A confusing or uninformative critique is not helpful to either the authors or the editor. If the reviewer disputes a point made by the authors, he or she should provide explicit justification for his or her argument. A critical justification for the strengths and weaknesses of the manuscript depends not only on the clinical expertise in a given subject area and the time available for the review but also on the use of standard guidelines during the revision process.
Without a standard and systematic revision, there is a risk of missing important parts of the manuscript. The consequence can be a superficial review, with no real justification and support for the editor’s decision.