The role of the manuscript reviewer in the peer review process.

Peer review of submitted manuscripts is recognized as a critical component of the publication process in all major medical journals. It lends respectability and scientific credibility to those journals that have adopted the process [1]. This function is delegated to a group of persons who perform the task selflessly and without compensation. Of the many facets of the peer review process, the selection of manuscript reviewers and their subsequent interaction with both editors and authors may be so poorly understood by aspiring authors that certain misconceptions ensue. Authors of rejected manuscripts may fear that reviewers have acted in an arbitrary and possibly censorial fashion [2, 3]. Conversely, authors of accepted manuscripts who face a mountain of revisions may wonder if such an effort is likely to improve their manuscript [4, 5]. The following questions come to mind: Where do the reviewers come from? What do they do, and what constitutes a good reviewer? What power do they have? How is reviewer performance measured? Can the editor recognize publicly the good reviewer? Are reviewers really blinded? How does one become a good reviewer? Who will be the reviewers of the future? While looking at these questions, we should consider objective approaches of assessing reviewer quality and wonder whether they would improve the quality of the published manuscript.