Acceptable Standards

To the Editor.—  In theory, reviewers of scientific papers impose standards for acceptance based on the aim of all scientists—to report a true result. For therapeutic trials a true result depends on appropriate design, ie, the results should reveal real treatment effects by measures that minimize biases in selecting patients and administering therapy. Acceptance of the results for publication implies merit, and without publication it is very difficult to establish a new treatment in practice. Medical journals thus become the filter through which appropriately studied modalities can go on to application, but through which inappropriately studied modalities should not be able to pass. While this has been increasingly true for medicinal agents, it has not been the case for new surgical procedures and new applications of established procedures. Most journal reviewers, abstract referees for scientific meetings and hospital research committees, maintain high standards for the design of medical therapeutic trials.