Biomedical journals have long been the hub of information-sharing in the health sciences. And behind every in- fluential journal is a team of editors, reviewers, statisticians, and support staff. As the gatekeepers of the peer-review process—by which research papers are critiqued by experts in the same field as the authors—journal editors bear tremendous responsibility. A number of DMS faculty members hold top editorial posts at leading journals. Here are insights into the peer-review process from a few of them.

Why are you a journal editor?

"I believe strongly in service—service to your academic community, both at your institution and also nationally. What drives me when I am asked to serve as an associate editor is to serve the scientific community."

—Ethan Dmitrovsky, M.D.
Associate Editor, Journal of the National Cancer Institute; Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics

What is your opinion of peer review as a system of evaluating research?

"When you are dealing with peer review, you are dealing with a process that has checks and balances built into it. Peer review is not perfect. Lord knows, it's got its problems. But it's like what Churchill said about democracy—it's the worst thing ever contrived except for everything else that's been contrived. So you have to accept peer review and do your damnedest to make sure that you're applying it honestly, without bias."

—William Morain, M.D.
Editor in Chief, Annals of Plastic Surgery

"When you are dealing with peer review, you are dealing with a process that has checks and balances built into it. Peer review is not perfect . . . it's got its problems. But it's like what Churchill said about democracy —it's the worst thing ever contrived except for everything else that's been contrived."

What can editors do to minimize the potential for bias in the peer-review process?

"We have policies in place to minimize the chance that friendship can play any role in decisions about an article. We have what we call the 'holiday card rule,' which basically is a series of conditions, such as having worked with an author in the recent past or if the author is part of the same division. . . . The holiday card [is a way] of defining an ongoing personal relationship—if you exchange holiday cards, then you should remove yourself from any discussion [about a paper by that person]."

—Harold Sox, Jr., M.D.
Editor, Annals of Internal Medicine

Are there improvements that could be made in the peer-review process?

"We've tried very hard for everybody's sake to take the mystery out of peer review, including its warts as well as its strengths, because we would like both the reviewers and the authors to know what we do and how we do it. So we have deliberately tried to look at our own process. We've done data analysis on our

process. We compare the senior associate editors to each other. We compare the two editors to each other, both in terms of time and apparent likelihood of dropping a manuscript before sending it out for review. So we are continuously monitoring our own process as much as we can."

—Ann Barry Flood, Ph.D.
Editor, Health Services Research

What do you enjoy about being a journal editor?

"We gain so much from study designs and methods in the literature and it helps us keep up [with our field]. . . . The reason I really continue to edit is it keeps me up with my profession probably better than anything else. That's what I love about it."

—James Weinstein, D.O., M.S.
Editor, Spine Journal

Are there any parts of the job that you dread?

"There's no time that I sit down to write an editorial that I don't have a lump in my throat, because I realize that I am very exposed. What I'm sitting there and musing is something that a lot of very opinionated people are going to be reading. I can embarrass myself with colleagues if I don't do well. . . . Every month I have this pre-editorial syndrome that I go through. I get irritable and I don't sleep well. . . . That's the only part I dislike about the journal."

—William Morain, M.D.
Editor in Chief, Annals of Plastic Surgery