Peer review – Potpourri

Peer review – Potpourri – medical journals

Harold Orlans

Peer review in biomedical publications is once again examined in the June 5 issue of the Journal of the American Medical Association. The “appalling standards” of these publications were not improved by peer review, JAMA editor Drummond Rennie declared in 1986: “There seems to be no study too fragmented, no hypothesis too trivial,…no design too warped, no methodology too bungled, no presentation of results too inaccurate, too obscure, and too contradictory,…no conclusions too trifling or too unjustified…for a paper to end up in print.” Sixteen years later, he finds all these problems persist “in abundance.”

Peer review thrives, Rennie says, because editors want expert advice on subjects they do not know well and they want “to spread…responsibility for unfavorable decisions.” Peer review democratizes the editorial process and counters “the impression that…[publication] decisions are arbitrary.”

Much medical research is of poor quality because it is conducted by clinicians with little training in research methods, Douglas Altman writes. Institutional review boards screen projects to protect human subjects, not to improve their research design. Most research is published in secondary journals with weaker standards; even major journals often do not scrutinize research methods.

Concealing the identity of reviewers is unfair if the author is identified, Fiona Godlee contends; and when the author is not identified, many reviewers surmise it. She favors open review, now adopted by the British Medical Journal and BioMed Central journals. Some potential reviewers decline, but naming them gives them credit and holds them accountable for their work. Editors also become accountable “and can no longer hide behind the spuriously heightened authority” of unknown reviewers. (See Change, Nov./Dec. 1998, for an earlier JAMA discussion of peer review.)

Harold Orlans has conducted many studies of higher education and research policy for private and government bodies in Washington, DC. He retains the copyright for this column.

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