BACKGROUND: Peer review is fundamental to quality scientific communication, yet reviewer behavior remain underexplored. The impact of emerging large language models (LLMs) on peer review practices is similarly understudied. We aim to characterize behavioral traits of Chinese medical journal peer reviewers and identify evidence-based recommendations to optimize review willingness, efficiency and quality. METHODS: An online questionnaire survey was distributed to 532 medical researchers in China through the Wenjuanxing platform in February 2025. The questionnaire (38 questions) assessed four domains: basic information, peer review model and efficiency, peer review quality, and reviewer motivations. Statistical analysis included descriptive statistics, Spearman correlations, Kruskal-Wallis tests, etc. RESULTS: The response rate was 51.9% (276/532, 95% confidence interval (CI): 47.6%-56.1%). The valid questionnaires were 275: 91.6% male; 64.7% of 41-55 years old. Double-blind was supported by 80.7% of respondents, exceeding international prevalence. Reviewers exhibited social desirability bias in self-reported review turnaround time: 92.7% reported completing reviews within 15 d, whereas the actual recent 3-year administrative data was only 69.7% (P 0.05). Regarding motivation, recognition and acknowledgment ranked first (74.9%), followed uniquely in China by requests for priority handling of their submissions (64.4%) and recommended submissions (63.6%), reflecting publication-pressure contexts. CONCLUSION: Misalignments exist between reviewer expectations and editorial capacity regarding review efficiency. System-level improvements in manuscript handling system and implementation of standardized review templates and training may improve review quality. Formal recognition of review contributions and fast handling of reviewer's submissions could enhance motivation while addressing unique pressures in Chinese academic journals.
Liu et al. (Tue,) studied this question.
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