—The initial responses to my commentary confirm my concern that "an increasing number of physicians assert that some editors are negligent in providing a sufficient number of papers with immediate clinical relevance."1 It is evident that today's peerreview publications are not meeting the needs of a significant segment of nonacademic clinicians. The letters in response to my editorial will assist me and the members of the Editorial Board as we strive to meet the educational needs of practitioners. Dr Naney comments on instances of fraud and irresponsible authorship. Occurrences of this nature will surface, but surely they are exceedingly rare. I have been an editor for 23 years and recall only three cases of plagiarism or investigational fraud.