PEER REVIEW is not perfect, and when it is done sloppily, journals publish research that is flawed. Even when peer review is rigorous, flawed research sometimes gets into the literature. Journals have long relied on peer review, yet concerns about its limitations have often been expressed.1-4Critics point out that some reviewers are unqualified and others, because of personal or professional rivalry, are biased. Editors may even select reviewers on the basis of the reviewers' biases. Furthermore, two or more reviewers may have widely discrepant opinions about a study. Critics also make the point that peer review not only fails to prevent the publication of flawed research but also permits the publication of research that is fraudulent. Some have described peer review as arbitrary, subjective, and secretive. In addition, many critics (including some of the popular press) maintain that it is simply unnecessary and slows the communication of information
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