Fabricated references in biomedical papers surged from 1 in 2,828 in 2023 to 1 in 277 by early 2026. The Lancet study used AI to detect AI hallucinations across 2.47 million papers, revealing systemic integrity risks for life sciences investors.
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A large-scale review of biomedical literature has uncovered a systemic integrity problem: 4,046 fabricated references across 2,810 published journal articles, with the rate of contamination accelerating more than 12-fold in under three years.
The findings, published as a correspondence in The Lancet, used an automated reference verification system developed by researchers at Columbia University and the University of Eastern Finland. The team reviewed 2,471,758 papers containing 125,615,773 references from PubMed Central's Open Access subset, covering January 1, 2023 through February 18, 2026.
What the data reveals is not a static background noise problem but a rapidly deteriorating one.
In 2023, approximately one in 2,828 papers had at least one fabricated reference. By 2025, that ratio had compressed to one in 458. In the first seven weeks of 2026, it worsened further to one in 277 papers – a 12-fold increase from the starting point.
The research team used the Claude 3.5 Haiku large language model from Anthropic to help separate honest citation errors from outright fabrications. Any reference that could not be located across PubMed, Crossref, OpenAlex and Google Scholar was classified as fabricated rather than simply erroneous.
A single paper published in 2025 in an open-access oncology journal, covering ureteroileal anastomotic techniques, contained 18 fabricated references out of 30 total citations – a 60% fabrication rate. Across the entire dataset, 246 different papers contained three or more fabricated references.
The research team identified specific authors as repeat offenders. One pair of authors had 11 separate papers in a single surgical journal in 2025, collectively containing 15 fabricated references. The authors called out so-called
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