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Under the system of peer review, a researcher submits findings to a journal for publication. Along with a review by editors, the article is sent to several specialists in the field.
 But peer review also lacks consistent standards. Procedures vary among the world's 10,000 or so journals. A peer reviewer often spends about four hours reviewing research that may have taken months or years to complete, but the amount of time spent on a review and the expertise of the reviewer can differ greatly, especially at lesser-known journals. 
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These reviewers are not paid for their time, their names are usually not published, and their comments usually remain secret. They are usually not allowed to contact the researchers directly to ask questions, and they do not try to replicate the research.The system has often had successes; many journal editors say peer review has saved countless prominent scientists from publishing seriously flawed work, and has spared the public from following mistaken medical advice. But peer review also lacks consistent standards. Procedures vary among the world's 10,000 or so journals. A peer reviewer often spends about four hours reviewing research that may have taken months or years to complete, but the amount of time spent on a review and the expertise of the reviewer can differ greatly, especially at lesser-known journals. ''It has been bandied about as a sort of 'Good Housekeeping Seal of Approval,' " said Marcia Angell, former editor of the New England Journal of Medicine. ''It is only as good as the peer reviewers and editors." The increasing focus on peer review will be highlighted next month, when dozens of journal editors and specialists in peer review meet in Chicago. Dozens of papers will be presented on topics that include whether peer review adds value, and whether conflict-of-interest rules are working. J. Scott Armstrong, a professor at the University of Pennsylvania who has spent years analyzing peer review, has voiced hope that the conference will lead to radical change in the way journals conduct peer review. The system, he said, is outdated and outmoded. Pointing to a move by some journals to put their information on the Internet and to publish the names of reviewers, he predicts that the current system of anonymous reviewers will be replaced by a version of Amazon.com, in which scientists from around the world contribute their thoughts to constantly updated research. Change is not likely to come, however, at the upcoming Fifth International Congress on Peer Review and Biomedical Publication. That gathering is intended as a forum for discussion, rather than decision-making. There is no governing body that defines what constitutes good peer review, or that demands that certain standards be followed. Moreover, some of the editors at some of the large journals are not eager to change the system. Dr. Jeffrey Drazen, who is the editor of the New England Journal of Medicine, said he supports keeping the review system anonymous and unpaid. "We don't think the system is broken and needs to be overhauled," Drazen said. Drazen also said peer review is not necessarily at fault when a study is not replicated by subsequent research. ''As a scientist, the things that give me the most joy is when someone is able to replicate something I published," Drazen said. ''That means that you got it right. But sometimes people cannot replicate things. It is a mistake to view it as black and white . . . if you do a second study but can't replicate the primary findings, it doesn't necessarily mean the original research was wrong."
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