Scientists at the US Centers for Disease Control and Prevention (CDC) publish an average of 50 peer-reviewed articles per week,1 in addition to numerous other widely disseminated materials. Review of scientific content at CDC is a key process by which the agency maintains high scientific standards. Formal CDC review processes, referred to as clearance, recently have come under scrutiny2 but have been upheld as crucial to maintaining the agency’s scientific reputation.3 | To help this process, particularly for short-term midcareer fellowships at CDC beginning in 2012, a review framework was developed empirically following the review of hundreds of scientific articles and incorporated into the curriculum. To facilitate its assimilation, the framework was captured in the mnemonic CLEAR, standing for Clarity, Logic, Ethics, Agency, and Relevance. This novel approach provides insight into the scientific review process at CDC, but also could be applied more broadly to improve the quality of public health science. | Our framework includes a three-level comment structure (Table 1) that prioritizes comments for author response. The most important distinction is between comments that require action by the author to correct errors of fact or policy misstatements (level 1) and comments intended to improve clarity or editorial changes (levels 2 and 3), for which the author has some discretion in responding. Use of the three-level comment system allows reviewers to refine their reviewing style and focus on communicating level 1 issues to the author.

We analyzed a process for the annual selection of a Federal agency's best peer-reviewed, scientific papers with the goal to develop a relatively simple method that would use publicly available data to assess the presence of factors, other than scientific excellence and merit, in an award-making process that is to recognize scientific excellence and merit. Our specific goals were (a) to determine if journal, disease category, or major paper topics affected the scientific-review outcome by (b) developing design and analytic approaches to detect potential bias in the scientific review process. While indeed journal, disease category, and major paper topics were unrelated to winning, our methodology was sensitive enough to detect differences between the ranks of journals for winners and non-winners.

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (International Association for the Study of Pain, IASP) [1]. Pain is the most frequent local adverse event following immunization (AEFI) [2], [3], [4], [5]. It results from the stimulation of nociceptive sensory neurons at the time of vaccine administration or inflammatory process in the damaged tissue afterward. | To date, there has not been a commonly accepted, standardized definition and related assessment of immunization site pain as an AEFI [6], [7], [8], [9], [10], [11], [12], [13], [14], [15]. This hinders comparability and uniform reporting of pain across study settings or surveillance systems. Establishing criteria for assessing immunization site pain during and following immunization is important for individuals collecting, analyzing, presenting and/or communicating data on immunization pain as AEFIs.

The quadrivalent human papillomavirus (HPV) vaccine was recommended in 2006 for routine vaccination of 11 or 12-year-old girls, with catchup through age 26 years, for the prevention of genital HPV-related diseases. The Vaccine Adverse Event Reporting System (VAERS) is a national spontaneous surveillance system of adverse events following vaccination in the United States. The objective of this study was to identify and review VAERS reports of invasive and in situ cervical cancer in women immunized with the quadrivalent HPV vaccine. A VAERS database search was performed to identify such cases reported in the United States from January 1, 2006, through April 9, 2009. Medical Dictionary for Regulatory Activities (MedDRA) search terms used were "cervix carcinoma," "cervix carcinoma stage 0," "cervix carcinoma stage III," "carcinoma in situ," and "cervical dysplasia." Case inclusion required a report to contain a clear statement of a cervical carcinoma or carcinoma in situ diagnosis on any screening or diagnostic test after at least one dose of the HPV vaccine. All reports were reviewed by two investigators. Four VAERS reports for MedDRA term "cervix carcinoma," one for "cervix carcinoma stage 0," none for "cervix carcinoma stage III," three for "carcinoma in situ," and 53 for "cervical dysplasia" were identified. Of these, three cases of carcinoma in situ and one case of microinvasive cervical cancer met study inclusion criteria. Cases of cervical cancer and precancers are not unexpected in vaccinated women. Cervical cancer screening continues to be important, even for women who have received the HPV vaccine.