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Authorship is the most tangible evidence of responsibility and credit for research and plays a central role in scholarly recognition and promotion. Four articles find that authorship disputes at one institution are increasing; most authors meet the authorship criteria of the International Committee of Medical Journal Editors, although most don't know what the criteria are; the number of senior authors has increased in the last 20 years; and both guest authors (persons who don't meet authorship criteria) and ghost authors (persons who have contributed significantly but aren't named) are frequent.

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Biomedical studies are judged by peer review, but can peer review itself be improved? Seven studies evaluate peer review and find that masking reviewers to authors' identities to reduce possible bias was difficult. However when masking was accomplished, it did not improve quality of peer review, nor did reviewers unmasking their identity to other reviewers or to authors by signing their reviews. No reviewer characteristics were able to identify which peer reviewers provide the best-quality reviews.

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Bias can threaten the accuracy of the biomedical literature. In this group of 7 studies, multiple sources of potential bias are evaluated: studies with statistically significant results are more likely to be published and come to publication more quickly; US reviewers seem to prefer manuscripts from the United States; and authors of reviews preferentially cite articles from their discipline and country.

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The quality of articles, the topic of these 7 studies, concerns readers, reviewers, editors, and, indirectly, patients. Abstracts, the most widely read part of a manuscript, were found to have multiple inconsistencies with the text, but instructions to authors did not improve abstract quality. Structured abstracts did not improve reporting in the text of the manuscript. Guidelines for economic submissions did not improve quality of submitted or published works, and randomized trials generally do not include a discussion of the totality of the available evidence. On the other hand, reviewers valued receiving related materials to help them with their reviews, and Cochrane reviews were more rigorous and updated more often than paper-based journal reviews.

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Do experts know what readers want? What editorial training do editors receive? No, and usually not much, are the answers provided by 2 of the studies on this topic.

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Jacques Villon, Le Philosophe, French, 1930.

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Peer Review in Prague

"In this issue of THE JOURNAL, we publish 33 articles, based on presentations in Prague, Czech Republic, on subjects surrounding the publication of science relevant to clinicians. . . . There had been [before 1986] remarkably few serious investigations into its workings, though no shortage of opinion written in the absence of fact."

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For your patients: a primer on medical research.

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