supplementary Fig. 3). The study characteristics for all 24 studies are summarised in Table  1 . Relevant numeric results were grouped by population: (i) general population of children (Table  2 ), (ii) children with asthma (Table  3 ), and (iii) children with ibuprofen hypersensitivity (Table  4 ). For the general population and children with asthma, data synthesis was performed for (i) ibuprofen versus an active comparator (Fig.  1 ) and (ii) ibuprofen versus baseline (i.e., children not taking an alternative antipyretic or analgesic). To increase homogeneity, the results were also grouped based on the duration of follow-up, in line with a recent similar systematic review [ 16 ]: short duration of ≤ 28 days or long duration of > 28 days.

Synthesis of results of ibuprofen versus active comparators. The active comparator for Kokki 2010 was ketoprofen; for all other studies, the active comparator was paracetamol. ( a ) General population of children over a short duration. ( b ) Children with asthma over a long duration. Abbreviations: OR = odds ratio; 95% CI = 95% confidence interval

General population

In total, 13 numeric results from 9 studies relevant to assessing ibuprofen use in a general population of children were identified [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ] (Table  2 ).

Ibuprofen versus active comparator

There were six results from six interventional studies (all RCTs) and two results from one observational cohort study that compared ibuprofen use with an active comparator in the general population. The main active comparator was paracetamol, with one study [ 29 ] using ketoprofen (Table  2 ). The durations of study for the interventional RCT were all short (≤ 28 days). Two of these results were from publications based on the same dataset, the Boston University Fever Study [ 30 , 31 ], of which the original publication was selected for primary analysis.

The synthesis of five results comparing ibuprofen with active comparators (four paracetamol, one ketoprofen) resulted in a common effect OR = 0.87; 95% CI=[0.55, 1.37], demonstrating a lack of significant difference between ibuprofen and active comparators (Fig.  1 a). Our sensitivity analyses were in agreement with this primary result (Supplementary Fig. 4).

A single observational study [ 36 ] assessed ibuprofen relative to paracetamol over both short and long durations (Table  2 ) in a general population of children. Over a short duration (14 days), no significant difference in wheezing was identified, but over a long duration (1 year), they observed a significant advantage to ibuprofen over paracetamol, with a reduction in health care practitioner visits for wheezing illness consistent with bronchiolitis or asthma.

Taken together, these interventional and observational results suggest that there is no difference between ibuprofen and active comparators in the general population over a short duration (≤ 28 days). This finding is driven largely by a single study, the Boston University Fever Study [ 31 ], conducted almost 30 years ago on a large sample ( n  = 83,915) of children aged 6 months to 12 years. Over longer follow-up durations of one year, there is evidence from only a single cohort study [ 36 ] to suggest that there may be a reduction in wheezing when ibuprofen is prescribed, rather than paracetamol, for a first episode of bronchiolitis in children aged 0–12 months.

Ibuprofen versus baseline

Five numeric results from three studies relevant to assessing ibuprofen relative to baseline (children not taking an alternative antipyretic or analgesic) in the general population were identified (Table  2 ). All outcomes were from observational studies. Due to the sparsity and substantive heterogeneity of the results, quantitative synthesis was not possible.

Two studies looked at general populations over short durations (≤ 28 days) [ 33 , 36 ]. Both studies suggest that ibuprofen might decrease wheezing when taken for either acute febrile illness or bronchiolitis (Table  2 ).

Two studies looked at general populations of children over long durations [ 35 , 36 ] and produced conflicting results. One study [ 36 ] compared those prescribed ibuprofen for a first episode of bronchiolitis to those not prescribed ibuprofen (or another drug) and followed up participants over a 1-year duration, observing a positive impact of ibuprofen prescription. The second study [ 35 ] compared children administered ibuprofen to those not administered ibuprofen during the first postnatal year and followed-up participants at a 3–5 year duration, observing a negative impact of ibuprofen on asthma development, and at a 7–10 year duration, observing no difference between cohorts (Table  2 ).

