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Peer Review in Health Sciences.
  1. Malcolm Consulting, East Grinstead, UK

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Peer Review in Health Sciences. Edited by Fiona Godlee and Tom Jefferson. (Pp 269; £27.00.) BMJ Publishing Group, 1999. ISBN0-7279-1181-3.

Why devote space in the PMJ to this topic? Because, although it is a topic to which most of us have probably given little consideration, it is one we should be concerned about and, as one of the contributors puts it, the system is “broke” and needs fixing. Peer review is a complex system for the appraisal of manuscripts submitted for publication in medical journals, of grant applications for research funding, or of research protocols. It is a supposedly rigorous process that has affected or will affect many of us in clinical practice and all of us in clinical research, basic research, and the development of drugs, gene therapeutics, and medical devices. It is an undeniably important filter to catch inaccuracies and errors and thus help to achieve the approval of documents of high standard. Attention by the original author to points raised in a reviewer's critique can also significantly enhance the quality of the final document.

However, relatively little attention seems to have been paid to examining peer review itself, to making it more efficient and effective, to eliminating bias, and to educating the reviewers so that they can do a better job.

The editors of Peer Review in Health Sciences have put together a broad ranging set of essays from leading health science editors, evidence based medicine experts, and others involved in medical research and funding. The contents provide good coverage of the major topics in peer review, so the editors have done a good job of choosing chapter titles and their authors. The division of the book into part I, “How it is now and what we know,” part II, “How to do it,” and part III, “The future” is helpful.

The chapter by Moher and Jadad on “How to review a manuscript” could be reproduced with great benefit for those who write reviews. The impact of internet based publishing is appreciated by several of the authors, and the special challenge of electronically communicated reviews is addressed in stimulating fashion by the communication development manager of The Medical Journal of Australia and by the editor of the BMJ.

This is not lightweight reading. It is a scholarly work. It is enlivened and enriched by Martyn's chapter reporting the mythical conversation between the editor of a scientific journal and the Athenian philosopher Socrates—a conversation which brings out many of the peculiarities and imperfections of the present system.

The book is likely to be of great value to professional biomedical editors and their staff, and to academics concerned with devising a better process for evaluating papers and proposals. It will also be of considerable help to those editing the “small journals” in setting policy and putting procedures in place for efficient peer review of manuscripts received. Beyond this, I doubt that, in its essay-type format, it will get much attention from ordinary clinicians and researchers. In a way this is a pity, for there is no doubt that peer review could be done better—and this to the advantage of journals, authors, grant awarding bodies, and so on. Perhaps for their next excursion into this field, Godlee and Jefferson could produce a condensed volume with more attractive contemporary design and layout.

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