Jun 15, 2026 | In Practice | 0 comments

Shining the Spotlight: The Dark Side of Publishing Gets Even Darker

Michael Nissen, Independent Medical Publications Professional, USA; Michelle Parrish, MEDiSTRAVA, an Inizio Medical Company; Jennifer Bodkin, Envision Spark, an Envision Medical Communications Agency, Envision Pharma Group, UK; Anna Santaromita, Natera, Inc., USA; Sam Cavana, Taylor & Francis Group, UK.

Email your questions and comments on this article to ismpp@ismpp.org.

The Exponential Growth of Predatory Publication Practices

Predatory journals and congresses.1,2 That’s the extent of it, right? No, unfortunately, it’s just the tip of the iceberg. You read about predatory journals and congresses in the Sept. 9, 2025, issue of ISMPP Insider (formerly The MAP Newsletter).1 Now, let’s explore paper mills and other fraudulent publishing activities threatening the integrity of research and publishing.

Operating in the medical publishing field since the early 2010s,3 and now empowered by artificial intelligence (AI), paper mills are fraudulent organizations that sell fake manuscripts.4,5 Their activities have exploded over the past decade or more. As if in a silent auction, imagine submitting a cost bid to be an author on a falsified paper, for which the highest bidder “wins.”3 From this transactional wheeling and dealing have emerged new quality problems in publishing: real science in fake journals and fake science in real journals. A recent report suggests that 10% of cancer publications could be fabricated.4,5 Author identity theft? Beyond long-standing abuses such as gift and ghost authorship, a more troubling development is emerging—researchers finding their names added to papers without their knowledge. In addition, a few bad actors have infiltrated journals and publishers as complicit insiders. Review mills (predatory peer review) and paper mines (hijacking of publicly available data sets for meaningless analyses) are also part of this market of fraudulent services for hire.

The result: large-scale fraud and a criminal enterprise with far-reaching consequences (Table 1).6 Why? Because integrity can be easily exchanged for financial or reputational gain, including incentives for landing jobs, promotions, and research grants.

Table 1. Implications of Untrustworthy Clinical Research

Reprinted with permission from Springer Nature from Vereen R., et al. Pediatr Res. 2025 Dec 7. doi: 10.1038/s41390-025-04647-0.6

The Flourishing Business of Paper Mills

The pressure to “publish or perish” is stronger than ever. Decreases in research funding have made it more difficult to conduct and publish legitimate research and hence, it’s become more attractive to cheat. Some complicit scientists, authors, and editors have turned to paper mills7 or “brokerages”7,8 to achieve publication. Others are interested simply in making a profit. “It’s the incentives,” noted Dr. Ivan Oransky, the executive director of the Center for Scientific Integrity, in a New York Times article, “Fraudulent Scientific Papers are Rapidly Increasing, Study Finds.”9

Paper mill is a fairly modern term for enterprises that churn out bulk quantities of fictitious, sham literature to make a profit, ignoring scientific reality and integrity.7–11 Publication brokerage is another term for a crooked organization that acts as an intermediary, becoming the “middle man” in offering services such as author match-making or journal targeting for fees.8 Alarmingly, growth in the publishing of fake science is outpacing growth in the publishing of legitimate science.10 As scientists, clinicians, funders, regulators, policymakers, and others rely on the veracity and integrity of published research, these predatory publishing practices can be considered scientific misconduct.10

At their core, paper mills are “contract-cheating organizations which provide undeclared services”11 to fabricate research and publications. These organizations are flourishing because they have a willing partner in researchers and authors who are primed to cheat or take shortcuts for gain. A study led by Luís Nunes Amaral of Northwestern University7–9 analyzed more than 5 million papers published in over 70,000 journals actively publishing in 2020.7 Of these, 30,000 published papers7 were either retracted or exhibited signs of coming from a paper mill. Furthermore, the Center for Scientific Integrity used a statistical model to estimate that the actual number might be 100-times that,7–9 which translates to an astounding and disconcerting 3 million fabricated articles as of 2020. Even more shockingly, the number of suspicious new papers is doubling every 1.5 years, while the number of authentic scientific papers is doubling at a rate of every 15 years.9 Whistleblowers to these predatory practices have sounded the alarm, warning that if these fraudulent practices are not stopped soon, they could outright destroy science.9

