Cumhuriyet Medical Journal (CMJ) is committed to the principles of quality, impartiality, transparency, and ethical responsibility in scholarly publishing. Manuscripts submitted to the journal are evaluated by independent experts with regard to their scientific validity, methodological rigor, originality, ethical compliance, and contribution to the aims and scope of the journal.

CMJ operates an independent and impartial double-blind peer review system. Under this model, the identities and institutional affiliations of the authors are concealed from reviewers, while the identities of reviewers are not disclosed to authors. All communication throughout the peer review process is managed by the Editorial Office through the online manuscript submission and management system.

This policy applies to original research articles, systematic reviews, meta-analyses, narrative reviews, case reports, short reports, and other scientific manuscript types considered by the journal, excluding editorials.

1. Submission and Technical Screening

All submitted manuscripts are initially reviewed by the Editorial Office for technical and administrative compliance. At this stage, the following elements are assessed:

• Compliance with the journal’s aims and scope;
• Suitability of the manuscript type, formatting, and adherence to the Instructions for Authors;
• Appropriate anonymization of the main manuscript file for double-blind peer review;
• Completeness of the title page, author information, institutional affiliations, corresponding author details, and ORCID iDs;
• Reporting of ethics committee approval, informed consent from patients and/or participants, and any other required permissions;
• Registration information for clinical trials, where applicable;
• Completeness of declarations regarding conflicts of interest, funding, author contributions, and acknowledgments;
• Compliance with the relevant reporting guideline;
• Similarity screening and assessment of potential research or publication ethics concerns;
• General quality of language, presentation, and scientific reporting.

Submissions with missing documents, inadequate anonymization, or substantial non-compliance with the journal’s submission requirements may be returned to the authors for correction before further consideration.

Manuscripts that fall outside the journal’s scope, raise fundamental ethical concerns, contain serious methodological deficiencies, or lack sufficient scientific contribution may be rejected without external peer review.

An editorial screening decision does not constitute a definitive judgment regarding the scientific merit of a manuscript; rather, it determines whether the manuscript is suitable for external peer review.

2. Evaluation by the Editor-in-Chief, Editors, and Section Editors

Manuscripts that pass the initial technical screening are forwarded to the Editor-in-Chief. The Editor-in-Chief may assess the manuscript directly or assign it to an appropriate Editor according to the subject area and editorial priorities of the journal. Where appropriate, the assigned Editor may subsequently allocate the manuscript to a Section Editor.

The Editor or Section Editor evaluates:

• The scientific and clinical relevance of the manuscript;
• The clarity of the research question;
• The appropriateness of the study design;
• The adequacy of ethical requirements;
• The suitability of the manuscript for external peer review.

The Editor or Section Editor may recommend that the manuscript be sent for peer review, rejected at the editorial level, returned to the authors for additional documentation, or referred for statistical or methodological evaluation when necessary.

3. Double-Blind Peer Review and Anonymity

CMJ uses a double-blind peer review process. The identities of authors and reviewers are not disclosed to one another.

Authors are responsible for removing information that could directly or indirectly reveal their identity from the anonymized manuscript file. The following information should not appear in the main manuscript submitted for peer review:

• Author names and institutional affiliations;
• Acknowledgments;
• Statements that directly identify the institution where the study was conducted;
• Self-citations that reveal the identity of the authors;
• Author-identifying information in file properties;
• Details that explicitly reveal the name of the ethics committee or institution.

Where information relating to ethics approval, funding, clinical trial registration, or institutional affiliation is required for editorial assessment, it may be reviewed separately through the submission system. Following acceptance, these details will be included in full in the final published version of the article.

4. Reviewer Selection and Assignment

Each original research article and other scientific manuscript types considered appropriate for external peer review are evaluated by at least two independent reviewers with relevant expertise.

The following criteria are considered in reviewer selection:

• Expertise relevant to the topic, study design, and methodology of the manuscript;
• Current research experience and publication record in the relevant field;
• Academic and professional qualifications;
• Previous peer review performance;
• Ability to provide timely and constructive feedback;
• Absence of competing interests;
• Institutional and geographical diversity.

Whenever possible, reviewers are selected from institutions other than those of the authors and should not have recent collaborative publications, project partnerships, consultancy relationships, or competitive relationships with the authors.

Reviewer selection is conducted solely under the authority and responsibility of the editorial team. Where feasible, institutional email addresses, ORCID iDs, and other reliable academic identity-verification resources are considered when inviting reviewers.

