Safeguarding the integrity of scientific literature in the 21st century.

The digital era has dramatically expanded scientific publishing, with journals and the annual number of publications increasing unprecedentedly. While this growth has enhanced accessibility, collaboration, and dissemination, it has also introduced significant challenges to the integrity of scientific literature. Mega-journals and open-access models, although beneficial in many respects, have contributed to inequities and facilitated the rise of predatory journals, which often publish low-quality or misleading research with minimal peer review. At the same time, the use of spin, defined as rhetorical strategies that exaggerate or misrepresent findings, has become widespread and can influence the interpretation of results by researchers, clinicians, and the public. Importantly, low-quality, misleading, and even fraudulent research is not confined to predatory outlets and can occur in well-established, high-impact journals, highlighting the limitations of relying solely on journal reputation. While critical appraisal remains central to evaluating research, traditional approaches often fail to fully address the risks of spin, predatory publishing, and fraud. This article explores these challenges, examining how such practices compromise scientific integrity, distort evidence, and affect decision-making. It also outlines practical strategies for researchers, reviewers, and clinicians to critically assess publications, safeguard reliability, and uphold the credibility of scientific literature. IMPACT STATEMENT: Researchers and clinicians now require a guide to navigate the modern landscape of scientific publishing, which is challenged by the proliferation of predatory journals, the use of "spin" to misrepresent findings, and outright fraud, which has eroded scientific integrity, leading to a need for a new level of scrutiny. This paper outlines practical strategies and tools for researchers, clinicians, and reviewers to identify unreliable evidence, emphasizing that critical appraisal must go beyond traditional methods to assess trustworthiness and integrity. By promoting these skills, all can safeguard the credibility of science and protect evidence-based practice.