European Respiratory Journal Response to Reviewers
An ERJ revision guide for aligning respiratory importance, study design, statistics, reporting checklists, validation, clean copy, and tracked copy.
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How to use this page well
These pages work best when they behave like tools, not essays. Use the quick structure first, then apply it to the exact journal and manuscript situation.
Question | What to do |
|---|---|
Use this page for | Building a point-by-point response that is easy for reviewers and editors to trust. |
Start with | State the reviewer concern clearly, then pair each response with the exact evidence or revision. |
Common mistake | Sounding defensive or abstract instead of specific about what changed. |
Best next step | Turn the response into a visible checklist or matrix before you finalize the letter. |
Quick answer: A European Respiratory Journal response to reviewers should connect each clinical or methodological concern to a visible manuscript change. Start with the editor's controlling issues, then answer every comment. State the action, result, and exact location. Cite page and line, table, figure, endpoint, model, cohort, reporting checklist, or supplement. Current ERS guidance calls for a clean revised copy, a visibly tracked copy, and a detailed response. All three should communicate the same respiratory claim and evidence boundary.
Last reviewed: July 13, 2026.
Use the ERJ revision readiness scan before upload. Initial fit belongs to the ERJ submission guide, status belongs to ERJ under review, and the ERJ journal profile provides venue context.
From our manuscript review practice
In ERJ revisions we review, the common mismatch is a broad respiratory or clinical conclusion supported by a selected tertiary cohort, unvalidated prediction model, or endpoint whose missingness and follow-up vary by site. The response must repair transport and interpretation, not only add covariates.
What the ERJ revision process requires
ERS guidance describes single-anonymised peer review and asks for a clean revised manuscript, a copy with changes highlighted, and a detailed response. ERJ instructions also tie study types to reporting standards and emphasize independent validation for several predictive or association claims.
Translate that into a respiratory evidence map:
Reviewer concern | Required revision evidence | Incomplete response |
|---|---|---|
Clinical relevance is unclear | Population, absolute magnitude, uncertainty, care or public-health consequence | Repeating statistical significance |
Cohort selection may bias results | Recruitment, exclusions, missingness, site variation, and sensitivity | Adding adjusted covariates only |
Prediction model is unvalidated | Calibration, discrimination, decision value, and independent validation | Random train-test split in one cohort |
Endpoint is inconsistent | Definition, timing, adjudication, competing events, and follow-up | Harmonizing labels after analysis |
Mechanism is overclaimed | Human, experimental, biomarker, or causal evidence proportional to claim | Calling association mechanistic |
Reporting is incomplete | STROBE, TRIPOD, CONSORT, PRISMA, or relevant checklist and transparent methods | Attaching a checklist without repairing text |
Copyable ERJ response template
Put editor and reviewer text in bold or boxes. Keep responses in regular text. Specify whether locations refer to the clean or tracked manuscript.
Dear Chief Editor and Section Editor,
Thank you for inviting revision of manuscript ERJ-2026-0921,
"Exacerbation Risk After Home Non-Invasive Ventilation." Your decision
identifies three controlling issues: cohort selection, external validation,
and interpretation of the biomarker association. We address these first and
then answer every reviewer comment. Page and line numbers refer to the clean
revised manuscript; all changes are visible in the tracked copy.
Editor Issue 1: Cohort selection and transport
Response: We clarified recruitment at all six sites, added the screening
flow diagram, report site-specific missingness, and repeat the analysis using
inverse-probability-of-observation weights. The conclusion is now limited to
tertiary-care patients meeting the stated eligibility criteria. See page 5,
lines 6-30; Figure 1; and Supplemental Table S3.
Reviewer 1, Comment 4
"The prognostic model requires independent validation."
Response: We agree. We locked the model and tested it in a later external
cohort from two hospitals. We report calibration slope, calibration plot,
discrimination, and decision-curve analysis. Performance attenuates, and the
abstract now describes the model as requiring broader prospective validation.
See page 12, lines 3-29 and Figure 4.
