Peer review at a crossroads--a case study.

Prepublication peer review has been the subject of scores of editorials, articles, critiques and letters, and an occasional book. The Sixth International Conference on Peer Review and Biomedical Publication will be held in Vancouver, British Columbia, Canada next year (Rennie et al. 2007). Collectively, these efforts discuss all aspects of the mechanics of the process, its virtues and faults and the reviewers who make it all work. They address specific problems such as fraud, poor quality, plagiarism, uninvolved authors and double publication of the same data. And while misconduct leads to heated discussions off the printed page, the hard facts often surface as relatively gentle words. In a history of peer review and discussion of misconduct, Fox (1994) provides a paragraph that may provoke argument, but may also hit the mark: