The peer review process (aka peer reviewology)

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In his editorial introducing the publication in the Journal of the American Medical Association (JAMA) of conference papers from the Fourth International Congress on Peer Review in Biomedical Publications, Drummond Rennie (2002) stated, “Indeed, if the entire peer review system did not exist but were now to be proposed as a new invention, it would be hard to convince editors looking at the evidence to go through the trouble and expense” (p 2759). What, then, is peer review, and why do scientific editors continue to rely so heavily on a process for which little, if any, supportive empirical evidence exists?