Professor Neena Chappell has thoughtfully reviewed my book, "Tomorrow's Cures Today? How to Reform the Health Research System" (Bulletin, June 2001).

She correctly paraphrases, both when asking "How do we predict today, what will be important in the future?" and when stating that "We need as much excellence in the design of our peer review system as we need excellence in science." However, she incorrectly implies I claim to have "found the solution."

The solution is to have funds for all active researchers. Failing this, we have to find a way of disbursing the available funds optimally. The book presents a possible solution to the problem — bicameral review — and advocates immediate implementation, if only on an experimental basis.

Instead of bold experimentation, we have bureaucratic foot-dragging with complacent declarations that, like democracy, the peer review system as currently operated is a terrible system, but it is the best we have.

While not herself a biomedical researcher, Professor Chappell has been heavily involved in the activities of Canadian granting agencies and is currently on a CIHR advisory board. Most biomedical researchers will find surprising her assertion that "for established investigators, the current system does put a major emphasis on their past research record, and it is incorrect to suggest otherwise."

Grant application forms have strict space limitations and require much detail of work proposed, not of track records. As far as I am aware there are no agency instructions to reviewers requiring them to place major emphasis on a track record despite the little space accorded that record in application forms. If there were such an instruction, then the agencies would already have taken an important step towards the bicameral review system I propose.

In practice, reviewers wanting to know more about an applicant's track record have to go to the original papers cited in the application. This takes time and energy which many reviewers are not willing to give. Furthermore, the published record may not accurately reflect the actual path of scientific enquiry and the wisdom of past expenditures. Bicameral review facilitates access to this information and thus makes applicants accountable. From those to whom much has been given much should be expected.

Among the "good points" that "will get little argument from me," Professor Chappell includes the facts that the current system is "error-prone," and that "the more creative the thinking, the less communicable it becomes." Yet she questions how bicameral review's "almost exclusive emphasis on past record could assist innovation."

As successful Wall Street analysts have long known, the best strategies in error-prone environments are — use the most objective parameters (i.e., track record), and hedge your bets. These are the essence of bicameral review. For more, please see the web site http://post.queensu.ca/~forsdyke/peerrev.htm.

Donald R. Forsdyke
Biochemistry, Queen's University

Dr. Forsdyke says I imply he has provided the solution to peer review whereas he has offered only a possible solution. No problem, but my review of his possible solution remains the same.

We seem to have two fundamental disagreements. Dr. Forsdyke believes that peer review at the current time does not take track record into account. He apparently rejects the notion that assessment of publications including journals published in and citations, and indepth review by those knowledgeable in one's field (both external and internal) who therefore should know the applicant's scientific contribution to the field, constitutes assessment of track record. We also disagree that almost exclusive focus on past record is problematic for funding innovation. In his response, Dr. Forsdyke does not provide reasons for why current assessment of track record is not adequate nor does he provide an argument as to how funding on the basis of track record promotes innovation.

I, therefore, still fail to see how the bicameral approach he proposes is a possible solution to the problems evident within our present peer review system.
— Neena L. Chappell