The international congress on peer review in biomedical publication.

"Peer review" has a variety of meanings for physicians. All physicians are accustomed to surveillance of their use of hospital beds or of the records they keep about the patients in those beds by utilization review and quality assurance committees made up of their peers. Physicians face yet more peer review when they double as investigators, put their proposals before institutional review boards, and have their grant applications assessed by expert panels of their peers. Finally, the product of all this—the manuscript that embodies their scientific brainchild and carries their hopes of fame and promotion—is subjected by journal editors to yet another round of peer review. Understandably, it is this last version that tends to interest journal editors the most. However, the workings of the editorial peer review system are of vital concern to every scientist and ultimately to all physicians and patients because all the important advances in science