How accurate are citations of frequently cited papers in biomedical literature?
Open accessPublished version of a preprint
Abstract
Citations are an important, but often overlooked, part of every scientific paper. They allow the reader to trace the flow of evidence, serving as a gateway to relevant literature. Most scientists are aware of citations’ errors, but few appreciate the prevalence of these problems. The purpose of the present study was to examine how often frequently cited papers in biomedical scientific literature are cited inaccurately. The study included an active participation of the first authors of included papers; to first-hand verify the citations accuracy. Findings from feasibility study, where we reviewed 1540 articles containing 2526 citations of 14 most cited articles in which the authors were affiliated with the Faculty of Medicine University of Belgrade, were further evaluated for external confirmation in an independent verification set of articles. Verification set included 4912 citations identified in 2995 articles that cited 13 most cited articles published by authors affiliated with the Mayo Clinic Division of Nephrology and Hypertension. A citation was defined as being accurate if the cited article supported or was in accordance with the statement by citing authors. At least one inaccurate citation was found in 11 and 15% of articles in the feasibility study and verification set, respectively, suggesting that inaccurate citations are common in biomedical literature. The most common problem was the citation of nonexistent findings (38.4%), followed by an incorrect interpretation of findings (15.4%). One-fifth of inaccurate citations were due to chains of inaccurate citations. Based on these findings, several actions to reduce citation inaccuracies have been proposed.
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Citation inaccuracies and distortions are common.
“However, citation inaccuracies and distortions are common (Wager and Middleton 2008, Jergas and Baethge 2015, Pavlovic et al. 2021).”
From Assessing citation integrity in biomedical publications: corpus annotation and NLP models (2024) · cites this paper as Pavlovic et al. 2021
Five studies provided numbers for a mean factor of 1.15 errors per index quotation error.
“Five studies provided numbers, for a mean factor of 1.15 errors per index quotation error [17, 30, 58, 60], but many reported merely the first error of a quotation.”
From Systematic review and meta-analysis of quotation inaccuracy in medicine (2025) · cites this paper as [30]
The Results and Discussion report rates and types of inaccurate citations, but do not give a count of errors per inaccurate quotation. Searches for the 1.15 factor and multiple errors per citation found no passage establishing that figure or this paper’s contribution to the five-study calculation. Page numbers were not provided in our copy. (LLM, conf=0.72)
Experimental — accuracy not yet measuredTraditional peer review often fails to address widely accepted, but suboptimal, research practices and guideline details.
“Traditional peer review often fails to address widely accepted, but suboptimal, research practices and guideline details.”
From Is the future of peer review automated? (2022) · cites this paper as [29]
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Cites
Drug and Opioid-Involved Overdose Deaths — United States, 2013–2017
Scholl, L., Seth, P., Kariisa, M., Wilson, N. O., & Baldwin, G. T. (2018) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm675152e1 · Cited by 1,734 · see citing works
Intra-articular fractures of the distal end of the radius in young adults.
Knirk, J. L., & Jupiter, J. B. (1986) · Journal of Bone and Joint Surgery · doi:10.2106/00004623-198668050-00003 · Cited by 1,368 · see citing works
Pipkins, H. R., Bradshaw, J. L., Keller, L. E., Swiatlo, E., & McDaniel, L. S. (2017) · PLOS ONE · doi:10.1371/journal.pone.0179159 · Cited by 1,338 · see citing works
Addiction Rare in Patients Treated with Narcotics
(1980) · New England Journal of Medicine · doi:10.1056/nejm198001103020221 · Cited by 1,106 · see citing works
Zhou, Q.-H. (2015) · Chinese Nursing Research · doi:10.1016/j.cnre.2016.01.001 · Cited by 738 · see citing works
Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?
