- Richard Horton, North American editora
- a Lancet, 655 Avenue of the Americas, New York, NY 10010, USA
- Accepted 23 January 1995
A naturalist's life would be a happy one if he had only to observe and never to write. (Charles Darwin)
Be careful while reading this article. My purpose is to persuade. To achieve this goal I must not only appeal to your intellect and seek your sympathy for my point of view but also diminish your natural reticence to believe all that you read. If I am successful you should remain unaware of my intention to penetrate your critical guard.
Medical journals—and grant awarding bodies for that matter—proudly adhere to the rigours of peer review despite the striking lack of research about either its efficacy or its reliability. But this system of collegiate accountability frequently ignores a factor that, to the doctor or scientist, may be thought too trivial to devote much attention to: the manipulation of language to convince the reader of the likely truth of a result.
The task of removing hyperbole from a paper is normally left to an editor. But just as qualitative review of research demands knowledge about the subject of that research, and just as statistical review requires mathematical skill, so the analysis of argument demands an understanding of the tools of persuasion available to the author. To interpret a result correctly reviewers, statisticians, editors, and readers should know the conscious and unconscious tricks of authorial rhetoric.
Although applied widely, peer review is by no means a secure discipline. For instance, Altman is critical of the entire notion of peer review, a term that he believes is jargon with no agreed meaning.1 He has described good peer review as the equivalent of good technical editing.
This view is unreasonable. Qualitative and statistical analyses of a research paper frequently raise important issues that, when resolved, improve the manuscript substantially.2 If peer review is …