• Proceedings of Singapore Healthcare adopts double-blinded peer reviews as golden standard
• There are several positive outcomes of blinded reviews
• Onus boils down to training and educating reviews to provide unbiased, quality reviews  

Being open to objective, critical appraisal is a fundamental tenet of all scholarly work.

In scholarly publishing, this is achieved by peer review, the use of independent content experts in evaluating the suitability of submitted manuscripts for publication.
The peer review process offers an impartial critique of works, but can come under attack when reviewers fall short on objectivity (3-5).

One widely adopted solution to reducing such bias is to hide the identities of authors from reviewers (single blinding) or to do the same vice versa double blinding).

Proponents of blinding reviews argue that the doing so increases the quality of reviews, a premise borne by the results of some studies (6-8).

However, other studies have shown that the quality of blinded reviews is not significantly higher than unblinded reviews (9-15).   Conversely, asking reviewers to reveal their identities can result in higher quality reviews (16).

Detractors of blinding reviews have also pointed out several drawbacks, such as increased administrative costs (19) and the inability of blinding reviews to completely eliminate bias (18).

Even though the effect of blinding on review quality is equivocal at best, there are positive effects associated with blinding reviews.

For instance, a study (23) found that papers that had undergone blinded reviews were more likely to be cited than those that had undergone unblinded reviews.

When a study is referenced frequently, it will help to create a greater impact on its field over time.

There are also intangible outcomes of blinded reviews to consider:  

• the reputation of authors with a stellar track record will not give them a free pass to publish mediocre research (26); 
• junior reviewers will not be hesitant in being too critical of authors of greater seniority (27);
• a veil of anonymity will serve to increase the diversity (such as in gender and nationality) of authors (28,29);
• the possibility of disagreement degenerating into unnecessary acrimony for fellow researchers with unblinded reviews (16), and
• the increased time taken to write unblinded reviews (25)

Blinded reviews are deeply entrenched in the culture of many healthcare journals and have been strongly preferred in surveys (27, 31-33).   It would not be easy to convince editors and reviewers to discard tradition.

Bias is inevitable, and double-blinding review affords the best solution to minimising bias (37).

The onus for maintaining the quality and integrity of research comes largely from training and educating reviewers to provide quality reviews (18,40,41).

Until this has become commonplace, the Proceedings of Singapore Healthcare has found that double-blinded peer reviews remain most effective, and has adapted it as the gold standard.

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