Reviewer 2, Comment 2
"The biomarker association is described as a mechanism."
Response: We removed causal language, added sensitivity to renal function and
systemic inflammation, and state that the biomarker may index rather than
mediate risk. See page 14, lines 8-27 and revised Discussion.
Sincerely,
Dr. A. Researcher, on behalf of all authorsThe response should make the clean and tracked copies auditable. Do not force the reviewer to use tracked changes as the only explanation of why a scientific conclusion changed.
Put page, line, cohort, and checklist in every reply
Each reply needs a page and line citation. Clinical and epidemiological concerns should also name the cohort, endpoint, model, figure, table, reporting-guideline item, or supplement. If a claim changes from causal to associational or from general to setting-specific, quote the revised language.
Recheck all locations after final formatting. Verify that the clean copy and tracked copy have identical scientific content and differ only in visible markup.
Typography for ERJ rebuttals
Differentiate reviewer comments from author responses with bold text, shaded blocks, labels, or indentation. Do not rely on color. Keep editor priorities, statistical reviewer comments, quoted revised text, and author explanations visually distinct.
Within the tracked manuscript, make changes to endpoint definitions, cohort denominators, model specifications, and reporting statements conspicuous. These can be more important than newly added prose.
Build a respiratory concern-to-evidence ledger
Comment | Clinical uncertainty | Artifact to revise | Claim affected |
|---|---|---|---|
Selection bias | Who entered the cohort | Flow diagram and sensitivity | Generalizability |
Endpoint differs by site | Measurement validity | Definitions and adjudication | Outcome association |
Model is overfit | Predictive transport | External validation and calibration | Clinical utility |
Missingness is informative | Estimation bias | Pattern analysis and sensitivity | Effect magnitude |
Biomarker is called causal | Mechanistic validity | Language and alternative explanations | Mechanism |
Checklist gaps remain | Reporting transparency | Methods, results, supplement | Reproducibility |
Assign each row to a coauthor but retain one integration owner. Clinical, statistical, and reporting changes must not contradict one another.
Tone calibration for ERJ responses
Avoid | Better |
|---|---|
"The reviewer misunderstands our cohort." | "The original recruitment description was incomplete. Figure 1 and page 5 now show screening, exclusions, sites, and the population boundary." |
"The model is well validated." | "The locked model was tested in an external cohort; calibration and decision value attenuated, and we now state the need for prospective validation." |
"Missing data were minimal." | "Missingness varied by site and severity. We report patterns, imputation assumptions, and complete-case and weighted sensitivity analyses." |
"The biomarker drives exacerbation." | "The association persists after measured adjustment, but mediation is untested; we now describe the biomarker as a risk indicator." |
"We complied with STROBE." | "The revised Methods and Results address the listed STROBE items, and the response names each repaired location." |
Concede reporting or design limitations directly. Push back by explaining what the requested analysis can and cannot identify.
In our review work with ERJ revisions
In our pre-submission and revision work with European Respiratory Journal manuscripts, we audit the response against recruitment, endpoints, follow-up, statistical models, validation, tables, figures, reporting checklists, supplements, abstract, and clinical interpretation. These are qualitative Manusights patterns, not ERJ acceptance statistics or confidential reviewer access.
Pattern 1: the ERJ conclusion travels farther than the cohort
A selected tertiary cohort, specialty registry, or trial subset supports a broad statement about respiratory patients. The revision adds demographic detail but does not test site, severity, access, treatment, or referral differences. In ERJ revisions, we build a transport ledger from screened population to analyzed sample and state which care setting the conclusion can support.
Pattern 2: prediction validation is only internal resampling
A reviewer requests validation, and the revised manuscript adds cross-validation or a random holdout from the same institutions and period. We distinguish optimism correction from transport. For a new diagnostic or prognostic model, an independent temporal or geographic cohort, calibration, and decision relevance answer a different question from internal discrimination.
Pattern 3: missingness and follow-up are treated as formatting details
In European Respiratory Journal revisions, site-specific tests, loss to follow-up, unavailable physiology, or incomplete exacerbation capture can depend on severity and care access. We inspect missingness by exposure, outcome, site, and patient state, then align imputation and sensitivity with that process. A single overall missing percentage does not resolve bias.
