Abstract
Papers p 23 Education and debate p 44 The BMJ has until now used a closed system of peer review, where the authors do not know who has reviewed their papers. The reviewers do, however, know the names of the authors. Most medical journals use the same system, but it's based on custom not evidence. Now we plan to let authors know the identity of reviewers. Soon we are likely to open up the whole system so that anybody interested can see the whole process on the world wide web. The change is based on evidence and an ethical argument. Peer review is at the heart of the scientific process yet was until recently largely unexamined. Now we begin to have a body of evidence on peer review (www.wame.org), and it illustrates many defects. Peer review is slow, expensive, profligate of academic time, highly subjective, prone to bias, easily abused, poor at detecting gross defects, and almost useless for detecting fraud. Evidence to support all these statements can be found in a book by Stephen …