What do fraudulent papers from paper mills look like? They contain fabricated data and doctored images, painting a scientific story that does not exist. Banks of images are created and marketed to researchers and to unsuspecting, undiscerning, or, in a few cases, even corrupt editors, and, once that pool of content is exhausted, new images are developed and new targets are found.9 After these papers are accepted, paper-mill clients, hoping to enrich their resumes, pay to be placed on bylines.3,9

Like predatory journals and congresses, many paper mills have legitimate-sounding names: the Academic Research and Development Association (ARDA)7,8, the Peer Publicon Consultancy10 in south India, and the International Publisher9 in Russia. What makes these entities paper mills are the steps they take to circumvent traditional ethical publishing practices.3 Figure 1 illustrates a synthesized, conceptual model of paper‑mill–associated publication practices. It is intended to summarize commonly observed patterns and roles, rather than reproduce or restate any single source or documented case.

Publishing quickly is often driven by the need to ensure research grants are released or paid. Enormous pressure to publish, combined with the long timelines required for robust journal peer review, increases the appeal of illicit publication routes for some academic researchers.11

Figure 1. Paper Mills — Coordinated Publication Workflow Across “Bad Actors”3

Conceptual model synthesizing commonly reported paper-mill publication practices, adapted from the Committee on Publication Ethics (COPE) and the International Association of Scientific, Technical & Medical Publishers (STM). Paper mills— Research report from COPE & STM. 2022.

The Worst of the Rest

Beyond these predatory methods, publishers, journals, and authors now contend with new means of deception: author identity theft, editor infiltration, review mills, and paper mines.

Predatory agents seek to reduce the probability of the paper being “desk-rejected” (i.e., early rejection for being out of scope or below journal standard) by illegitimately adding a well-known researcher with substantial credentials to a manuscript byline. This is done without the researcher’s knowledge, involvement, or consent (i.e., author identity theft). Depending on the types of peer review employed (e.g., single anonymized), the presence of well-known names on bylines may lend undeserved credibility to manuscripts, which is precisely the intent of the fraud.

Manipulation of journal “special issues” has led to significant problems with peer-review irregularities, citation rings, and other fraudulent behaviors, which, in turn, has led to mass retraction of articles in special issues.10 Special journal issues started as well-intentioned themed issues to highlight key trends and emerging areas of research. In early practice, they leveraged leading experts’ names, presumably with the experts’ awareness and engagement, to encourage high-quality submissions. These collections became a strong channel for increasing visibility, views, and citations of articles, thereby growing the journals’ reputation and readership. However, not all special issues are managed that way. In the context of predatory publishing, guest advisors function as figureheads and guest editors participate in editorial decisions, opening the door to these irregularities and manipulation.

A flag for another type of misbehavior, editor fraud, occurs when predatory agents contact editors via non-traditional routes (e.g., through LinkedIn, WhatsApp, WeChat, and other social media avenues) that leave no permanent record.7,8,10 Editors are asked to accept a paper with a financial incentive (essentially a bribe) to bypass integrity checks and reviews.7,8,10 The resulting fraud results from a willing accomplice, the editor, acting within the journal structure.

A scourge to ethical publishing practices, review mills function as “citation rings,” in which non-qualified reviewers seek and actively take on peer-review assignments in bulk. In yet another predatory practice, they frequently provide non-authoritative review comments and pressure authors to cite recently published articles authored by these reviewers or to cite other paper-mill articles.12 This leads to artificial increases in citations of their content.