Pattern 4: respiratory association becomes biological mechanism
A biomarker, imaging feature, microbiome signature, or physiological measure predicts outcome, and the Discussion describes a causal pathway. We map temporal order, confounding, mediation, experimental support, and alternative explanations. The response can preserve clinical utility while narrowing mechanistic language.
The useful information gain is transport alignment: recruitment, measurement, model, validation, and conclusion must describe the same respiratory population and decision.
Check the ERJ response and revised clinical evidence together before re-review.
Handling reviewer disagreement
If a statistical reviewer requests narrower inference while a clinical reviewer asks for broader implications, summarize the tension for the editor. Preserve the validated estimate and explain where clinical relevance is plausible versus demonstrated.
Direct concerns about review conduct or process to the editor. Do not turn the public point-by-point letter into a personal dispute with a reviewer.
Why ERJ revisions still end in rejection
Revision is not acceptance. Rejection-on-revision risk remains when independent validation is requested but not supplied, reporting checklists reveal uncorrected design gaps, missingness can change the result, or the clinical conclusion remains broader than the cohort and follow-up.
Most dangerous is a meticulous tracked copy that leaves the underlying validity problem unchanged.
Submit if; think twice if
Submit if: screening and denominators are reconciled, endpoint definitions are stable, missingness and sensitivity are transparent, prediction claims have appropriate validation, reporting guidance is repaired in the manuscript, and the clinical conclusion stays inside the tested respiratory population.
Think twice if: validation is only a random split from the same cohort, missingness differs by site or severity without sensitivity analysis, causal language survives an observational design, or the tracked copy is complete while the clean manuscript retains the broader claim. Those are rejection-on-revision risks.
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How this page was reviewed
We reviewed current ERJ instructions, ERS peer-review and rebuttal guidance, and manuscript-preparation requirements, then applied the respiratory concern-to-evidence audit above. We separated official file and reporting requirements from Manusights interpretation of clinical validity and transport. This page helps authors verify revision coherence; it does not estimate acceptance, infer a private editorial decision, or replace ScholarOne instructions. The live task list and decision letter remain authoritative for the revision package.
Final ERJ revision audit
- Put editor priorities before reviewer sections.
- Answer every comment and subpart.
- Cite page, line, cohort, endpoint, table, figure, checklist, and supplement.
- Reconcile screening, exclusions, denominators, and follow-up.
- Match causal language to design.
- Report missingness and sensitivity transparently.
- Distinguish internal validation from transport.
- Update the reporting checklist and manuscript together.
- Synchronize clean copy, tracked copy, and response.
- Keep reviewer and author text visually distinct.
Measure after 14 final GSC days. At day 21, keep, revise, or stop based on indexing, query ownership, impressions, clicks, and qualified review starts. The 8,644 journal impressions and two starts are demand proxies, not exact-query forecasts.
ERS sources establish revision files, peer-review process, and reporting expectations. The respiratory concern-to-evidence ledger is Manusights analysis.
Frequently asked questions
Begin with the Chief or handling editor's controlling clinical and methodological issues, then answer every reviewer comment. State the action, result, and exact page, line, table, figure, analysis, reporting-checklist, or supplement location.
Current ERS peer-review guidance says revised submissions should include a clean copy, a copy with additions highlighted through tracked changes or another conspicuous method, and a detailed response to reviewer comments. Follow the actual ScholarOne task list and decision letter.
Yes. Identify the clinical or validity question behind the request, explain why the proposed analysis may not answer it, provide the closest valid analysis or evidence, and state the remaining boundary. Direct process concerns to the editor rather than arguing personally with a reviewer.
Expect renewed scrutiny of respiratory importance, design, endpoint and model validity, independent validation where required, reporting-guideline compliance, missingness, uncertainty, clinical interpretation, and agreement among response, clean manuscript, tracked manuscript, tables, figures, and supplements.
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