Taken together, ibuprofen use in the general population of children during acute febrile illness or bronchiolitis might decrease wheezing when assessed in the short-term (≤ 28 days), with both observational studies reporting strong significant effects (Table  2 ). Over longer durations, the two observational studies identified in this review have substantive heterogeneity in design, analysis, and outcome, preventing meaningful synthesis. Additionally, their numeric findings are inconsistent (Table  2 ).

Asthmatic population

Five numeric results from four studies relevant to assessing ibuprofen in asthmatic paediatric populations were identified [ 38 , 39 , 40 , 41 ] (Table  3 ).

Three results across three studies compared ibuprofen with an active comparator (paracetamol in all cases) in asthmatic populations (Table  3 ). One interventional study assessed outcomes over a short duration [ 39 ] and found no difference between treatments. While further analyses in this paper did suggest a favourable outcome for ibuprofen relative to paracetamol, the results from this second post-hoc Boston Fever Study report are at very high risk of bias in the selection of the reported result (Supplementary Fig. 2).

Two studies looked at the comparison between ibuprofen and paracetamol in asthmatic populations over long durations [ 38 , 41 ]. The RCT study [ 41 ] identified no difference between drugs (OR = 0.90 [ 0.57, 1.41]). In contrast, the observational cohort study [ 38 ] identified a significant disadvantage for ibuprofen relative to paracetamol in asthmatic populations (aOR = 2.10 [1.17, 3.76]). These conflicting results for ibuprofen relative to paracetamol in asthmatic populations over long durations are challenging to resolve due to the different experimental designs. However, there are also several similarities in their designs: use of the same active comparator, inclusion of asthmatic populations of children with similar age ranges (Sheehan: 1–4.9 years; Fu: 1–5 years) over similar follow-up durations (Sheehan: 46 weeks; Fu: 52 weeks), and use of asthma exacerbation as the outcome. As an exploratory analysis, we synthesised these results, which resulted in a common effect OR = 1.24; 95% CI=[0.87, 1.77], suggesting an overall non-significant effect, which is consistent with the RCT study result alone (Fig.  1 b).

Taken together, these interventional and observational results suggest that there is no difference in asthma exacerbation between ibuprofen and paracetamol in asthmatic populations over short or long durations.

Only a single study looked at an asthmatic population over both short and long durations [ 40 ]. Over a short duration, this study found that ibuprofen increased asthma exacerbation. Over a long duration, they found no effect of ibuprofen on asthma exacerbation in the asthmatic population.

Ibuprofen hypersensitive population

Four drug provocation studies were identified that studied ibuprofen-hypersensitive children where ibuprofen was ingested and adverse events reported as part of hypersensitivity diagnosis [ 42 , 43 , 44 , 45 ]. A range of respiratory adverse effects were reported that included asthma, coughing, wheezing, dyspnoea, and respiratory distress (Table  4 ). Across the four studies, there was a total of 10 children with respiratory adverse events reported in a total of 80 children. Thus, in children with ibuprofen hypersensitivity, the average rate of respiratory adverse events following ibuprofen ingestion was 12.5%.

Unsynthesised papers

Seven studies were identified that reported the relationship between ibuprofen and asthma in children, which were not synthesised in this review [ 18 , 46 , 47 , 48 , 49 , 50 , 51 ]: five studies reported on single cases, and two group analysis studies had substantive differences in methodology and outcomes relative to other studies included in this review.

One crossover RCT [ 46 ] assessed the prevalence of ibuprofen-sensitive asthma in children with mild or moderate persistent asthma using bronchoprovocation challenge and found a prevalence of 2%. Another non-randomised controlled study [ 18 ] assessed the impact of short-term ibuprofen treatment on pulmonary function in children with mild to moderate stable asthma and self-reported aspirin allergy. Relative to a healthy control group, the asthmatic group exhibited a drop in FEV1 (forced expiratory volume in the first second) of 18.85% and an increase in FeNO (fractional exhaled nitric oxide) of 20.76 ppb. A summary of the results from these two studies is provided in Supplementary Table 3.

Four case reports of severe adverse events to ibuprofen were identified [ 47 , 48 , 50 , 51 ], and in all cases, the children had pre-existing asthma. Last, in a case series of fatal asthma in Finland, a single death due to ibuprofen ingestion was reported in a child with severe asthma and a known allergy to ibuprofen [ 49 ].