5. Responsibilities of Reviewers

Reviewers are expected to assess assigned manuscripts objectively, constructively, confidentially, and on the basis of scientific evidence.

Reviewers are expected to:

• Consider their expertise, availability, and potential competing interests before accepting an invitation to review;
• Inform the Editor and decline the invitation if a competing interest exists because of competition, collaboration, personal relationships, financial ties, or institutional associations;
• Evaluate manuscripts solely on scientific merit;
• Avoid personal, derogatory, discriminatory, or otherwise inappropriate comments about the authors;
• Present comments clearly, with appropriate justification and, where relevant, supporting references;
• Maintain the confidentiality of all information, data, ideas, and findings obtained during the review process;
• Refrain from using unpublished manuscript content for personal research or other benefit;
• Not share the manuscript with others or delegate the review task without prior authorization from the Editor;
• Report any suspected plagiarism, data fabrication, data falsification, image manipulation, duplicate publication, lack of ethics approval, or other potential research or publication ethics concerns;
• Inform the Editorial Office promptly if they are unable to complete the review within the requested timeframe.

Reviewer reports should not consist solely of a recommendation to accept or reject a manuscript. They should provide detailed, constructive, and well-reasoned comments on the scientific quality of the work.

6. Use of Artificial Intelligence Tools by Reviewers

Manuscripts under peer review are confidential documents. Reviewers must not upload manuscript text, supplementary files, tables, figures, data, or any other information related to the peer review process into publicly accessible generative artificial intelligence tools or tools that do not provide adequate confidentiality safeguards.

Reviewers should not use generative artificial intelligence tools to assess the scientific validity, methodology, statistical analyses, or conclusions of a manuscript. The scientific content of the peer review report must be based on the reviewer’s own expertise and independent judgment.

Where the limited use of a secure, confidentiality-protected tool has been explicitly authorized by the Editorial Office, reviewers must transparently disclose such use to the Editor.

7. Reviewer Assessment Criteria

Reviewers are asked to evaluate manuscripts using a structured review form that addresses the following domains:

• Clarity of the research question and/or hypotheses;
• Significance of the theoretical, methodological, scientific, or clinical contribution;
• Adequacy of the research design;
• Appropriateness of statistical and other analyses;
• Adequacy of the interpretation of research findings;
• Critical appraisal of the study design and findings;
• Quality of the discussion of theoretical and/or practical implications;
• Clarity of the conclusions and their consistency with the findings;
• Adequacy and currency of the literature review;
• Quality of the writing style and scientific language;
• Clarity and adequacy of tables, figures, and other visual materials;
• Appropriate reporting of the study limitations.

Reviewers are also asked to provide constructive and reasoned comments for the authors, as well as confidential comments intended only for the Editor. At the end of the review, reviewers are asked to recommend one of the following decisions:

• Accept;
• Minor Revision;
• Major Revision;
• Reject and Resubmit;
• Reject.

The final publication decision is made by the Editor after consideration of the reviewer reports, editorial assessment, and, where necessary, statistical or methodological expert opinion.

Reviewers are also expected to comment on, or notify the Editor of concerns regarding:

• Potential conflicts of interest;
• Suspected research or publication ethics violations;
• Plagiarism, duplicate publication, data manipulation, or image manipulation;
• Adequacy of ethics committee approval and informed consent procedures;
• Compliance with reporting guidelines appropriate to the study design;
• Appropriate consideration of sex and gender in the design, analysis, reporting, and interpretation of the study.

8. Statistical and Methodological Evaluation

The Editor-in-Chief, Editor, or Section Editor may refer a manuscript to an independent statistical editor, methodological expert, or additional reviewer when necessary.

Statistical evaluation may be requested particularly for manuscripts involving:

• Complex study designs;
• Multivariable analyses;
• Management of missing data;
• Repeated-measures analyses;
• Survival analyses;
• Diagnostic accuracy studies;
• Sample size and power calculations;
• Meta-analyses;
• Large datasets or advanced statistical modelling methods.

The opinion of the statistical editor forms part of the overall editorial evaluation of the manuscript.

9. Editorial Decision-Making Process

The Section Editor considers the reviewer reports, any statistical or methodological opinions, and their own assessment before making a recommendation to the Editor.

Editorial decisions may include:

• Acceptance;
• Minor Revision;
• Major Revision;
• Rejection with an invitation to resubmit;
• Rejection.