Hyseni, L., Elliott-Green, A., Lloyd‐Williams, F., Kypridemos, C., O’Flaherty, M., McGill, R., Orton, L., Bromley, H., Cappuccio, F. P., & Capewell, S. (2017) · PLoS ONE · doi:10.1371/journal.pone.0177535 · Cited by 281 · see citing works
(2021) · International Committee of Medical Journal Editors; Media Sphera Publishers; Association of Science Editors and Publishers eBooks · doi:10.24069/recicmje-2021 · Cited by 219 · see citing works
A 1980 Letter on the Risk of Opioid Addiction
Leung, P. T. M., Macdonald, E. M., Stanbrook, M. B., Dhalla, I. A., & Juurlink, D. N. (2017) · New England Journal of Medicine · doi:10.1056/nejmc1700150 · Cited by 193 · see citing works
How accurate are quotations and references in medical journals?
de Lacey, G., Record, C., & Wade, J. (1985) · BMJ · doi:10.1136/bmj.291.6499.884 · Cited by 160 · see citing works
Linear mixed models and penalized least squares
Bates, D. M., & DebRoy, S. (2004) · Journal of Multivariate Analysis · doi:10.1016/j.jmva.2004.04.013 · Cited by 128 · see citing works
Eichorn, P., & Yankauer, A. (1987) · American Journal of Public Health · doi:10.2105/ajph.77.8.1011 · Cited by 114 · see citing works
Systematic Reviews on Rehabilitation Interventions
Handoll, H. H. (2006) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2006.04.006 · Cited by 114 · see citing works
The International Committee of Medical Journal Editors
van der Weyden, M. V. (2006) · doi:10.2349/biij.2.4.e54-13 · Cited by 110 · see citing works
The accuracy of citation and quotation in otolaryngology/head and neck surgery journals
Fenton, J. E., Brazier, H., Souza, A., Hughes, J. P., & McShane, D. P. (2000) · Clinical Otolaryngology · doi:10.1046/j.1365-2273.2000.00322.x · Cited by 94 · see citing works
Quotation accuracy in medical journal articles—a systematic review and meta-analysis
Jergas, H., & Baethge, C. (2015) · PeerJ · doi:10.7717/peerj.1364 · Cited by 88 · see citing works
Mogull, S. A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0184727 · Cited by 75 · see citing works
Citation and quotation accuracy in three anatomy journals
Lukić, I. K., Lukić, A., Glunc̆ić, V., Katavić, V., Vuc̆enik, V., & Marus̆ić, A. (2004) · Clinical Anatomy · doi:10.1002/ca.10255 · Cited by 56 · see citing works
Quotation and Reference Accuracy of Three Nursing Journals
Schulmeister, L. (1998) · Image: the Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.1998.tb01269.x · Cited by 53 · see citing works
Incorrect citations give unfair credit to review authors in ecology journals
Teixeira, M. C., Thomaz, S. M., Michelan, T. S., Mormul, R. P., Meurer, T., Fasolli, J. V. B., & Silveira, M. J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0081871 · Cited by 52 · see citing works
van der Vet, P. E., & Nijveen, H. (2016) · Research Integrity and Peer Review · doi:10.1186/s41073-016-0008-5 · Cited by 50 · see citing works
Reference accuracy in the emergency medicine literature
Goldberg, R., Newton, E., Cameron, J., Jacobson, R., Chan, L., Bukata, W. R., & Rakab, A. (1993) · Annals of Emergency Medicine · doi:10.1016/s0196-0644(05)81995-x · Cited by 49 · see citing works
Accuracy of references in general surgical journals — An old problem revisited
Reddy, M. S., Srinivas, S., Sabanayagam, N., & Balasubramanian, S. P. (2008) · The Surgeon · doi:10.1016/s1479-666x(08)80067-4 · Cited by 41 · see citing works
Lee, S. Y., & Lee, J. S. (1999) · International Journal of Dermatology · doi:10.1046/j.1365-4362.1999.00706.x · Cited by 34 · see citing works
Reference accuracy in the general surgery literature
Awrey, J., Inaba, K., Barmparas, G., Recinos, G., Teixeira, P. G. R., Chan, L. S., Talving, P., & Demetriades, D. (2011) · World Journal of Surgery · doi:10.1007/s00268-010-0912-7 · Cited by 33 · see citing works
Quotation errors in general science journals
Smith, N., & Cumberledge, A. (2020) · Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences · doi:10.1098/rspa.2020.0538 · Cited by 32 · see citing works
(2005) · PubMed · Cited by 28 · see citing works
Inappropriate attribution: the “lazy author syndrome”
GAVRAS, H. (2002) · American Journal of Hypertension · doi:10.1016/s0895-7061(02)02989-8 · Cited by 27 · see citing works
Buijze, G. A., Weening, A. A., Poolman, R. W., Bhandari, M., & Ring, D. (2012) · The Journal of Bone and Joint Surgery. British volume · doi:10.1302/0301-620x.94b2.27618 · Cited by 27 · see citing works
Misquotation of a Commonly Referenced Hand Surgery Study
Porrino, J. A., Tan, V., & Daluiski, A. (2008) · The Journal Of Hand Surgery · doi:10.1016/j.jhsa.2007.10.007 · Cited by 24 · see citing works
The Virtues of Correct Citation
Mertens, S., & Baethge, C. (2011) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2011.0550 · Cited by 19 · see citing works
How accurate are quotations and references in medical journals?