Here, we assessed the association between ibuprofen use and asthma in children aged 0–18 years. Both observational and interventional studies were reviewed in the general population as well as the asthmatic population. Studies that benchmarked ibuprofen against an active comparator almost exclusively used paracetamol, and in both populations of children, the combined evidence suggested no difference in asthma-related adverse events between ibuprofen and paracetamol (or ketoprofen) use. A single observational study suggested a potential benefit of ibuprofen over paracetamol prescription in response to bronchiolitis in the general paediatric population after a one-year follow-up. When ibuprofen use was assessed relative to no alternative drug administration, differences emerged between the general and asthmatic populations. In the short-term follow-up (1–14 days) to ibuprofen use, two observational studies reported favourable effects in the general population, while one observational and one interventional study observed unfavourable effects in the asthmatic population. Over a longer follow-up period (12 weeks to 10 years), no clear effect emerged for either population.

The majority of research on the association between ibuprofen use and asthma-related adverse events in children has been conducted in the general population, benchmarked relative to paracetamol, and participants followed-up over a short duration [ 29 , 30 , 31 , 32 , 34 , 36 , 37 ]. The aggregate result from five RCTs conducted in this context is driven primarily by the Boston University Fever Study [ 31 ], conducted almost 30 years ago on children aged 6 months to 12 years. While a single observational study [ 36 ] conducted five years ago corroborates this finding, research is sparse. Furthermore, only a single study comparing ibuprofen with paracetamol use with a short-term follow-up was conducted in children with asthma [ 39 ], and this study was a second post-hoc analysis publication of the same Boston University Fever Study dataset. Given the increased vulnerability of the asthmatic population to respiratory adverse events from ibuprofen use that was observed in our review, there is a clear lack of research comparing the short-term effects of ibuprofen relative to alternative analgesics and antipyretics such as paracetamol in children with asthma.

Two studies [ 38 , 41 ] assessing differences between ibuprofen and paracetamol use over longer follow-up periods in asthmatic populations report conflicting results. Due to several study similarities, we tentatively synthesised the two results, and no aggregate difference between ibuprofen and paracetamol was observed. However, in the RCT [ 41 ], the median dose of trial medication (ibuprofen or paracetamol) was 5.5 doses (IQR = 1–15) and matched between trial arms. In the retrospective cohort study [ 38 ], it could not be determined by the original investigators whether patients took the medication prescribed. Additionally, the observational study did not control for upper respiratory tract infections, a well-documented source of confounding by indication [ 35 , 52 ], which were not well-matched between the ibuprofen and paracetamol cohorts. For these reasons, the RCT finding alone or the synthesised outcome of no difference between drugs seems most justifiable.

Comparing the asthmatic and general populations for short-term asthma-relevant outcomes after ibuprofen use, no conflicts in results were observed. The two observational studies in the general population [ 33 , 36 ] both observed reductions in asthma-related outcomes, while one observational [ 40 ] and one interventional [ 18 ] study in the asthmatic population both observed increases in asthma-related outcomes. These findings highlight the importance of avoiding naïve pooling of results from studies in these different paediatric populations.

