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Peer review in health sciences.

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    Peer review in health sciences. F Godlee, T Jefferson, editors. (Pp 271; £30). London: BMJ Books, 1999. ISBN 0-7279-1181-3.

    Reviewing a book on peer review is not without some degree of boldness, even more when one knows about some of the limitations of peer review. But it is precisely the increasing effort to “guard the guardians” that is largely summarised in this book, grouped under three main titles: how it is now and what we know, how to do it, and the future. Godlee and Jefferson, with the contribution of 28 other prominent editors of biomedical journals, researchers in the area of peer review and funders, succeed in pulling together the not always consistent evidence on the role of peer review. The authors cover a broad variety of aspects, ranging from the state of the evidence about peer review, not only applied to editorial work but also to grant applications, including its effectiveness, as well as the biases that have been investigated, to innovative topics such as peer review and the pharmaceutical industry, and its role in small journals and non-English language journals. The chapters in part 2 are particularly useful for editors, reviewers and authors as they cover systematic approaches to the implementation of peer review systems, including statistical, economical and ethical aspects. The final part deals with some of the hottest issues in peer review, such as the role of internet and the use of systematic reviews as ways of improving the overall quality of the system, with two informative appendices on the so called Vancouver Group and the World Association of Medical Editors.

    The main message of this book is twofold: the good news is that it shows that peer review, as a procedure to select and improve the best scientific evidence, is here to stay, although most probably in a more open and flexible manner, thanks to improvements in communications technology, most notably the internet. The bad news is that, as it is based on human judgement, a greater vigilance needs to be put on factors that may bias such judgement—the evidence is not always clear or, simply, is lacking—, such as author and reviewer identification, gender, seniority, and language, among many others. Although some readers—including myself—may not fully agree with D Rennie's statement that “peer review is democracy” (page 11)—where are the voters and their votes ?—, but, rather, would prefer to consider it as an “illustrated” screening test that—with dissemination and time—will turn into a “democratic” diagnostic test, the best news is that this book shows that, since Stephen Lock's seminal workA difficult balance: editorial peer review in medicine almost 15 years ago, the scientific community has been moving towards a more “evidence-based” role of peer review, providing a wealth of information that is nicely compiled and commented on in this book.

    Editors, reviewers, funders and health science researchers at large, together with science sociologists and media experts should definitely use this book as a bedside tool, while awaiting the new evidence that will be presented at the incoming Fourth Congress on Peer Review in Biomedical Sciences in September 2001.