Effect of blinded peer review on abstract acceptance

Does blinding during the peer review process decrease bias? This study of abstract acceptance at a national meeting, published in the April 12 JAMA, provides evidence of bias in the open review of abstracts, favoring authors from the United States, English-speaking countries outside the United States, and prestigious academic institutions. 

Ross JS, Gross CP, Desai MM, Hong Y, Grant AO, Daniels SR, Hachinski VC, Gibbons RJ, Gardner TJ, Krumholz HM. Effect of blinded peer review on abstract acceptance. JAMA 2006;295:1675-1680.

CONTEXT: Peer review should evaluate the merit and quality of abstracts but may be biased by geographic location or institutional prestige. The effectiveness of blinded peer review at reducing bias is unknown.
OBJECTIVE: To evaluate the effect of blinded review on the association between abstract characteristics and likelihood of abstract acceptance at a national research meeting.
DESIGN AND SETTING: All abstracts submitted to the American Heart Association’s annual Scientific Sessions research meeting from 2000-2004. Abstract review included the author’s name and institution (open review) from 2000-2001, and this information was concealed (blinded review) from 2002-2004. Abstracts were categorized by country, primary language, institution prestige, author sex, and government and industry status.
MAIN OUTCOME MEASURE: Likelihood of abstract acceptance during open and blinded review, by abstract characteristics.
RESULTS: The mean number of abstracts submitted each year for evaluation was 13 455 and 28.5% were accepted. During open review, 40.8% of US and 22.6% of non-US abstracts were accepted (relative risk [RR], 1.81; 95% confidence interval [CI], 1.75-1.88), whereas during blinded review, 33.4% of US and 23.7% of non-US abstracts were accepted (RR, 1.41; 95% CI, 1.37-1.45; P<.001 for comparison between peer review periods). Among non-US abstracts, during open review, 31.1% from English- speaking countries and 20.9% from non-English-speaking countries were accepted (RR, 1.49; 95% CI, 1.39-1.59), whereas during blinded review, 28.8% and 22.8% of abstracts were accepted, respectively (RR, 1.26; 95% CI, 1.19-1.34; P<.001). Among abstracts from US academic institutions, during open review, 51.3% from highly prestigious and 32.6% from nonprestigious institutions were accepted (RR, 1.57; 95% CI, 1.48-1.67), whereas during blinded review, 38.8% and 29.0% of abstracts were accepted, respectively (RR, 1.34; 95% CI, 1.26-1.41; P<.001).
CONCLUSIONS: This study provides evidence of bias in the open review of abstracts, favoring authors from the United States, English-speaking countries outside the United States, and prestigious academic institutions. Moreover, blinded review at least partially reduced reviewer bias.
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Ethics: Dismembering the ethical physician

I couldn't resist the title of this article just published in the April issue of Postgraduate Medical Journal:

Genuis SJ. Ethics: Dismembering the ethical physician. Postgrad Med J 2006;82:233-238.

Abstract: Physicians may experience ethical distress when they are caught in difficult clinical situations that demand ethical decision making, particularly when their preferred action may contravene the expectations of patients and established authorities. When principled and competent doctors succumb to patient wishes or establishment guidelines and participate in actions they perceive to be ethically inappropriate, or agree to refrain from interventions they believe to be in the best interests of patients, individual professional integrity may be diminished, and ethical reliability is potentially compromised. In a climate of ever-proliferating ethical quandaries, it is essential for the medical community, health institutions, and governing bodies to pursue a judicious tension between the indispensable regulation of physicians necessary to maintain professional standards and preserve public safety, and the support for "freedom of conscience" that principled physicians require to practise medicine in keeping with their personal ethical orientation.

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