Everybody hurts: The Reviewer-Imposed Pain (RIP) matrix.

The peer review process supports authors by providing feedback on manuscripts from external, expert readers. However, not all reviews are supportive. Some reviews are just painful. But just how painful are they? In this study, we set out to validate a matrix describing the levels of pain authors experience in response to the sting of peer reviewer comments. The study was carried out in two phases. In Phase 1, we developed a matrix combining two scales-i.e. the Suffering Scale and the Grind Gauge. The first categorises review-induced pain across four levels, with Level 1 being the least pain and Level 4 the greatest pain. The second categorises the amount of work required by the author to respond to and address reviewer comments, with Level 1 being the least amount and Level 4 the greatest amount. In Phase 2, we tested the performance of the matrix by recruiting multiple, global study sites to provide performance data. This work resulted in the development and validation of the Reviewer-Imposed Pain (RIP) matrix. A statistician analysed our data and assures us that the RIP matrix is now a validated tool. Our study shows that the pain associated with academic peer review affects physiologic, affective, and cognitive dimensions. This tongue-in-cheek paper pokes fun at the peer review process; however, the response from survey participants suggests that the process is not necessarily funny. Peer review is essential for advancing science; however, for these advancements to occur, peer reviewer comments need to be constructive. The RIP matrix encourages both authors and reviewers to reflect on the impact of reviewer comments. This is essential because, as previous research has illustrated and as Voltaire succinctly stated, pain is real.