Where reviewer reports differ substantially, serious methodological or statistical concerns are identified, or the Editor considers further evaluation necessary, the manuscript may be sent to a third or additional reviewer.

Although reviewer recommendations are an important component of the decision-making process, the final decision is not based solely on the numerical balance of reviewer recommendations. Editorial decisions are made by the Editor and, where necessary, the Editorial Board after considering the scientific quality of the manuscript, ethical compliance, relevance to the journal’s scope, editorial priorities, and the reasoned content of reviewer reports.

A serious ethical, methodological, or scientific concern raised by a single reviewer or Editor may result in rejection of the manuscript.

10. Revision Process

For manuscripts requiring revision, authors are requested to submit:

• A detailed point-by-point response letter addressing all reviewer and editorial comments;
• A revised manuscript with all changes clearly indicated;
• Updated declarations relating to ethics approval, registration, funding, conflicts of interest, or data sharing, where applicable.

Unless otherwise specified, revised manuscripts should be resubmitted within 15 days. Requests for an extension must be submitted to the Editorial Office, with justification, before the revision deadline.

Depending on the nature and extent of the revision, the revised manuscript may be reassessed by the Editor, returned to the original reviewers, sent to new reviewers, or referred to a statistical editor.

A manuscript may be rejected if the major concerns raised by reviewers or Editors have not been adequately addressed.

Manuscripts not resubmitted within the specified period may be considered withdrawn or removed from further consideration following editorial assessment.

11. Manuscripts Submitted by Editors and Editorial Board Members

Editors, Section Editors, Editorial Board members, and journal staff who are authors of a submitted manuscript are excluded from all editorial decisions concerning their own work.

For such manuscripts:

• The manuscript is assigned to an independent Editor;
• The relevant Editor or Editorial Board member does not have access to reviewer selection, reviewer reports, or the editorial decision-making process;
• At least two independent external reviewers are appointed;
• The final decision is made by an Editor or Editorial Board member with no competing interest.

Invited editorials are subject to evaluation by the Editor-in-Chief.

12. Suspected Ethical Misconduct and Peer Review Irregularities

If concerns arise at any stage of the editorial or peer review process regarding plagiarism, data fabrication, data falsification, duplicate publication, inappropriate authorship, lack of ethics approval, fraudulent reviewer suggestions, misuse of reviewer identity, or any other research or publication ethics issue, the Editorial Office will initiate an appropriate investigation.

CMJ evaluates allegations of ethical misconduct in accordance with the principles of the Committee on Publication Ethics (COPE), the International Committee of Medical Journal Editors (ICMJE) Recommendations, and other relevant international publication ethics standards.

Breaches of reviewer confidentiality, failure to disclose competing interests, inappropriate citation requests, personal or abusive comments in reviewer reports, unauthorized sharing of manuscript content, or fraudulent peer review practices are considered serious forms of misconduct. Where necessary, the reviewer’s assignment may be terminated and editorial records may be reviewed.

13. Appeals and Complaints

Authors may submit a scientifically reasoned appeal against an editorial decision within 30 days of the decision date.

An appeal should include:

• The manuscript title and submission number;
• The decision being appealed;
• A clear scientific rationale for the appeal;
• Specific explanations addressing reviewer or editorial comments.

Appeals are assessed, whenever possible, by an Editor or Editorial Board member who was not directly involved in the original decision. Additional peer review may be sought where appropriate.

Submission of an appeal does not guarantee that the manuscript will be reconsidered or that the original decision will be changed. The decision reached following review of the appeal is final.

14. Confidentiality and Record Retention

Manuscript files, reviewer reports, editorial decisions, revision correspondence, and all related records are treated as confidential.

Reviewer reports, editorial decisions, and records of the manuscript assessment process are securely archived within the submission system to support the investigation of publication ethics concerns and the evaluation of potential appeals. These records are retained for at least five years in accordance with applicable regulations and the requirements of relevant indexing bodies.

Reviewer identities will not be disclosed to authors or third parties, except where legally required or in the context of a serious research or publication ethics investigation.

15. Target Timelines

CMJ aims to maintain an efficient and predictable editorial process. The following timeframes are targets and may vary depending on reviewer availability, manuscript complexity, the need for additional expert assessment, ethical review, or the extent of revision required:

• Technical screening: 7–10 days;
• Initial editorial decision: 10–14 days;
• Peer review: 21 days;
• Revision period for authors: 15 days;
• Editorial decision after revision: 14–21 days.

CMJ does not guarantee acceptance without peer review or a final publication decision within a specified timeframe.