At the frontier of biomedical publication: Chicago 2005

Evidence started to matter in biomedical publishing soon after it came to matter in medicine— relatively recently. The first international congress on peer review and biomedical publication was held in Chicago in 1989. At the time of the third congress, in 1997, only 146 original scientific articles had been published on peer review, of which 22 were prospective studies and 11 randomised controlled trials.1 Since then, the body of evidence has been growing, with about 200 abstracts indexed in Medline a year.2 We now have plenty of evidence to support the contention that peer review is "expensive, slow, subjective and biased, open to abuse, patchy at detecting important methodological defects, and almost useless at detecting fraud or misconduct."3 The evidence on how to improve the process is scarce. What did the fifth congress add?