If a paper is published in a peer reviewed medical, biological or scientific journal there is a tacit assumption made by a significant proportion of readers, as well as many in the mainstream media, that it has survived a closely scrutinised, transparent and vigorous process of analysis and criticism from learned colleagues, before acceptance by the journal’s editors. It must surely be a good paper and it must surely have something worthwhile to say, otherwise it will have been rejected. The reality is that the paper may have a worthwhile message, but it may not.

As Richard Smith, former editor of the BMJ, says, peer review is hard to define, its defects are easier to identify than its attributes, and until recently it has been unstudied. He adds that “if you persist long enough you can get anything published, no matter how terrible”.¹

A paper submitted to the Emergency Medicine Journal (EMJ) must be done so electronically via Bench>Press on the EMJ …