Editing and publishing a weekly journal is a fairly substantial undertaking. When it has a large international circulation and a general content, the task can be formidable. For example, the usual issue of JAMA in 1983 contained between 13 and 20 major articles, plus MEDICAL NEWS, LEADS FROM THE MMWR, LETTERS, BOOKS, INTERNATIONAL ABSTRACTS, QUESTIONS AND ANSWERS, OBITUARIES, announcements, and advertising. We published 704 major articles, which were selected from some 3,600 manuscripts, giving an acceptance rate for all manuscripts of 19%. When only unsolicited manuscripts are considered, the acceptance rate was 13%. Obviously, it takes the expertise of hundreds of people to ensure quality. All manuscripts received are briefly reviewed on the same day and assigned by Dr Southgate or myself to any one of our ten physician-editors. Each of these editors has the responsibility to review personally and the authority to consult, reject, or work with the authors
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