Evidence map›Paper›PMID 40390570›Full record

ArticleMedical education2026

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

Lara Varpio, Linda Snell, Jason R Frank, Jonathan Sherbino

Abstract read
In one paragraph

Article in Medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Lara VarpioDepartment of Pediatrics, Perelman School of Medicine, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-1412-4341
Linda SnellDepartment of Medicine and Institute for Health Sciences Education, McGill University, Montreal, Quebec, Canada.ORCID 0000-0002-1686-5207
Jason R FrankDepartment of Emergency Medicine, Centre for Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada.ORCID 0000-0002-6076-0146
Jonathan SherbinoDepartment of Medicine, McMaster Education Research, Innovation and Theory (MERIT) Centre, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-0344-8057

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

PainPeer Review, ResearchHumans

Identifiers

PMID40390570
PMCPMC12717499

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.