Commentary Research and Evidence Ethics, Regulation, and Responsible Use

Stop pretending AI peer review isn’t happening

Why every journal article should have an AI reviewer―and how banning AI from peer review could be making science worse.

April 21, 2026 By Editor-in-Chief: Johnson Thomas, MD, FACE, FEAA 8 min read
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Clinical Report: Stop Pretending AI Peer Review Isn’t Happening

Overview

The current peer review system is under strain due to increasing submissions and a lack of qualified reviewers. Evidence suggests that integrating AI into the peer review process can enhance quality and efficiency without biasing outcomes.

Background

The peer review system is facing significant challenges, including a shortage of qualified reviewers and persistent biases. With global scientific output rising dramatically, the need for innovative solutions is critical. AI has the potential to address these issues, yet its adoption in peer review remains controversial.

Data Highlights

No numerical data available in the article.

Key Findings

  • AI can improve the peer review process by providing systematic feedback on objective issues.
  • In a study, 27% of reviewers updated their reviews after receiving AI-generated feedback.
  • Blinded evaluators preferred revised reviews in 89% of cases, indicating enhanced quality.
  • AI's involvement did not affect acceptance rates, maintaining fairness in the review process.
  • Over 50% of researchers have used AI in peer review despite existing prohibitions.

Clinical Implications

Healthcare professionals should consider the potential of AI to alleviate the burdens of peer review while maintaining quality. A collaborative model that includes AI could enhance the efficiency and reliability of the review process.

Conclusion

The integration of AI into peer review processes presents a promising avenue for addressing systemic challenges in scientific publishing. A reevaluation of current prohibitions may be necessary to harness AI's benefits effectively.

References

  1. NIH, Grants.nih.gov, 2023 -- The Use of Generative Artificial Intelligence Technologies is Prohibited for the NIH Peer Review Process
  2. Wolters Kluwer, Today's Hospitalist, 2023 -- Are you using ‘shadow AI’ in your practice?
  3. npj Digital Medicine, 2026 -- Guidelines for Clinical AI: Insights from Aviation on Human-AI Collaboration in Healthcare
  4. npj Digital Medicine, 2025 -- Exploring the Untested Hazards of AI Scribes in Healthcare Settings
  5. Journal of Medical Internet Research, 2025 -- Large Language Model–Assisted Risk-of-Bias Assessment in Randomized Controlled Trials Using the Revised Risk-of-Bias Tool: Evaluation Study
  6. Frontiers in Digital Health — Artificial intelligence in rehabilitation: a review of clinical effectiveness, real-world performance, safety, and equity across modalities and settings
  7. NOT-OD-23-149: The Use of Generative Artificial Intelligence Technologies is Prohibited for the NIH Peer Review Process
  8. Journal of Medical Internet Research - Large Language Model–Assisted Risk-of-Bias Assessment in Randomized Controlled Trials Using the Revised Risk-of-Bias Tool: Evaluation Study
  9. Use of Artificial Intelligence in Peer Review Among Top 100 Medical Journals | Medical Journals and Publishing | JAMA Network Open | JAMA Network

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