If you watch the medical journals, you may have noticed that the June 5, 2002 issue of JAMA focused largely on editorial peer review. And, if you're like me - a firm believer that double-blind peer review is the moral high ground, indeed, the central process of science, you approached the issue with a big dose of skepticism - I mean, "What is the question?" Is there not firm evidence that scientific knowledge is honed by cyclical rounds of discovery and refutation, resting on the bedrock of peer review? Are not the most highly rated journals judged as such in large part because of peer review? Is not peer review the essence of democratization of the editorial process and the key counterpoint to charges of bias in editorial decisions? Yet, as I put these questions to paper, I know that even the most time-honored practices need a periodic dusting-off, with occasional airing of assumptions.

The JAMA issue does some heavy dusting. First, there is little empirical research on peer review, and studies that have been done are so varied in focus and design that synthesis of findings is difficult. One effort at synthesis led to the conclusion that "Editorial peer review, although widely used, is largely untested and its effects are uncertain" (Jefferson, Alderson, Wager, & Davidoff, 2002, pg. 2784). In the editorial, Deputy Editor Drummond Rennie comments that in this issue "We publish studies that fail to show any dramatic effect, let alone improvement, brought about by editorial peer review" (Rennie, 2002, p. 2759). But the point is also made that research is scant, designs generally weak, and, according to Dr. Rennie, we may be using the wrong tools to study the wrong factors (Rennie). The weight of long-standing opinion favors peer review, so unless and until solid evidence proves otherwise, this may be one sacred cow worth keeping.

Meanwhile, at Nursing Research, we pledge to authors and readers alike unflagging effort to achieve rigorous, fair, constructive, and timely peer reviews. We continually refine and improve editorial processes. For example, this past spring, Nursing Research Editor Molly Dougherty initiated a process for additional statistical review of all manuscripts that contain advanced statistics as a safeguard to reviewer judgment on sophisticated quantitative analyses.

I am likely to be the world's last holdout for double-blind peer review, but I must admit the JAMA issue challenged my assumptions. Let me turn the challenge to you, readers and authors of Nursing Research. What opinions do you hold about peer review? Is this a case for evidence-based research, or can you live with the sacred cow? Let us at Nursing Research know your views.

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