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.3-5 The essence of peer review consists of asking experts “How important and how good is this paper, and how can it be improved?” (see 6.1.2, 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 the 1980s.5-9
Experts in the topic of a paper are needed to assess importance and quality. However, peer review has been criticized for its reliance on human judgments that are subject to biases and conflicts of interest, and there have been few empirical documentations of the efficacy of the peer review process.8-13 Empirical research on editorial peer review has begun to address some of the deficiencies in knowledge about it. See the March 9, 1990; July 13, 1994; July 15, 1998; and June 5, 2002, issues of JAMA for articles from the first 4 International Congresses on Peer Review in Biomedical Publication.
Peer reviewers should assess all components of a manuscript, including online-only supplementary material, and are usually asked to provide comments for the authors regarding the strengths and weaknesses of a paper, including suggestions for improvement. Reviewers also make recommendations to the editor, usually on a form provided by the journal (Figure 2), but specific criticisms and suggestions are much more valuable than summary judgments. It is remarkable that the peer review process depends largely on the efforts of peer reviewers who donate their time—sometimes large amounts of it14—in the interest of the quality of publications in their field. The speed and efficiency of the peer review process has been improved by the availability of electronic or Internet-based peer review systems. Using such systems, which are often combined with electronic or Internet-based manuscript submission, peer reviewers can be queried regarding their availability, receive or download a copy of the submission for review, and send their review and recommendations electronically, eliminating the time previously required for telephone contacts and mailing or faxing of paper copies.