Lowry, S. R. (1985) · BMJ · doi:10.1136/bmj.291.6506.1421 · Cited by 19 · see citing works
Singh, S., & Chaudhary, R. (2009) · Indian Journal of Dermatology, Venereology and Leprology · doi:10.4103/0378-6323.55392 · Cited by 14 · see citing works
Ingelfinger, F. J. (1976) · New England Journal of Medicine · doi:10.1056/nejm197611042951911 · Cited by 13 · see citing works
Davis, T. R. C. (2008) · Journal of Hand Surgery (European Volume) · doi:10.1177/1753193408088242 · Cited by 5 · see citing works
Handoll, H. H., & Atkinson, G. (2015) · BMJ · doi:10.1136/bmj.h6309 · Cited by 4 · see citing works
Process and outcome of care for patients with ovarian cancer.
Lawton, F. E., & Blackledge, G. R. P. (1985) · BMJ · doi:10.1136/bmj.291.6506.1421-d · Cited by 2 · see citing works
Flagged first, then by citations
1 of the 37 references couldn’t be matched to a known paper.
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Sorted by citations
Is the future of peer review automated?
Schulz, R., Barnett, A., Bernard, R., Brown, N. J. L., Byrne, J. A., Eckmann, P., Gazda, M. A., Kilicoglu, H., Prager, E. M., Salholz-Hillel, M., et al. (2022) · BMC Research Notes · doi:10.1186/s13104-022-06080-6 · Cited by 80 · see citing works
Self-citationDe Cassai, A., Geraldini, F., De Pinto, S., Carbonari, I., Cascella, M., Boscolo, A., Sella, N., Monteleone, F., Cavaliere, F., Munari, M., et al. (2022) · Anesthesiology · doi:10.1097/aln.0000000000004302 · Cited by 34 · see citing works
Quotation accuracy in educational research articles
Lazonder, A. W., & Janssen, N. (2021) · Educational Research Review · doi:10.1016/j.edurev.2021.100430 · Cited by 20 · see citing works
Burden of proof: combating inaccurate citation in biomedical literature
Peoples, N., Østbye, T., & Yan, L.-J. L. (2023) · British medical journal · doi:10.1136/bmj-2023-076441 · Cited by 13 · see citing works
Drivers of citations in social pharmacy and practice research articles
Shcherbakova, N., Desselle, S. P., Bandiera, C., Canedo, J., Law, A. V., & Aslani, P. (2024) · Research in Social and Administrative Pharmacy · doi:10.1016/j.sapharm.2024.03.004 · Cited by 14 · see citing works
Assessing citation integrity in biomedical publications: corpus annotation and NLP models
Sarol, M. J., Ming, S., Radhakrishna, S., Schneider, J., & Kilicoglu, H. (2024) · Bioinformatics · doi:10.1093/bioinformatics/btae420 · Cited by 12 · see citing works
Peoples, N., Gebert, J. T., & Clark, D. (2023) · Medical Humanities · doi:10.1136/medhum-2023-012695 · Cited by 12 · see citing works
Presence and consequences of positive words in scientific abstracts
Edlinger, M., Buchrieser, F., & Wood, G. M. D. O. (2023) · Scientometrics · doi:10.1007/s11192-023-04864-6 · Cited by 11 · see citing works
Systematic review and meta-analysis of quotation inaccuracy in medicine
Baethge, C., & Jergas, H. (2025) · Research Integrity and Peer Review · doi:10.1186/s41073-025-00173-z · Cited by 11 · see citing works
Kamel, S. A., & EL-Sobky, T. A. (2023) · Research Integrity and Peer Review · doi:10.1186/s41073-023-00135-3 · Cited by 9 · see citing works
The impact of winning funding on researcher productivity, results from a randomized trial
Barnett, A. G., Blakely, T. A., Liu, M., Garland, L., & Clarke, P. (2024) · Science and Public Policy · doi:10.1093/scipol/scae045 · Cited by 11 · see citing works
