***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To determine the characteristics of  good peer review ers .  Design : Cross-sectional analysis of data gathered during a r and omized controlled trial . Setting : The Journal of General Internal Medicine . Participants : 226 review ers of 131 consecutively su bmi tted manuscripts of original research . 201 ( 91 % ) completed the review and su bmi tted a curriculum vitae . Measurements and main results : The quality of each review was judged on a scale from 1 to 5 by an editor who was blinded to the identity of the review er . Review er characteristics were taken from the curricula vitae . 86 of the 201 review ers ( 43 % ) produced good review s ( a grade of 4 or 5 ) . Using logistic regression , the authors found that when a review er was less than 40 years old , from a top academic institution , well known to the editor choosing the review er , and blinded to the identity of the manuscript ’s authors , the probability that he or she would produce a good review was 87 % , whereas a review er without any of these characteristics had a 7 % probability of producing a good review . Other characteristics that were significant only on bivariate analysis included previous clinical research training , additional postgraduate degrees , and more time spent on the review . There was a negative but statistically nonsignificant association between academic rank and review quality : 37 % of full professors , 39 % of associate professors , and 51 % of assistant professors or fellows produced good review s ( p=0.11 ) . Conclusions : Good peer review  ers for this journal tended to be young , from strong academic institutions , well known to the editors , and blinded to the identity of the manuscript ’s authors OBJECTIVE To study whether review ers aware of author identity are biased in favor of authors with more previous publications . DESIGN R and omized controlled trial . SETTING Editorial office of the Journal of Developmental and Behavioral Pediatrics . PARTICIPANTS Two " blinded " and two " nonblinded " review ers assigned to 57 consecutive manuscripts su bmi tted between September 1991 and March 1992 . OUTCOME MEASURES Spearman rank correlation coefficients were used to compare the sum of rating scores of 1 to 5 ( 1 , accept ; 5 , reject ) given by the two blinded review ers , the two nonblinded review ers , and the editors to the number of articles published previously by the first and senior authors ( as determined from requested curricula vitae ) . Blinded review ers were sent a question naire asking whether they could determine the identity of the authors , how they knew , and whether they thought binding changed the quality or difficulty of their review . RESULTS The Wilcoxon Sign Rank Test disclosed no differences between blinded and nonblinded scores . The number of previous articles by the senior author was significantly correlated ( P < .01 ) with blinded scores ( r = -.45 ) and editors ' decisions ( r = -.45 ) , but not with nonblinded scores ; the number of articles by the first author was correlated ( P < .05 ) with editors ' decisions ( r = -.35 ) but not with blinded or nonblinded scores . Fifty ( 46 % ) of 108 blinded review ers correctly guessed the identity of the authors , mostly from self-references and knowledge of the work ; 86 % believed blinding did not change the quality of their review , and 73 % believed it did not change the difficulty of performing a review . CONCLUSIONS Blinded review ers and editors in this study , but not nonblinded review ers , gave better scores to authors with more previous articles . These results suggest that blinded review ers may provide more unbiased review s and that nonblinded review ers may be affected by various types of bias OBJECTIVE To study the association between referee characteristics and their manuscript assessment s , the influence of manuscript language on referees ' judgments , and the usefulness , quality , and extent of referees ' free-text comments . DESIGN Two nonauthentic , but realistic , short manuscripts with a number of common method ological flaws were sent to 180 Sc and inavian referees . Through r and omization , each referee received one of the manuscripts in English and the other manuscript in the national language . A structured assessment of the manuscript quality was expressed on a 5-point scale , and the impact of referee characteristics ( age , gender , experience , and so on ) was analyzed by multiple linear regression . MAIN OUTCOME Manuscript quality assessed by referees . RESULTS A total of 312 review s from 156 referees could be used for the study of referee characteristics and language . With increasing experience , the referees gave lower quality scores ( P < .05 ) . A tendency toward stricter assessment with younger age was seen ( P < .05 ) . No influence of referees ' gender , specialty , or nationality was found . For the test manuscript of the poorest quality , the English version was assessed to be better than the national- language version ( P < .05 ) . A total of 159 of 312 review s included free-text comments applicable for the method ological study . In 54 review s ( 34 % ) , no method ological comments accompanied the assessment , and in six review s they were only incomplete . Wrong sampling unit was mentioned by one fourth of 80 referees . Only one referee mentioned the incorrect use of a parametric test in the analysis of data whose distribution was nonparametric . CONCLUSIONS Experienced and young referees gave a stricter assessment of the manuscripts than their less experienced and older colleagues . An English version seemed to be accepted more easily than a national- language version of the same manuscript . Most referees spontaneously mentioned the shortcomings of the manuscripts only as part of their overall judgment The system is currently being evaluated by a r and omized controlled trial of conputer system records versus st and ard hospital records in respect of efficiency in recording and retrieval of information , ( the timne it takes to use the system , the amistrative effort , and the cost . Patients attending hypertension clinics are highly selected , the group hopes to develop a modified version of the system for use in general practice , with a view to aiding nmanagement and study of hypertensive patients in the population at large Peer review is the ordinary method for judging the acceptability of scientific papers for publication . Yet there are few prospect i ve data defining the accuracy or reproducibility of this method . This study was aim ed at evaluating interrater consistency in review ing a single manuscript and at determining whether a referee 's likely predisposition ( inferred from his or her own published papers in the field ) influences his or her attitude toward this manuscript . A computerized search identified 33 first authors of research papers about transcutaneous electrical nerve stimulation .  They were asked to review part of a fictitious scientific paper on the topic ; they were not made aware of being tested . Review ers ' ratings were recorded by multiple-choice answers in a structured question naire . The answers revealed poor interrater reliability . Furthermore , referees were clearly influenced by their own preconceptions and judged according to their own published experience in that particular medical subject . That is , referees who would be expected to agree with the paper 's findings tended to judge is less harshly than did referees who would be expected to disagree . These results suggest significant impact of review er bias on referee 's judgment and imply that the peer review system in its present form has room for improvements in fairness and consistency Peer review ers are blinded sometimes to authors ' and institutions ' names , but the effects of blinding on review quality are not known . We , therefore , conducted a r and omized trial of blinded peer review .  Each of 127 consecutive manuscripts of original research that were su bmi tted to the Journal of General Internal Medicine were sent to two external review ers , one of whom was r and omly selected to receive a manuscript with the authors ' and institutions ' names removed . Review ers were asked , but not required , to sign their review s. Blinding was successful for 73 % of review ers . Quality of review s was higher for the blinded manuscripts ( 3.5 vs 3.1 on a 5-point scale ) . Forty-three percent of review ers signed their review s , and blinding did not affect the proportion who signed . There was no association between signing and quality . Our study shows that , in our setting , blinding improves the quality of review s and that research on the effects of peer review is possible In a retrospective survey , 487 research projects approved by the Central Oxford Research Ethics Committee between 1984 and 1987 , were studied for evidence of publication bias . As of May , 1990 , 285 of the studies had been analysed by the investigators , and 52 % of these had been published . Studies with statistically significant results were more likely to be published than those finding no difference between the study groups ( adjusted odds ratio [ OR ] 2.32 ; 95 % confidence interval [ Cl ] 1.25 - 4.28 ) . Studies with significant results were also more likely to lead to a greater number of publications and presentations and to be published in journals with a high citation impact factor . An increased likelihood of publication was also associated with a high rating by the investigator of the importance of the study results , and with increasing sample size . The tendency towards publication bias was greater with observational and laboratory-based experimental studies ( OR = 3.79 ; 95 % Cl = 1.47 - 9.76 ) than with r and omised clinical trials ( OR = 0.84 ; 95 % Cl = 0.34 - 2.09 ) . We have confirmed the presence of publication bias in a cohort of clinical research studies . These findings suggest that conclusions based only on a review of published data should be interpreted cautiously , especially for observational studies . Improved strategies are needed to identify the results of unpublished as well as published studies We conducted a prospect i ve 9-month survey to assess the refereeing work load of British Medical Journal referees , and , in particular , to compare the work loads of pediatricians and psychiatrists . Referees completed a record form for each manuscript review ed and a question naire on demographic characteristics and attitudes toward refereeing . Two hundred eleven referees formed a sample of one sixth of the British Medical Journal 's active referees ; all remaining pediatricians ( n = 67 ) and psychiatrists ( n = 65 ) formed two further sample s. Of the 343 referees selected , 301 returned forms or question naires . One hundred forty-six referees were editors or on editorial boards . They review ed for a mean of five journals . They review ed 1980 manuscripts ( a median of 6 for the main sample , 6.5 for the pediatricians , and 8 for the psychiatrists ) . Most manuscripts were review ed for journals in the referee 's own specialty ; only one third were review ed for other journals . Psychiatrists did significantly more work for general journals than pediatricians ( 13 % vs 9 % ) . All three groups spent less than 2 hours per manuscript 
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There were many possible reasons for this lacunapeer review was so clearly the best method it did not require evaluation .
There was no point because no better system existed .
However , less reassuring are those studies that attempt to judge how reliably review ers make these assessment s. Unstructured peer review in which two or more referees  comment on the same manuscript has relatively low reliability .
Agreement on global measures such as recommendation to accept or reject is satisfactory ( although this strictly is an editorial , and not a peer review , judgement ) , however , assessment s of study importance and method ological quality are not reliable ( Ernst et al. 1993 ) .