PubMed · 1255699
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R M Rippey. 1976. Letter: Evaluations.. https://pubmed.ncbi.nlm.nih.gov/1255699/
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High publication demands and the low acceptance rate of peer review journals place the journal editors and their reviewers in a powerful position. Journal reviewers have a vital role not only in influencing the journal editor's publication decisions, but also in the very nature and direction of scientific research. Because of their influence in peer review outcomes, journal reviewers are aptly described as the "gatekeepers of science." In this article we describe several pitfalls that can impede reviewers' impartial judgement. These include such issues as confirmatory bias, the negative results bias (the file drawer problem), the Matthew effect, the Doctor Fox effect, and gender, race, theoretical orientation, and "political correctness." We argue that procedures currently used by many professional journals, such as blind or masked review, may not completely alleviate the effects of these pitfalls. Instead, we suggest that increasing reviewers' awareness of the pitfalls, accountability, and vigilance can improve fairness in the peer review process. The ultimate responsibilities belong to the journal editors who are confronted with the difficult task of satisfying journal readers, contributors, reviewers, and owners. We recommend that the journal editors conduct periodic internal and external evaluations of their journals' peer review process and outcomes, with participation of reviewers, contributors, readers and owners.
Clinical judgement, the keystone of medical expertise, is a hot topic. By contrast, patient judgement, also of central importance in health care, receives little attention. Patients have the last say concerning whether or not they seek medical treatment for symptoms, follow a doctor's advice or accept reassurance. Delay in seeking help for serious symptoms, non-compliance with treatment advice and failure of doctors to reassure many of the 'worried well' have long been recognized as serious problems. We argue that what is common to these important problems is patient judgement. Surveys yielding information about the average influence of a large number of individual variables do not do justice to the complex interaction of influences that can influence the judgements of an individual person under particular social circumstances. This is what explains the wide variety of patient reactions. From the medical standpoint, such unpredictable patient behaviour seems irrational. The patient perspective on the meaning of their actions is a hiatus in our knowledge, which is hampering the planning of effective interventions. Too few studies have sought the perspective of patients by asking them why they acted as they did. Thus, the wide spectrum of patient response in these situations in relation to personality, life experience and social context cannot be studied without interpretive field studies that include interview of patients with qualitative interpretation.
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