Cureus. 2025 Oct;17(10): e95357
Peer review has long stood as the principal safeguard for scientific credibility, yet much of its authority rests on tradition rather than empirical proof of efficacy. In recent years, persistent vulnerabilities, ranging from bias and inconsistency to opaque procedures and protracted delays, have eroded trust in the peer review system. Rising submission volumes, mounting commercial influences, and dwindling reviewer engagement have amplified the strain. Problems span structural and individual levels: an overburdened reviewer base, lack of standardized practices, unclear decision-making, slow turnaround times, and limited diversity in evaluation panels, together with personal pitfalls such as unconscious bias, conflicts of interest, poor accountability, inadequate training, and breaches of confidentiality, are present in the spectrum of issues. This editorial explores practical and ethical reforms to strengthen the process, including elevating reviewing to a recognized profession, introducing meaningful incentives, incorporating artificial intelligence judiciously, embracing transparent yet protective models, expanding reviewer diversity, and streamlining editorial workflows.
Keywords: artificial intelligence; bias; health research; peer review; publication; research review; review; review system; reviewer; scientific article