I unfortunately do not have industry experience in a design review, but I can imagine how these meetings impact the development of the project. During these meetings it must also be important to stay on top of the changes that need to be made to the documents or else it may become overwhelming. Also, with some many different opinions, it may be hard to come to a conclusion some times. When a change needs to be made does that person need to provide some sort of reason as to why these changes are being made? Do they supply some type of research to back up their reasoning? I would assume it would be necessary to provide reasoning or documentation as to why a change should be made.