We have now held 4 Peer Review Congresses at 4-year intervals, and their success is demonstrated by the stimulus they have given to an evolving science—investigation of the process whereby scientific work is selected and published.1-4 Since the announcement of the first Peer Review Congress in 1986, the numbers of abstracts submitted to successive Congresses have increased from 50 to 110, 160, and 180, respectively. We have noted similar increases in the number of MEDLINE citations on peer review.5