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Lancet: False AI-generated biomedical citations see 12-fold increase from 2023-2025

ended 19. May 2026

Doctors could be treating you based on principles influenced by AI hallucinated studies and the cause of the problem has accelerated 12-fold since 2023.

The Lancet has published a Columbia University audit of 2.5 million biomedical papers that found 4,046 citations to research that doesn't exist, scattered across nearly 3,000 published studies. The rate has climbed from 1 in 2,828 papers in 2023 to 1 in 277 by early 2026, with the sharpest spike coinciding with the rise of AI writing tools in mid-2024.

The study's lead author, Maxim Topaz, Associate Professor of Nursing, discovered the problem when an AI tool slipped a fake citation into his own paper, and it passed through multiple rounds of peer review before a single editor caught it. Professionally, he said after 15 years research work, "I was mortified."

Scientists use AI to help find supporting research, but if those initial finds are supported by fabricated citations lower in the chain, they don't know if the 'facts' they are seeing are accurate. No researcher can verify the full citation chain, which is where fabricated references hide. The journals with the highest rates of fabrication are large open-access publishers that charge authors to publish.

We'd like your views:

  • If you use AI tools in your own research or professional writing, what does a fabrication rate of 57 per 10,000 papers mean for the work you produce?
  • If you rely on published studies to inform decisions, what does a 1-in-277 fabrication rate mean for the research you conduct?
  • Should regulatory bodies like NICE apply different evidentiary weight to research from journals whose business model incentivises volume over verification?
  • Topaz said he believed none of the 4,046 fabricated references have been corrected or retracted. Who carries the clinical liability if a treatment decision was made using a guideline built on a study that never happened?

4 responses from the Newspage community

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Colette Mason
AI Ethics Consultant at Clever Clogs AI
If an academic with 15 years of peer-review experienced nearly published a hallucinated citation despite multiple rounds of peer review, what chance does a member of the public have when they upload biomedical papers to analyse their own needs?

Patients routinely ask AI tools to summarise studies, explain treatment options, and find supporting evidence, with no way of knowing whether the citations they're shown point to work that was actually conducted.

When the professional safeguards failed a specialist, expecting a lone layperson to catch what peer review couldn't isn't a realistic expectation.

This has important ramifications for all industries. The audit only looked at biomedical research, legal, financial, engineering, and policy literature weren't, but there's no reason to believe they're clean either.
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Katrina Young
Futurist | Chief Technology Officer CTO/CDO Ethical AI & Digital Transformation Strategist at KYC Digital
The Lancet audit of 2.5 million biomedical papers found 4,046 fabricated references across nearly 3,000 studies, with the rate rising more than 12-fold since 2023. The issue is not just AI hallucinations. It is a verification weakness AI has accelerated.

Peer review was never designed to authenticate every citation in a reference chain, and researchers cannot realistically verify every downstream source manually. That creates conditions where fabricated references can pass through authors, reviewers and publishers unnoticed.

The concern is not one fake citation in isolation, but the possibility of fabricated references influencing evidence reviews and clinical guidance through repetition and perceived legitimacy.

Regulators and publishers now need stronger citation validation and provenance checks.
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Mitali Deypurkaystha
AI Governance Strategist & CMO at AISensa
Nearly 30% of UK GPs are already using AI tools during patient consultations, according to the Nuffield Trust, yet fabricated biomedical citations are now spreading through research at a rate of 1 in 277 papers, creating a dangerous new form of “phantom evidence” in healthcare. The old warning that a lie can travel halfway around the world before the truth has pulled its boots on becomes far more serious when AI can package fiction with the confidence and formatting of legitimate science. The real danger is not a single fake study, but fabricated references quietly recycling through reviews, guidelines and AI systems until nobody can tell where the contamination started. If a treatment decision is later linked to research that never existed, we may discover modern medicine has created an accountability black hole where publishers, AI companies, reviewers and regulators can all deny responsibility.
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Kate Underwood
Founder & Chief People Strategist at Kate Underwood HR and Training
It’s shocking, but it’s also completely predictable when AI is used without proper checks. A fabrication rate rising to 1 in 277 papers means you can’t just assume a citation is real because it looks ‘academic’ and has a fancy reference list. One fake citation can quietly poison a whole chain of ‘evidence’ and still stroll through peer review. It’s like quoting a witness in court and later finding out the person never existed. If published studies are informing clinical decisions, the bare minimum is verifying sources properly, not trusting a system that’s clearly been waving things through because everyone’s busy and the formatting looks convincing.