TUESDAY, May 12, 2026 (HealthDay News) -- There has been an increase in fabricated references used in medical papers, according to a research letter published in the May 9 issue of The Lancet.Maxim Topaz, Ph.D., from Columbia University in New York City, and colleagues developed an automated reference verification system scanning PubMed Central's Open Access subset from Jan. 1, 2023, to Feb. 18, 2026, including 2,471,758 papers and 125,615,773 structured references. References were extracted from full-text extensible markup language, retaining those with a PubMed identifier (PMID).The researchers found that 97.1 million of the 125.6 million references carried a PMID and were verified; the remaining 23 percent were excluded. References passing all filters were verified; those not found in any database were classified as fabricated. Of the 97.1 million verified references, 4,046 references across 2,810 papers were identified as fabricated. Approximately one in 2,828 papers contained at least one fabricated reference in 2023; this increased to one in 458 by 2025 and one in 277 papers in the first seven weeks of 2026. The fabrication rate increased from about four per 10,000 papers in 2023 to 51.3 per 10,000 papers in the fourth quarter of 2025, reaching 56.9 per 10,000 papers in early 2026."A medical professional or clinical guideline developer has no way of knowing that the evidence they are relying on does not exist. For example, one paper we reviewed had 18 out of 30 fake references," Topaz said in a statement. "Some of those citations are already being cited by other papers and appear in systematic reviews that inform clinical care."Abstract/Full Text.Sign up for our weekly HealthDay newsletter