title: Efficacy of Double-Blind Peer Review in an Imaging Subspecialty Journal.
abstract: Many scientific journals use double-blind peer review to minimize potential reviewer bias concerning publication recommendations. However, because neuroradiology is a relatively small subspecialty, this process may be limited by prior knowledge of the authors' work or associated institutions. We sought to investigate the efficacy of reviewer blinding and determine the impact that unblinding may have on manuscript acceptance.
  
  
  
  For manuscripts submitted to theAmerican Journal of Neuroradiology(AJNR) from January through June 2015, reviewers completed a brief anonymous questionnaire after submitting their evaluations, assessing whether they were familiar with the research or had knowledge of the authors or institutions from which the work originated.
  
  
  
  The response rate for 1079 questionnaires was 98.8%; 12.9% of reviewers knew or suspected that they knew authors, and 15.3% knew or suspected that they knew the associated institutions. Reviewers correctly identified the authors in 90.3% of cases and correctly stated the institutions in 86.8% of cases. Unblinding resulted from self-citation in 34.1% for both authorship and institutions. The acceptance rate when reviewers knew or suspected that they knew the authors was 57/137 (41.6%) and 262/929 (28.2%) when reviewers did not. The acceptance rate when reviewers knew or suspected that they knew the institutions was 60/163 (36.8%) and 259/903 (28.7%) when they did not. The Fisher exact test showed that author (P< .038) and institution (P< .039) familiarity was associated with greater manuscript acceptance.
  
  
  
  While theAJNRprocess of double-blind peer review minimizes reviewer bias, perceived knowledge of the author and institution is associated with a higher rate of manuscript acceptance.
authors.affiliation: From the Department of Radiology (E.E.O., M.C., J.A.L.), Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania erin.oconnor@umm.edu.
authors.forename: E E
authors.identifier: 0000-0002-9483-1117
authors.initials: EE
authors.lastname: O'Connor
authors.affiliation: From the Department of Radiology (E.E.O., M.C., J.A.L.), Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.|Department of Radiology (M.C.), University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: M
authors.identifier: 0000-0003-2355-9627
authors.initials: M
authors.lastname: Cousar
authors.affiliation: From the Department of Radiology (E.E.O., M.C., J.A.L.), Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
authors.forename: J A
authors.identifier: 0000-0002-1296-2341
authors.initials: JA
authors.lastname: Lentini
authors.affiliation: From the Department of Radiology (E.E.O., M.C., J.A.L.), Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.
authors.forename: M
authors.identifier: 0000-0003-2960-1064
authors.initials: M
authors.lastname: Castillo
authors.affiliation: American Journal of Neuroradiology (K.H.), Oak Brook, Illinois.
authors.forename: K
authors.identifier: 0000-0002-1417-404X
authors.initials: K
authors.lastname: Halm
authors.affiliation: Neurometrika (T.A.Z.), Potomac, Maryland.
authors.forename: T A
authors.identifier: 0000-0002-0846-4577
authors.initials: TA
authors.lastname: Zeffiro
mesh_terms: D001319:Authorship; D004311:Double-Blind Method; D006801:Humans; D017712:Peer Review, Research / Q000379:methods*; D010506:Periodicals as Topic / Q000592:standards*; D011643:Publishing; D011795:Surveys and Questionnaires