An author’s guide to mastering academic writing skills: Discussion of a medical manuscript
EL-Sobky, T. A. (2021) · Journal of Musculoskeletal Surgery and Research · doi:10.25259/jmsr_79_2021 · Cited by 9 · see citing works
Wang, Z., Yang, Y., Tang, F., & Wu, M. (2024) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2024.102615 · Cited by 9 · see citing works
Inaccuracy of idiopathic intracranial hypertension diagnosis in case reports
Eshtiaghi, A., Margolin, E., & Micieli, J. A. (2023) · Eye · doi:10.1038/s41433-023-02499-8 · Cited by 6 · see citing works
Quotation Accuracy of Systematic Review and Meta-Analysis Protocols on Acupuncture
Morán, J. M., Romero-Moreno, M., García, A. S., & Herrera‐Peco, I. (2021) · Healthcare · doi:10.3390/healthcare10010055 · Cited by 6 · see citing works
Sauder, M., Newsome, K., Zagales, I., Autrey, C., Das, S., Ang, D. N., & Elkbuli, A. (2022) · The American Surgeon · doi:10.1177/00031348211067993 · Cited by 5 · see citing works
Citation Misuses in the Biomedical Literature and Its Effects on Public Health
Dumas-Mallet, E., & Gonon, F. (2022) · Springer eBooks · doi:10.1007/978-3-030-99680-2_42 · Cited by 5 · see citing works
Curlewis, K., Leung, B., Sinclair, L., Ricketts, D., & Rogers, B. A. (2022) · European Journal of Orthopaedic Surgery & Traumatology · doi:10.1007/s00590-022-03243-w · Cited by 4 · see citing works
Wakeling, S., Paramita, M. L., & Pinfield, S. (2025) · Journal of the Association for Information Science and Technology · doi:10.1002/asi.70000 · Cited by 8 · see citing works
Le mésusage des citations et ses conséquences en médecine
Dumas-Mallet, E., Boraud, T., & Gonon, F. (2021) · médecine/sciences · doi:10.1051/medsci/2021142 · Cited by 5 · see citing works
The evolution of scientific literature as metastable knowledge states
Koneru, S., McCauley, D. R., Smith, M. C., Guarrera, D., Robinson, J., & Rajtmajer, S. M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0287226 · Cited by 3 · see citing works
An Author’s Guide to Mastering Research Communication Skills: Introduction of a Medical ManuscriptPreprint
EL-Sobky, T. A. (2021) · Preprints.org · doi:10.20944/preprints202112.0191.v1 · Cited by 3 · see citing works
Artificial intelligence: a new editor limiting self-citation malpractice
Sanfilippo, F., Messina, A., Corradi, F., & Robba, C. (2023) · Critical Care · doi:10.1186/s13054-023-04601-8 · Cited by 3 · see citing works
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Barnett, A. G. (2025) · eLife · doi:10.7554/elife.108748 · Cited by 3 · see citing works
de Waal, A. (2026) · Journal of Engineering Management and Competitiveness · doi:10.5937/jemc2600001w · Cited by 2 · see citing works
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Amen, J., Kamel, S. A., & EL-Sobky, T. A. (2024) · Journal of Musculoskeletal Surgery and Research · doi:10.25259/jmsr_249_2024 · Cited by 2 · see citing works
Rollano, C., Pérez-González, J. C., & Román-González, . (2025) · Accountability in Research · doi:10.1080/08989621.2025.2495287 · Cited by 1 · see citing works
Tamrin, S. I., Omar, N. F., Ngah, R., Bakhodirovich, G. S., & Absamatovna, K. G. (2025) · Lecture notes in computer science · doi:10.1007/978-3-031-95296-8_2 · Cited by 1 · see citing works
August, E. T., Mahieu, A., & Brouwer, A. F. (2026) · PLOS Global Public Health · doi:10.1371/journal.pgph.0007257 · Cited by 2 · see citing works
