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Peer review was first used for biomedical publications by the Royal Societies of London and Edinburgh in the 18th century, but it evolved haphazardly and was not used consistently until after World War II. The essence of peer review consists of asking experts “How important and how good is this paper, and how can it be improved?” (see , Assessment Criteria). The use of expert consultants to advise editors about the selection and improvement of papers has become a standard quality-assessment measure in biomedical publication. Yet the process and effectiveness of peer review have come under scientific scrutiny only since Less