Artificial Science in a Post-Intelligence Crisis: The Storm in Medical Publishing

When I first heard the term ‘post-truth’ used to describe our current era, I imagined a period of conflict between opposing powerful forces that would envelope public debate, news media, the political process and possibly popular culture too. But I also imagined that our trusted institutions of empiricism and reason would hold sway, thwarting the excesses of subjectivism and phony facts.

Alas, my scientific idealism may have got the better of me! Today the medical and scientific publishing industry is grappling with a crisis so severe it threatens the integrity of research publishing and by implication the scientific record. The crisis, which has reached the attention of mainstream media, involves the publication of tens of thousands of bogus papers, potentially hindering drug development and compromising medical research. Newspapers have run headlines declaring that ‘the situation has become appalling’ [1] and have quoted experts who are concerned that ‘scientific publishing is broken and unsustainable’ [2].

The crisis is being driven by several interconnected factors, which have created what might be called a perfect storm [2]:

• Manuscript Overload: The volume of published papers has increased dramatically in recent years. One study has shown that between 2016 and 2022 the number of published papers has grown by 47%, which far outpaced the limited growth in the scientific workforce [3]. In one recent case, a journal rejected a manuscript simply because the editor was “unable to find the required number of reviewers” [4]
• The "Publish or Perish" Culture: Researchers are heavily incentivised to publish frequently to advance their careers. This pressure can lead to unethical practices such as p-hacking where data is manipulated to achieve statistical significance, or salami slicing - the practice of breaking one study into multiple redundant publications to inflate individual publication counts
• Publisher Business Models: Many publishers benefit from the volume of submitted manuscripts. For example, between 2015 and 2018, researchers paid over US$1 billion in open access fees to the "big five" science journal publishers [5]. This creates a strong incentive for journals to launch large numbers of "special issues" to attract even greater numbers of submissions

Threats to Integrity

As the system becomes overwhelmed, journals increasingly struggle to find qualified reviewers for submitted manuscripts. One study found that academics provided over 100 million hours for peer reviewing in 2020 alone – time which is donated free of charge to journals [6]. The consequent fatigue in the peer-reviewing system is causing it to fail as a safeguard for the integrity of scientific reporting. As a result, the door has been opened for unscrupulous activities such:

• Paper Mills: Commercial entities that produce fraudulent manuscripts and may sell authorship positions on them. Products of paper mills can be difficult to spot as they often use authentic manuscripts as templates, rendering them with random gene or disease names. Once published, these fraudulent papers can then get incorporated into large databases that are used in drug discovery
• Artificial Intelligence (AI)-Generated Fraud: Recent cases have highlighted nonsensical, AI-generated figures and text appearing in journals, raising serious questions about editorial oversight and the integrity of the peer-review system [7]

The Scale of the Issue

In 2023, manuscript retractions topped 10,000 for the first time [8]. However, Ivan Oransky and Adam Marcus, co-founders of the organisation Retraction Watch, believe this number is merely the "tip of the iceberg" and suggests the number of manuscripts that should be retracted may be as much as ten times this number [9].

Large language (AI) models are only as good as the data they are trained with. The prevalence of unchecked AI-generated content in scientific manuscripts poses the danger that artificial data will not only be replicated as it gets cited by other manuscripts or used in meta-analyses, but will become ever more enriched within manuscripts, as the ratio of AI to human generated content steadily increases.

Common Types of Medical Publishing Fraud

In contrast, some publishers argue that the increase in published manuscripts is beneficial and reflects a more globalised research landscape. For example, Ritu Dhand of Springer Nature suggests that the surge in publications is not necessarily a negative "greedy" trend, but rather a reflection of a research landscape that has quadrupled in size over the last 25 years [2]. In this way, research has become a truly global endeavour, with significant leadership now coming from China rather than just Western nations. Dhand argues that the volume of papers published in a digital world doesn’t matter so much. What is more important is ensuring that the globalised scientific community has the opportunity to publish.

Several potential solutions have been suggested in order to mitigate the impact of ever-growing manuscript submissions [10][11]]. These include extending reviewer search periods, expanding reviewer recruitment internationally, utilizing editorial board members or offering incentives for peer review such as public recognition or reviewer credits with the journal publishing group. The non-profit journal Federation of European Biochemical Societies (FEBS) Letters has introduced another solution, “portable peer review”, which allows authors to transfer peer-review reports of a rejected manuscript to another journal, enabling editorial decisions without repeating the review process¹⁰.

With well-seasoned skills of reason and ingenuity, scientists, publishers and industry colleagues alike are starting to come together to find solutions for the crisis. After all, the crisis may merely reflect the dawn of a technological revolution for which our established approaches are no longer sufficient. But while we play catch up, journals need to implement rigorous measures to prevent the corruption of the scientific record and the collapse of confidence in it. To this end, an army of medical writers awaits deployment to conduct integrity reviews of manuscripts, many of whom may have lost their medical writing jobs as a result of the very same technological revolution.

Adapting a quote from an old revolutionary, one might say: the epoch of human creation is dying, and the new technological age struggles to be born - now is the time of monsters!

References

1. McKie (2024). ‘The situation has become appalling’: fake scientific papers push research credibility to crisis point. The Guardian.
2. Sample (2025). Quality of scientific papers questioned as academics ‘overwhelmed’ by the millions published. The Guardian.
3. Hanson et al. (2024). The strain on scientific publishing. Quantitative Science Studies.
4. Selmaoui. (2025). When Reviewer Scarcity Becomes a Reason for Rejection, Scientific Integrity Is at Risk. The Scientist.
5. Butler et al. (2023). The oligopoly’s shift to open access: How the big five academic publishers profit from article processing charges. Quantitative Science Studies.
6. Aczel et al. (2021). A billion-dollar donation: estimating the cost of researchers’ time spent on peer review. Research Integrity and Peer Review.
7. Woodruff Health Sciences Center Library (2025). Medical Frymbial–or, How Did We Get Here With AI?
8. Van Noorden. (2023). More than 10,000 research papers were retracted in 2023 — a new record. Nature.
9. Oransky, I. and Marcus, A. (2023). There’s far more scientific fraud than anyone wants to admit. The Guardian.
10. Wright. (2024). Five problems plaguing publishing in the life sciences—and one common cause. FEBS Letters.
11. Vineis. (2024). Scientific publishing: crisis, challenges, and new opportunities. Frontiers in Public Health.