It is noteworthy that all RCTs reviewed compared ibuprofen with an active comparator. Of the studies comparing ibuprofen with a baseline of no alternative drug, three were cohort studies [ 35 , 36 , 40 ], and one was cross-sectional [ 33 ]. One non-randomised interventional study [ 18 ] compared an asthmatic sample with a healthy control sample. This highlights one of the limitations of the RCT design approach in assessing adverse events in the youngest children [ 53 , 54 ]. As a recent RCT feasibility study found [ 55 ], almost three quarters of parents surveyed described the use of a placebo comparator treatment as unacceptable for treating their child’s fever or pain. This ethical unacceptability of using a placebo arm in clinical trials for treating pain and fever in young children [ 55 , 56 ] introduces an ambiguity into these active comparator RCT studies, as a lack of difference among active comparators does not exclude the possibility that both ibuprofen and active comparator use may be associated with parallel increases in asthma exacerbations [ 41 , 56 ]. It has been argued that, given that ibuprofen and paracetamol have different mechanisms of action, it is unlikely that their use could be associated with similar increases in the rate of asthma-related complications that are known to be determined by disparate mechanisms of disease [ 41 , 56 ]. However, this speculation requires careful examination and empirical support. Observational studies with comparator groups in which an active treatment was not prescribed or taken can be used as a baseline control to assess the impact of ibuprofen alone, acknowledging the challenges of inferring causality in observational studies. It is these advantages and disadvantages of both RCTs and observational designs that require a review of the association between ibuprofen use and asthma-related outcomes in children to consider and attempt to synthesise all study design types. This feature of our review adds substantially to two recent systematic reviews in this area [ 14 , 56 ] that either limited the study designs to RCTs [ 14 ] or limited the population to those under 2 years [ 56 ].

We identified four drug provocation trials in which ibuprofen hypersensitivity was confirmed in children by controlled administration of ibuprofen [ 42 , 43 , 44 , 45 ] and respiratory adverse events were recorded. The average percentage of children with confirmed ibuprofen hypersensitivity who displayed respiratory adverse events was 12.5%. Relative to other adverse events, such as angio-oedema and urticaria (which were by far the most common adverse events), asthma and asthma-like respiratory events were less commonly reported. While adverse respiratory reactions to ibuprofen ingestion in those with ibuprofen hypersensitivity can be quite severe, as reported in a handful of case reports [ 47 , 48 , 50 , 51 ], fatalities appear to be very rare. In this review, only a single case of ibuprofen-induced asthma fatality was identified [ 49 ].

The number of studies in this review that were relevant to important clinical populations and contexts was unfortunately sparse. Only a single publication was identified for each of the following three contexts: the general population where ibuprofen is compared with an active comparator with a follow-up duration longer than 1 month [ 36 ]; the asthmatic population where ibuprofen is compared with an active comparator with a short-term follow-up [ 39 ]; and the asthmatic population where ibuprofen is compared with a baseline of no active comparator with a follow-up duration longer than 1 month [ 40 ]. These limitations hinder the generalisability of findings to several important clinical contexts and are an ongoing issue to be addressed.

Here, we found that research is most lacking for populations of children with pre-existing asthma, who are the population at most risk for potential respiratory adverse events following ibuprofen use. Our review highlights the importance of assessing both interventional and observational studies and analysing the general population and asthmatic population separately. Continued investigation into the role of early-life ibuprofen use and its short-term and long-term impact on childhood asthma is needed.

Data availability

All data (data collection form, risk of bias assessment forms, and data used for all analyses) are publicly available on the project’s OSF site: https://doi.org/10.17605/OSF.IO/ZBDS7 . All code used for the meta-analysis is publicly available on Zenodo: https://doi.org/10.5281/zenodo.11258287 .

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Acknowledgements

We thank Imran Lodhi, Fiona Murray-Zmijewski, Frederic Esclassan, and Bill Laughey for reviewing and advising on improvements for this systematic review. We thank Carolyn Smith, the Outreach Librarian at University of Oxford’s Bodleian Libraries, who performed the search strategy PRESS Peer Review.

This work was funded by Reckitt. Employees of Reckitt were involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of a manuscript; and decision regarding where to submit the manuscript for publication.

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LB: conceptualization, methodology, data curation, formal analysis, investigation, visualization, writing – original draft, writing – review & editing. MC: methodology, data curation, investigation, validation, writing – review & editing. AB: conceptualization, methodology, data curation, investigation, writing – review & editing. RS: conceptualization, methodology, data curation, investigation, writing – review & editing. OS: conceptualization, methodology, project administration, writing – review & editing. NS: conceptualization, methodology, project administration, writing – review & editing.

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Baxter, L., Cobo, M.M., Bhatt, A. et al. The association between ibuprofen administration in children and the risk of developing or exacerbating asthma: a systematic review and meta-analysis. BMC Pulm Med 24 , 412 (2024). https://doi.org/10.1186/s12890-024-03179-3

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