A new audit in The Lancet found fabricated references embedded in biomedical publications indexed on PubMed Central, highlighting how AI-enabled workflows can introduce errors into the permanent research record. Associate professor Maxim Topaz at Columbia University’s School of Nursing and colleagues reviewed nearly 2.5 million biomedical papers and 97 million citations. The researchers identified more than 4,000 fake references across nearly 3,000 papers, with the rate rising over time; Topaz reported a vertical increase in 2024 after AI tools became more widely used in research tasks. The study found that, over the first seven weeks of 2026, roughly one in 277 papers included at least one non-existent reference. For faculty, editors, and research compliance teams, the findings raise immediate operational questions about citation verification, AI tool controls, and journal screening protocols—especially because biomedical evidence chains rely on citations to guide clinical decisions.