AI Hallucinations and Fake Citations Threaten Trust in Biomedical Research: Experts Warn
USA: The integrity of scientific literature relies fundamentally on the accuracy of its references. Each citation is expected to direct readers to verifiable evidence supporting the claims made. However, two recent large-scale studies—“Fabricated citations: an audit across 2·5 million biomedical papers” by Maxim Topaz and colleagues, and “LLM hallucinations in the wild: Large-scale evidence from non-existent citations” by Zhenyue Zhao and team—have revealed a growing and concerning disruption to this foundation.
Researchers estimated that nearly 147,000 non-existent citations were generated in 2025 alone, rising sharply with increased AI use. These hallucinated references often appear credible, with realistic titles, real author names, and proper formatting, making detection difficult.
Such errors were more common in AI-intensive fields and AI-assisted manuscripts, with smaller teams and early-career researchers disproportionately affected. Notably, these citations frequently credited well-established and male researchers, raising concerns about reinforcing existing academic biases.
- Over 4,000 fabricated references identified across 2,810 biomedical papers
- More than a 12-fold increase in fabricated citations from 2023 to 2025
- By early 2026, nearly 1 in 277 papers contained at least one fabricated reference
- The majority of affected papers had 1–2 fabricated citations, though some had several
- Review articles showed a 57% higher rate of fabricated references
- Approximately 147,000 AI-generated non-existent citations were estimated in 2025
- Errors more common in AI-intensive fields and AI-assisted manuscripts
- Early-career researchers and smaller teams are more frequently affected
- Hallucinated citations often appeared credible and difficult to detect
- Most affected papers remained uncorrected or unretracted
Together, the findings highlight a growing challenge: fabricated and AI-generated citations are entering scientific literature at scale, while current peer review systems struggle to detect them. This threatens not only individual studies but also the reliability of the broader evidence base.
Given that research informs clinical guidelines and policy decisions, inaccurate or fictitious citations can compromise the entire evidence chain. Alarmingly, most affected papers had not been corrected or retracted, underscoring gaps in existing quality control mechanisms.
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