AI in Peer Review After ICMJE 2026: What Reviewer AI Rules Mean for Your Submission

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AI in Peer Review After ICMJE 2026: What Reviewer AI Rules Mean for Your Submission

Increasingly, artificial intelligence technologies impact scientific publishing – both in terms of preparing and editing a manuscript, peer reviewing and making editorial decisions. In January 2026, ICMJE Recommendations were revised with a new section covering the role of AI in scientific publishing. More specifically, the recommendations address the usage of AI by authors, reviewers, and editors ensuring accuracy, transparency, responsibility, and confidentiality of manuscripts. [1]

It is especially relevant for researchers planning to submit manuscripts to medical journals as the usage of AI is not only the problem of authors anymore. The confidentiality of a manuscript can be compromised even by the usage of AI by reviewers. AI in scientific publishing has therefore become an important consideration for researchers, reviewers, and editors.

1. What Changed in the ICMJE 2026 Recommendations?

January 2026 ICMJE update provided expanded guidance for the use of AI by authors, reviewers, and editors. January 2026 ICMJE update provided expanded guidance for the use of AI by authors, reviewers, and editors. The guidelines stress that AI can generate incorrect, misleading, biased, and authoritative-sounding information. These ICMJE AI recommendations and ICMJE guidelines 2026 provide guidance for responsible AI use in scientific publishing.

The major areas addressed include:

Area	ICMJE 2026 Focus	What It Means
Authors	Disclosure of AI use	Authors should disclose whether and how AI-assisted technologies were used
Reviewers	Permission and confidentiality	Reviewers should follow journal policy and obtain permission before using AI
Editors	Responsible governance	Editors should establish and communicate appropriate AI policies
Accountability	Human responsibility	Humans remain responsible for accuracy, integrity, and originality
Confidentiality	Protection of manuscripts	Manuscripts should not be uploaded to AI systems when confidentiality cannot be assured

ICMJE states that journals should have policies governing AI use and make those policies known to authors, reviewers, and editors. [1,2]

2. What Do the New AI Rules Mean for Peer Reviewers?

The crucial point regarding peer review is the mandatory obligation for reviewers to abide by the journal’s AI policy or to obtain approval to employ AI tools to aid in review. This makes reviewer AI disclosure rules an important part of responsible AI-assisted peer review.

It is also the duty of the reviewer to ensure the confidentiality of manuscripts submitted for review. According to the ICMJE guidelines, uploading a manuscript into an AI system might violate confidentiality due to the lack of sufficient safeguards. [2]

There lies a crucial difference between the employment of AI as a productivity tool and the uploading of confidential content of the manuscript into an AI system.

Those reviewers who employ AI tools should also inform the journal about their employment and analyse the results, as AI-generated content can be inaccurate, incomplete, or biased.

3. Why Manuscript Confidentiality Matters

Confidentiality plays a vital role in peer review because confidential communications take place among the author, the reviewer, and the journal. A manuscript may include confidential data, figures, unpublished research, methods, intellectual property, or clinical information.

If these data were uploaded to any AI system without due consent, confidentiality risks would arise, including those relating to:

Confidentiality
Intellectual Property
Unpublished Research
Disclosure of sensitive participant information

This is why the ICMJE makes confidentiality an essential part of AI-assisted peer review. [2] Peer reviewer confidentiality AI considerations are particularly important when confidential manuscripts are processed using AI systems.

4. What Authors Need to Know Before Submission

Even though the reviewing guidelines mainly focus on the reviewer, the authors must also be familiar with the guidelines since the submission process is also affected.

According to the ICMJE 2026 recommendations, any author who uses AI-enabled tools in his/her work is supposed to declare this at the time of submission and indicate how they were used. This can be done in one of the four places in the manuscript. [1]

For example:

AI Application	Appropriate Reporting Consideration
Language editing	Disclose according to journal policy
Manuscript drafting	Describe AI involvement and review output carefully
Data analysis	Report AI use in the methods where applicable
Figure generation	Describe AI-assisted generation where applicable
Literature assistance	Verify sources and citations independently

AI tools should not be listed as authors because they cannot assume responsibility for the accuracy, integrity, and originality of published work. Human authors remain accountable for the submitted manuscript. Authors should therefore understand the requirements for AI use in journal submissions before submitting their work.

5. AI Does Not Replace Human Peer Review

The trend gaining momentum currently is the shift towards human supervision of the AI-assisted publication process.

AI might facilitate pattern identification, summarization, language improvement, and some other analytical procedures. Nevertheless, scientific peer review involves the need to make expert judgments on the validity, methodology, interpretation, originality, ethics, and clinical importance of the research performed.

The ICMJE explicitly states that the results of the use of AI may be wrong, incomplete, or biased. Thus, the AI-assisted peer review cannot be considered an alternative to human reviewer’s evaluation. [2] This principle is central to AI peer review ethics and responsible scholarly publishing.

