735

research division. Some of the laboratory’sresearch teams have, however, been re-tained by the Erasmus University in Rot-terdam. A gene therapy firm was estab-lished in July, and from Jan 1, 1994, theprimate centre and all animal facilities willbe run as an independent for-profit organi-sation. And a gene therapy firm was estab-lished in July. Last year the managementalso asked an international agency to adviseon ways of increasing the income to bederived from contract financing. TNO :insiders are uneasy about the conflicts ofinterest that arise when research on the less

profitable aspects of medicine have to giveway to the emphasis on finance and profitand have been feeling that the organi-sation’s market orientation since the 1980shas caused an overall deterioration deterio-ration in their international reputation.However, in a survey by the Dutch RoyalAcademy of Sciences the internationalscientific community still thought highly ofthe TNO, though reservations were

expressed about the costs of the organi-sation. The government’s plan is that

TNO’s funding from the Department of

Centres for research into ageingAt the official opening of the IVVO in Dec, 1991, the Minister of Education and Scienceexpressed some commitment to enable the IVVO to be the coordinating centre for aEuropean Foundation for Ageing (see Lancet 1992; 339: 299). The concept, wellaccepted by many European institutions, is that the European institute would be madeup of a network of existing research facilities in Europe following a coordinatedprogramme of research. With the current preoccupation over large subsidies, it is notsurprising that the IVVO is still awaiting a response from the Department of Educationand Science to its request for a starting subsidy of about DFl 230 000. However, a fewmonths ago the IVVO received a grant to set up the Netherlands Centre for AgeingResearch, which will coordinate work on a variety of topics, the first being mobility.

Vivien Choo

Welfare, Public Health, and Culture (fortargeted projects) will be reduced to aboutDPI 10 million in 1997 (after reductions of 2million in 1995, 3 million in 1996, and 34million in 1997). Since the reductions areonly part of the government’s measures forcutting back expenditure on medicalresearch-and there are influential lobbiesfor other areas of research (eg, cancer)-TNO’s researchers fear that it would be

difficult to maintain their internationalreputation as an innovative institute. :

In view of the inefficient way in which

medical research is organised, the predic-tion is that there will be some kind of overall

reorganisation. Options put forward by theDutch Royal Academy of Sciences and theNetherlands Organisation for MedicalResearch include the formation of a Dutchmedical research council, along the lines ofthat in the UK, but part 2 of RGO is

expected to recommend some other line.

Marjanke Spanjer

CONFERENCE

Peer review 1993

Stephen Lock, in his 1985 RockCarling Fellowship on editorial peerreview (London: Nuffield ProvincialHospitals Trust), concluded that "wehave no better way of distinguishingbetween the promising and the meri-tricious or for improving the scientificand the linguistic qualities of an

article". Since then, many questionshave been posed about the validity of aprocess that is often held up as anindication of a journal’s integrity or apaper’s scientific credibility. At the Second International Con-

gress on Peer Review in BiomedicalPublication held in Chicago, USA,last week, several groups presentedconvincing evidence that peer reviewis beneficial. Editors at the Annals of ;Internal Medicine reported that expertassessors found reviewed papers to besubstantially better than unreviewedones. Moreover, the best reviewerswere aged under 40 years, camefrom centres of academic excellence,and were blinded to the authors’

identity. Difficulties remain. Editors rarely

apply the same exacting standards of =

refereeing to review articles as they doto research papers. Randomised con-trolled trials published in journalsupplements are commonly of poorerquality than their counterparts pub-lished in the regular journal. A jour-

nal’s marketing and advertisingstrategy may take precedence overeditorial standards in this instance.Additionally, statistical review is oftenof poor quality. For example lainChalmers and colleagues reported thatonly 9% of papers published in fourobstetrics and gynaecology journalsbetween 1990 and 1991 gave an ade-

quate description of randomisationtechniques. As Jerome P Kassirer, editor of the

New England Journal of Medicine :

pointed out, there has been little or noresearch into the cognitive processesinvolved in peer review. If these de-cision pathways are examined, one cansee the highly subjective manner inwhich peer review operates. Much

depends on unquantifiable percep-tions (of the journal’s readership, ofthe relative importance of an article),on recent journal publications, onoriginality, and on clinical applica-bility. Such bias has important impli-cations for identifying research papersto be included in meta-analysis.

: Peer review has also come underclose legal scrutiny. The recent UScourt judgment in Daubert vs MerrellDow seems to question the importanceof the entire peer review process. Forscientific research to be admissible in

court, it had been argued that a mi-nimum standard must be publication

in a peer-reviewed journal. If this viewhad been endorsed, peer review mighthave been substantially strengthened.But the court decided that the judgealone could make his or her own

decision on admissibility and stand-ards of evidence provided that the datain question were "relevant" and "re-liable". But to whom?

Several speakers called for some

way of punishing editors who trans-gressed generally agreed editorial

guidelines-eg, when there is a con-flict of interest for an editor. A scienti-fic "press council" could arbitrateover author-editor disputes andrecommend necessary restraints on

editors when necessary, with the ulti-mate sanction being recommendationof dismissal of the editor in question.Much of the research presented in

Chicago was anecdotal and confined tosingle journals. For example, the_7our-nal of Paediatrics was found not guiltyof bias in favour of well-known

academic institutions and J AMA wasinnocent of gender discimination. Yetthe difficulty faced by journal editorswho wish to test the efficacy of theirreview strategies is shown by therecent refusal by the National Libraryof Medicine to fund a multijournalrandomised trial of blinded peer re-view. The logistical requirements ofthis trial were enormous: 25 years and

$1-5 million.

Richard Horton