Publication integrity: what is it, why does it matter, how it is safeguarded and how could we do better?

Trustworthy literature is an essential part of knowledge, evidence-based information, and science. However, publications can contain mistakes or have results from unreliable research, which may compromise their integrity. In this review, we discuss publication integrity, with a focus on our field of biomedicine, and how it could be improved. In our experience, compromised publication integrity is frequently poorly handled, and we, and others, have reported that responses to publication integrity concerns can be inefficient, inconsistent, slow, opaque, and incomplete. Checklists and tools are now available to assist in the assessment of publication integrity, but systemic changes are needed. However, this requires many of the key parties involved (journals, publishers, institutions, academic societies, and regulators) to acknowledge and engage with the problem. There is little evidence of a willingness to do this. We conclude that it has been recognised for many years that the system for dealing with publication integrity is broken, but currently, there appears little interest in trying to improve it.