$npx -y skills add Aperivue/medsci-skills --skill self-reviewPre-submission self-review for the user's own manuscripts, applying a reviewer perspective. Systematic check across 10 categories with research-type branching. Outputs Anticipated Major/Minor Comments with severity framing and optional R0 numbering for /revise pipeline integratio
| 1 | # Self-Review Skill |
| 2 | |
| 3 | You are helping a medical researcher check their own manuscript before journal submission. |
| 4 | The goal is to anticipate reviewer comments by applying the same critical lens used in |
| 5 | peer review across medical journals. |
| 6 | |
| 7 | This is NOT about writing a review. It's about producing an actionable list of |
| 8 | anticipated reviewer comments with specific fix suggestions, so the manuscript can be |
| 9 | strengthened before reviewers ever see it. |
| 10 | |
| 11 | ## Optional Flags |
| 12 | |
| 13 | - `--fix`: After generating the review report, automatically apply fixes for all issues where `fixable_by_ai` is true. Edits the manuscript in place, then reports a diff summary. Does NOT fix issues marked `fixable_by_ai: false` (e.g., missing data, design flaws). Maximum 2 fix-and-re-review iterations. |
| 14 | - `--json`: Output the structured JSON block (see Phase 3c below) in addition to the markdown report. Default when called from `/write-paper` Phase 7. |
| 15 | - `--panel`: Run the multi-agent panel review (Phase 2.6) — several domain-expert reviewers in parallel plus an editor synthesis — instead of the single-pass review. Opt-in and **off by default** (a panel spawns N reviewer agents + 1 editor, so it costs several times more tokens). Reserve it for a high-stakes pre-submission final pass on a top-tier target. Do **not** combine with `--fix`: a panel diagnoses and prioritizes; run `--fix` as a separate follow-up pass once the author has triaged the panel's findings. |
| 16 | |
| 17 | ## Severity Framing |
| 18 | |
| 19 | When flagging issues, classify severity: |
| 20 | - **Fatal**: Fundamental design flaw that cannot be fixed with existing data (e.g., data leakage |
| 21 | that invalidates all results, absence of any reference standard, label-feature circularity). |
| 22 | The manuscript likely needs redesign. Submission would likely result in Reject. |
| 23 | - **Fixable**: Significant but addressable with existing data (e.g., missing calibration analysis, |
| 24 | unclear exclusion criteria, absent CIs, incomplete reporting). These are the most actionable findings. |
| 25 | |
| 26 | Most issues are Fixable. Reserve Fatal for true design-level problems. |
| 27 | |
| 28 | ## Two Objectives: the Floor and the Ceiling |
| 29 | |
| 30 | A submission-ready manuscript optimizes **two** things at once, and most of this skill (and |
| 31 | the gate stack behind it) only optimizes the first: |
| 32 | |
| 33 | - **Floor — minimize rejection-for-cause.** Fabricated citations, numbers that do not |
| 34 | reconcile, overclaims, missing checklist items, leakage. Categories A–K and the |
| 35 | deterministic gates (Phases 2.5–2.5f) do this, and they are right to. Many of them raise the |
| 36 | floor by **adding** material: a hedge, a caveat, a disclosure, an audit trail, a checklist row. |
| 37 | - **Ceiling — maximize editorial-championing.** Will a handling editor read a *confident |
| 38 | narrative* (problem → design → result → meaning) and want to send it out, or a *defensive |
| 39 | audit* and bounce it? Nothing in the floor stack pushes here, and several floor gates push the |
| 40 | other way. Iterated, a manuscript over-hardens: every individual gate finding is correct, yet |
| 41 | the **accumulated** product reads as a rebuttal letter — over-hedged, audit-trail-heavy, |
| 42 | Abstract buried under caveats, the strongest sensitivity result hidden in Limitations, too long. |
| 43 | |
| 44 | These objectives can conflict, so the order matters: **the floor gates run first and secure |
| 45 | accuracy; then the ceiling pass (category L / Phase 2.5g) reads the accurate manuscript as a |
| 46 | whole and recommends SUBTRACTION — REMOVE, MOVE, or TIGHTEN — so the same content is read |
| 47 | confidently.** The ceiling pass is advisory and never blocks; it cannot relax a floor gate. |
| 48 | Without it, repeated self-review monotonically over-defends. Surface the ceiling findings as |
| 49 | their own first-class output (Phase 3), not folded silently into the "add this" comments. |
| 50 | |
| 51 | ## Workflow |
| 52 | |
| 53 | ### Phase 1: Intake |
| 54 | |
| 55 | 1. Get the manuscript -- PDF, Word doc, or pasted text. |
| 56 | 2. Ask the user: |
| 57 | - Target journal? (affects reporting standards and scope expectations) |
| 58 | - Manuscript type? (original research / review / technical note / letter / meta-analysis / case report) |
| 59 | - Anything they're already worried about? |
| 60 | - **Review depth?** The default is a single-pass review. For a high-stakes pre-submission final pass, a multi-agent **panel** (`--panel`, Phase 2.6) is available — several domain-expert reviewers run independently, then an editor consolidates them (more thorough, but it spawns several agents so it costs several times more tokens). On an interactive run, surface this option **once** in one line and offer it; then proceed with the single-pass review unless the |