Peer-review is the system used to assess the quality of a manuscript before it is published. Independent researchers in the relevant research area assess submitted manuscripts for originality, validity and significance to help editors determine whether the manuscript should be published in their journal. EHJMED is a fully peer reviewed journal with a rigorous multi-stage editorial screening and assessment process. We undertake an initial in-house quality check to identify potential issues such as competing interest, compliance with ethical standards for studies involving human and animal subjects, financial disclosures, data availability, and other scientific and policy requirements. Submissions may be returned to authors for changes or clarifications at this stage. Subsequently, manuscripts submitted to EHJMED are assessed by our editors and/or peer reviewers. Editor(s) are expected to obtain a minimum of two peer reviewers for manuscripts reporting primary research or secondary analysis of primary research. It is recognized that in some exceptional circumstances, particularly in niche and emerging fields, it may not be possible to obtain two independent peer reviewers. In such cases, Editor(s) may wish to make a decision to publish based on one peer review report. When making a decision based on one report, Editor(s) are expected to only do so if the peer review report meets the standards set out in the journal. Overall editorial responsibility for the journal is with the Editor with Editorial Board Members acting as section or handling editors