Our readers expressed views that fell into two main categories. First, we were asked why JMCP published an article that could be used by groups antagonistic to managed care pharmacy. Second, some readers questioned the scientific validity of the study and how our peer review process allowed "imperfect science" to appear in the Journal. Since these concerns drive to the heart of our philosophy, we are taking this opportunity to address them in depth.

Why We Publish, What We Publish
Since its inception the Journal has been dedicated to the principle that managed care pharmacy requires evaluation, analysis, and discussion of its methods and results. Due to the competitive nature of the marketplace and the lack of a formal body of science with which to substantiate benefit decisions, it has been a practice of the Journal to publish reports and studies which describe, evaluate, and report the results of various methods for managing drug therapy and its incumbent costs. Our commitment is to seek out and publish well-researched studies to question the assumptions, definitions, and methods of managed care pharmacy and confirm the tools of managed care pharmacy on a more rigorous scientific footing.

Our Peer Review Process
The questions regarding the scientific validity of this manuscript and the operation of the Journal's peer review process are of a much greater concern.

First, this column is not the proper forum for a discussion of the scientific validity of any study. Such a debate and discussion should come in the form of letters to the editor, submission of studies on the same or similar study groups, and additional literature addressing the capitation of medical groups. We encourage a debate of the study's findings in such forums and will make every effort to ensure that such a discussion occurs.

Second, at the heart of our philosophy is that the scientific methodology and validity of studies is thoroughly evaluated in the peer review process. Since we endeavor to continually improve our peer review process, The Journal's Editorial Advisory Board has initiated a complete review of the entire process as it does every year. This review should lead to further enhancements that will emphasize our commitment to our readers that every effort has been taken to ensure that the highest quality of research has been published. Steps already have been taken to expedite the peer review process so that articles containing information on current and relevant topics are published in a timely manner.

Caveats
In anticipation of the distribution of any article from the Journal we would like to offer the following caveats:
For those who will use one study to castigate any tool or method when the literature presents few examples of support or refute, we would note that the scientific method requires confirmation. One study is precisely "one of one."
For those who would generalize any study to encompass all situations, we would cite that all scientific studies have a study design that limits generalization beyond the study parameters with any certainty and are purely speculative.
For those who promote anything in print as dogma, or insist that statistics provide irrefutable causality, we would cite that the purpose of publication is to provide information and methods in a public forum for debate. Science is furthered by such discussions, and the use of statistics is intended to illuminate relationships, but only multiple studies under multiple circumstances can begin to verify or refute causality.

This discussion emphasizes our commitment to publish valid and interesting research. If controversy occurs, we welcome the debate.

Craig Stern, R.Ph., Pharm.D., M.B.A.
JMCP Editor-in-Chief
crstern@hsc.usc.edu