Finding · Confirmed fabrications
0
citations in the biomedical literature that point to studies which do not exist. Verified across PubMed, Crossref, OpenAlex, Google Scholar.
CaseCIT-2026-01
Status● Open
WindowJan 2023 — Feb 2026
CorpusPubMed Central OA · 2.5M papers

References
to nowhere.

An automated audit of citation integrity across 2.5 million biomedical papers uncovers a rising signature of references that cite studies which do not exist — spreading through the peer-reviewed literature at more than twelve times the rate of three years ago.

Topaz · Roguin · Gupta · Zhang · Peltonen
Columbia University Irving Medical Center · The Lancet, Vol 407, May 9, 2026
Download published paper PDF · The Lancet 2026
Scroll
Growth
>12×
Fabricated citations per 10,000 papers, 2023 → early 2026.
Prevalence
1 : 458
Papers containing at least one fabricated citation, by 2025.
Corpus
2.5M
Biomedical papers audited · 125.6M references extracted.
Most affected single paper
18 / 30
References fabricated in one published study (Ren et al., 2025).
§ 01 / The TrendFig. 1

A more than 12× rise in three years. No precedent.

The quarterly rate per 10,000 papers indexed in PubMed Central rose from approximately four in 2023 to 56.9 in early 2026, a more than twelvefold increase, with no precedent in the recorded history of citation error.

~4/10k
Baseline — 2023
56.9/10k
Latest — early 2026
>1,200%
Change over audit window
Fabricated citations · quarterly rate
PMC OA · 2023 → early 2026 · n = 2.5M
§ 02 / The ScaleFig. 2

From 125 million references to 4,046 fabrications.

Every reference in the corpus was verified against four independent databases. The funnel below traces how 125.6M references narrowed to 4,046 confirmed fabrications.

Step 01References extracted
125,600,000100.000 %
Step 02With verifiable identifiers
97,100,00077.310 %
Step 03Flagged for mismatch
30,8120.024 %
Step 04 · ConfirmedFabricated citations
4,0460.0032 %
§ 03 / The AnatomyInteractive

Can you spot the fake?

Fabricated citations are engineered to look indistinguishable from real ones: real-sounding authors, plausible journals, credible dates. Select the one you believe is fabricated, then reveal the verdict.

Prompt — Click the fabricated citation
Citation [23] · Real
Verified
Martinez-Lopez R, Chen W, et al.
"Oxidative stress biomarkers in cardiovascular disease: a systematic review."
J Cardiovasc Med. 2021;45(3):234–241.
Found in PubMed (PMID 33XXXXXX)
Title matches indexed record
Authors verified
Journal exists
Citation [47] · Suspect
Fabricated
Robertson AJ, Nakamura T, et al.
"Novel redox-sensitive nanoparticle delivery systems for targeted cardiac regeneration therapy."
Adv Cardiol Res. 2024;12(1):89–102.
Not found in PubMed
Not found in Crossref
Not found in OpenAlex
Not found in Google Scholar
Journal "Adv Cardiol Res" does not exist

Both citations read as equally professional. Only automated verification across FOUR INDEPENDENT DATABASES can reliably tell them apart.

§ 04 / The Case StudyRen et al., 2025

One paper. Thirty references. Eighteen fabricated.

Each tile below is one reference in a single published paper on ureteroileal anastomotic stricture rates. Eighteen point to studies that do not exist.

Ren C, Xiao M, Zhu J, Tong W, Yi F. Front. Oncol. 15, 1613772 (2025)
Fabricated · 18 Valid · 12 Unverified · 3

Citation pattern suggests systematic rather than incidental fabrication. Source paper ↗

§ 05 / The ConcentrationFig. 3

Not all publishers are equal.

Fabricated citations are not uniformly distributed. The highest-rate publisher produced fabrications at more than fourteen times the rate of the most selective journals in the dataset.

Rate per 10,000 papers · top publishers (anonymized)
Publisher A
56.8
Publisher B
40.9
Publisher C
21.6
Publisher D
13.7
Publisher E
8.0
Publisher F
5.1
Most selective
3.9
Ratio · Highest vs. most selective
14×

More than a third of all fabricated citations came from just two publishers.

The concentration is not random. It tracks editorial intensity, peer-review depth, and the economics of fast-turnaround publishing.

§ 06 / Human-ReadableIn plain terms

What the data means.

1/458

By 2025, one in every 458 biomedical papers contained at least one fabricated citation.

18/30

The most affected single paper had eighteen of thirty references pointing to studies that do not exist.

≥ 3

Many affected papers contain three or more fabricated citations — evidence of systematic, not incidental, fabrication.

Estimated in real time
0

fabricated citations have entered the biomedical literature since you opened this page.

Session 00:00 Rate · 56.9 / 10,000 Flux · ~1,600 papers/day

The literature does not correct itself.