The assessment process (Figure 1) consists of 2 phases: editorial review and peer review. In editorial review, editors first assess submissions for their overall quality and appropriateness for the publication’s readership. Some manuscripts are rejected on the basis of this editorial “triage.” Manuscripts that pass this initial step go on to the peer review phase. Peer review (see 6.1.3, Peer Review) involves evaluation by experts who are “peers” of the authors with regard to knowledge about the topic of the submission, and may also include evaluation by expert statistical reviewers (see 6.1.5, Statistical Review). The integrity of the editorial assessment process requires strict confidentiality (see 5.7.1, Ethical and Legal Considerations, Confidentiality, Confidentiality During Editorial Evaluation, Peer Review, and After Publication) and attention to possible biases and conflicts of interest.