Research integrity is the cornerstone of academic medicine. The basic principles of research integrity are ethical writing, honest authorship, and formal peer review [1,2]. Peer review is the academic evaluation of scholarship by scientists in the same field (peers) that aim to ensure scientifically valid and ethical research [3,4]. The principles of peer review are largely based on professionalism and academic attitude. Although peer review has been considered the standard to evaluate research, it has problems, bias, flaws, and limitations that should be addressed and optimized [5]. Currently, in the demand for abundant publications on researchers, it may be easy to get attracted by predatory journals inviting to submit a paper in the gold open access route that requires the author to pay a fee if the paper is published. In this publication factory, the journals will publish almost anything for a fee, with a short or without a peer review; therefore, effortless and useless publications will be increasing. Other journals have notorious high rejection rates. Although the high number of submissions justifies a high rejection rate, this reflects another bias of the peer-review process; the reviewers are encouraged to reject manuscripts in most cases in order to preserve this quality measure, and solely manuscripts that find favour within the reviewers get published [5][6][7][8].Peer review is considered a biased process with identified defects; it is a compromise between the likelihood of accepting a bad paper (type I error) and the likelihood of rejecting a good paper (type II error). Although peer review is supposed to reduce type I errors, it also increases the chances of a type II error. Minimizing the likelihood of a type I error will * Marius M. Scarlat