6. Common Risks Authors Should Anticipate

Authors should be aware of several AI-related risks that may arise during the publishing process.

Risk	Potential Impact	Recommended Response
Unauthorized manuscript upload	Confidentiality breach	Review journal AI policy
AI-generated inaccuracies	Incorrect review comments	Human verification
Hidden AI use	Lack of transparency	Follow disclosure requirements
Data exposure	Privacy or intellectual-property risks	Avoid unauthorized AI systems
AI bias	Unfair assessment	Maintain expert human judgment

These risks reinforce the importance of checking the specific AI policy of the target journal before submission. Authors should also understand how manuscript AI screening may be used and what safeguards are in place to protect submitted research.

7. How Authors Can Prepare for AI-Aware Peer Review

The following are some ways through which authors may enhance the preparedness of their submissions by keeping well-organized documentation of all activities carried out using artificial intelligence tools as well as ensuring that the final manuscript is independently scrutinized by the researchers. [3]

Prior to making any submission, the following needs to be considered:

The journal’s policy on artificial intelligence and peer review.
Identification of important AI-assisted activities.
Verification of all AI-assisted claims, citations, tables, and figures.
No confidentiality breaches in the research.
Human accountability in the final manuscript.

Authors should also review the target journal’s journal AI review policy and ensure that their use of AI follows the applicable ICMJE 2026 AI peer review recommendations.

8. Emerging Trend: AI-Assisted but Human-Governed Publishing

Guidelines from the 2026 ICMJE acknowledge a greater trend in academia towards AI-assisted, human-controlled scholarly publishing. While one may not consider all uses of AI to be wrong or right, responsible use of AI increasingly relies on the purpose, transparency, and confidentiality. [4]

In other words, in addition to scientific excellence, publication success in the future will depend on how researchers use AI throughout the process of research and publishing.

Connect with us to explore how we can support you in maintaining academic integrity and enhancing the visibility of your research across the world!

Conclusion

Thus, the 2026 January ICMJE Recommendations should be seen as a great achievement on the road to responsible AI use in medical publishing. The updated recommendations allow for better comprehension of what responsible use of AI by authors, reviewers, and journal editors implies, stressing the importance of confidentiality, transparency, accuracy, and human responsibility.

For authors, the key thing to remember is that using AI should be transparent, controlled, and confirmed by humans. Researchers must learn the AI policy of the targeted journal, track AI use in their work, ensure confidentiality, and make sure of the scientific accuracy of their paper.

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Frequently Asked Questions (FAQs)

1. What are the ICMJE 2026 AI recommendations?

The ICMJE 2026 recommendations provide guidance on the responsible use of artificial intelligence by authors, reviewers, and editors, emphasizing transparency, confidentiality, accuracy, and human accountability.

2. Can peer reviewers use AI to review manuscripts?

Peer reviewers should follow the target journal’s AI policy and obtain any required permission before using AI tools. They must also ensure that confidential manuscript content is protected.

3. Why is confidentiality important when using AI for peer review?

Manuscripts may contain unpublished research, intellectual property, clinical information, and sensitive data. Uploading confidential material to an AI system without appropriate safeguards could create confidentiality and privacy risks.

4. Do authors need to disclose their use of AI?

Yes. Authors using AI-assisted technologies should disclose whether and how AI was used, in accordance with the ICMJE recommendations and the specific requirements of the target journal.

5. Can AI replace human peer reviewers?

No. AI can assist with tasks such as summarization, language improvement, and pattern identification, but human reviewers remain responsible for expert assessment of methodology, validity, originality, ethics, and interpretation.

6. What should authors do before submitting a manuscript?

Authors should check the journal’s AI policy, document significant AI-assisted activities, verify AI-generated information and citations, protect confidential research data, and ensure that human authors remain accountable for the final manuscript.

References

Bauchner, H., & Rivara, F. (2026). Using AI to improve peer review and research integrity in scientific journals. Health affairs scholar, 4(2), qxag028. https://doi.org/10.1093/haschl/qxag
Erkmen, B., Duymaz, Y. K., Şahin, Ş., & Bahşi, İ. (2026). What Do the ICMJE Recommendations Tell Us?: Some Recommendations Regarding the Use of Artificial Intelligence, Focusing on the January 2026 Update. The Journal of craniofacial surgery, 37(7-8), 2133–2135. https://doi.org/10.1097/SCS.0000
Lemberger, T., Mastboim, N. S., & Rechavi, O. (2026). How do authors want to use AI for review? : A survey to assess the perception of scientists who received both AI and human reviews of their manuscripts. EMBO reports, 27(6), 1388–1392. https://doi.org/10.1038/s44319-026-00725-4
Miller, L. E., Bhattacharyya, D., Miller, V. M., & Bhattacharyya, M. (2023). Recent Trend in Artificial Intelligence-Assisted Biomedical Publishing: A Quantitative Bibliometric Analysis. Cureus, 15(5), e39224. https://doi.org/10.7759/cureus.39224