Peer review is a cornerstone of modern scientific publishing, yet its current form is a relatively recent development that became institutionalised in the mid-20th century. While intended to ensure rigour, credibility and quality control, the peer review system now faces mounting pressures. Rapid growth in manuscript submissions, reliance on unpaid reviewer labour, reviewer fatigue and the rise of predatory journals have strained its effectiveness. These challenges contribute to delays, inconsistent review quality and increasing retraction rates, highlighting vulnerabilities that peer review often fails to detect at scale. Evidence from randomised trials suggests that most proposed reforms offer limited benefit, although adding statistical reviewers and adopting elements of open peer review produce modest improvements. Sustainable reform will require evidence-guided changes, better recognition of reviewer contributions, and careful integration of technological tools to preserve the integrity of scientific publishing.
Milne et al. (Sun,) studied this question.