[A critical review of the "peer review" process]

The main objective of biomedical journals is to publish high-quality scientific studies and to ensure a widespread dissemination of their contents, Journals compete for the best science generated in their respective disciplines and, therefore, they critically scrutinize the scientific quality of all submitted papers in order to identify and select only those thar merit publication. The "peer review" system represents the cornerstone of the scientific process. It provides a critical appraisal, by external independent experts, of the studies under consideration. The system is intended to improve the quality of the submitted papers but also to help the Editors in their decision-making process. The process has been widely embraced by the scientific and editorial onternational community but it is not free from caveats. In fact, although several strategies have been implemented to improve its quality and the results obtained, limitations still persist. Accordingly, its quality should be closely monitored to ensure excellence, limited scientific information exists on its real value. In this review we will critically analyze the "peer review" process and we will advance some ideas that may help to understand why, in spite of its limitations, it remains the "gold standar" for the selection of scientific manuscripts by biomedical journals.