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An AI-assisted audit led by researchers at Columbia University and published in The Lancet has identified 4,046 fabricated references across 2,810 peer‑reviewed biomedical papers after scanning 2.47 million open‑access articles (Jan 2023–Feb 18, 2026). Of 125.6 million extracted references, 97.1 million carried PubMed identifiers and were verified against PubMed, Crossref, OpenAlex and Google Scholar.
Fabricated citations — reference entries whose claimed titles correspond to no existing publication — rose sharply: about one in 2,828 papers in 2023, one in 458 in 2025, and one in 277 in the first seven weeks of 2026.
The authors report a more than 12‑fold increase since 2023, with the steepest jump after mid‑2024 coinciding with wider adoption of large language models (LLMs). The team used an automated verification pipeline (reporting 91% precision) with filters including an LLM to reduce false positives.
Examples included individual papers with a majority of references fabricated and patterns suggestive of paper‑mill activity.
Authors call for publishers to adopt automated reference checks, indexers to add integrity metadata, and retrospective screening and corrective action where needed.
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The audit identifies a worrying rise in fabricated citations but relied heavily on AI screening and a database‑matching workflow with imperfect precision. Practitioners warn of false positives and limited human verification, prompting calls for stronger editorial checks and targeted audits.


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