Clinicians who make up-to-date, evidence-based decisions about patient care are often presented with manuscripts describing database studies. Databases are immense resources, rife with large volumes of patient information. They do, however, have limitations, and the related analyses introduce challenges and potential pitfalls. To help ensure that we are true stewards of our literature, it is important for these publications undergo an optimal peer review process. In addition, to be judicious readers of scientific manuscripts, it is helpful to understand which specific factors contribute to reliable database studies. This Expert Lecture thus delineates the present knowledge and ideal approaches to peer review overall, then focuses on the specifics of analyzing database studies. It explains key components of the analytic approach, as well as specific details related to vetting these manuscripts. Intended for peer reviewers, authors, and critical readers of these manuscripts, this presentation has both didactic and interactive components. The course instructors are the Editor-in-Chief and Deputy Editor of Otolaryngology-Head and Neck Surgery and OTO-Open, the official journals of the American Academy of Otolaryngology-Head and Neck Surgery.