Nature vs. Nurture in Science: The Effect of Researchers Segregation on Papers’ Citation Histories
Jaramillo, A. M., Montes, F., & de Menezes, R. P. (2023) · Springer proceedings in complexity · doi:10.1007/978-3-031-28276-8_13
Baghele, O. N., Nagime, S. C., Ugale, G. M., Vandana, K. L., & Bhandari, V. D. (2023) · Research Square · doi:10.21203/rs.3.rs-2981924/v1
Baghele, O. N., Nagime, S. C., Ugale, G. M., Bhandari, V. D., & Vamdama, K. L. (2023) · Journal of the International Clinical Dental Research Organization · doi:10.4103/jicdro.jicdro_60_23
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Khan, N., & Bhat, A. (2023) · Journal of Information and Knowledge · doi:10.17821/srels/2023/v60i6/170821
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Macdonald, S. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5365578
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Hicks, R. W. (2025) · AORN Journal · doi:10.1002/aorn.14418
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Kamel, S. A., & El-Sobky, T. A. (2024) · Figshare · doi:10.6084/m9.figshare.26611871
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EL-Sobky, T. A., & Mahmoud, S. (2026) · Journal of Musculoskeletal Surgery and Research · doi:10.25259/jmsr_586_2025
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Macdonald, S. (2026) · Social Science Information · doi:10.1177/05390184261456132
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Lukić, A., KHAMOOSHI, P., Patel, N., Hemmat, A., Modrić, M., Mirkarimi, S., Reiner, K., Candido, K. D., Suresh, S., Edelstein, S. B., et al. (2026) · Frontiers in Anesthesiology · doi:10.3389/fanes.2026.1868790
- Authors
- Pavlovic, V., Weissgerber, T., Stanisavljevic, D., Pekmezovic, T., Milicevic, O., Lazovic, J. M., Cirkovic, A., Savic, M., Rajovic, N., Piperac, P., Djuric, N., Madzarevic, P., Dimitrijevic, A., Randjelovic, S., Nestorovic, E., Akinyombo, R., Pavlovic, A., Ghamrawi, R., Garovic, V., & Milic, N.
- Affiliations
- University of Belgrade (RS)
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE)
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Mayo Clinic (US)
- Corresponding author
- Milic, Natasa
- ORCID
- Venue
- Clinical Science
- Publisher
- Portland Press Ltd.
- Published
- 2021-03
- Volume
- 135
- Issue
- 5
- Pages
- 671-681
- ISSN
- 0143-5221 (ISSN-L)
- 1470-8736
- PMC
- PMC8048031
- OpenAlex
- W3131199412
- Cited by
- 46
- References
- 37
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 7 · 2023: 11 · 2022: 5 · 2021: 5
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Science (publishedVersion, cc-by)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- National Repository of Dissertations in Serbia (submittedVersion, other-oa)
- Funders
- National Heart, Lung, and Blood Institute (R01HL136348)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › scientometrics and bibliometrics research
- Social Sciences › Arts and Humanities › History and Philosophy of Science › Academic Writing and Publishing
- Social Sciences › Safety Research › Academic integrity and plagiarism
- Keywords
- citation errors, citation accuracy, biomedical literature, citation verification, scientific integrity
- MeSH terms
- Data Accuracy, Periodicals as Topic, Bibliometrics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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