Recently, as part of an effort to promote data sharing for legitimate secondary analyses, researchers have fallen prey to paper mines, which have begun exploiting openly available data sets. They create scientifically meaningless, “new” findings from an existing data set, often with the assistance of large language models (LLMs).13 Often the goal is “to fake something that would be amazing if it were true.”13 In this way, paper mills may also operate as paper mines. They exploit data sets with non-scientific analyses, “moving on when the quarry is exhausted.”13

Collectively, these threats illustrate predatory publishing is no longer limited to illegitimate journals or congresses. Rather, they represent a coordinated and evolving ecosystem operating across multiple dimensions of the publication process, including venue (journals and congresses), content generation (paper mills), peer review (review mills), data analysis (paper mines), and technology. Addressing these risks requires a holistic approach that considers vulnerabilities across the full publication life cycle.

Artificial Intelligence—Both Accomplice and Protector in Medical Publishing

Artificial intelligence (AI) is a multifaceted force with potential to work both as an accomplice to those wishing to undertake malfeasance, and as a protector of scientific integrity (Figure 2).

Figure 2. The Double-Edged Sword of AI: Accomplice to Malfeasance and Protector of Publication Integrity

Artificial intelligence is shown as a simple square-with-computational-nodes icon between a caution icon for AI as an accomplice and a shield icon for AI as a protector

Sophisticated AI tools function as offensive weapons when deliberately wielded by paper mills, enabling bad actors to fabricate images and manuscripts that appear credible to the untrained eye.8,9,14 In addition, AI has also been used to manipulate the peer-review process by using hidden prompts to pre-select for “a positive review only” or using LLMs to generate shallow or biased critiques, and create plausible citation requests for unrelated research, among other peer-review abuses.15,16

Although a complex issue, use of AI in medical research and publications is not inherently problematic.17,18 In responsible hands, AI can enhance the quality and accessibility of publications, yet its use requires careful, constant human oversight and transparency.17,19 AI systems do not replace in-depth scientific judgment or editorial and authorship responsibility, and they can amplify existing scientific and publication-process flaws when used uncritically. Even well-intentioned use of AI can introduce bias, errors, or nonsense, as was the case in an infamous publication featuring a highly inaccurate image of “giant rat genitalia.”20 Before the publication was retracted, it had passed author, editor, and expert peer review, exposing how uncritical scrutiny of AI-generated outputs can undermine integrity of scientific research and publishing. Complicating matters for publishing, concern for confidentiality of data loaded into AI tools makes its use in peer review that much more problematic, with potential legal implications. A new section on the use of AI by reviewers was added to the recommendations of the International Committee of Medical Journal Editors (ICMJE) as part of their January 2026 update.21 These principles set expectations for responsible and transparent use of AI in medical publications.

Journals without rigorous editorial quality-control practices risk publishing AI-generated content that does not meet integrity standards. Just as plagiarism detection tools have become an accepted safeguard for research integrity, tools designed to detect AI use may play a similar role in supporting transparent and responsible authorship.22 AI can help publishers streamline editorial processes, potentially expediting and simplifying publication processes.23–27 This, in turn, may help reduce some of the allure of predatory journals.

Identifying predatory journals remains a daunting task, often requiring experience that early or unsupported researchers may not possess. A range of AI tools (some built for purpose) can support identification of predatory journals using established criteria and directories as training material.28–32 However, these tools are guides and not authoritative, as many journals may fall into a gray zone between legitimate and predatory or risk being mislabeled as predatory using currently available tools (AI or otherwise).29,30 “False positives” inflict serious reputational harm and can be avoided only through human verification.29

AI is increasingly being used to combat a range of predatory practices. For example, detection services employed by the publisher Wiley have intercepted paper-mill manuscripts10,33 (Figure 3), among other applications. 5,34‒36 A 2025 analysis of design and production styles (e.g., typography, white space, page sizes, figures, and meta-data) identified significant differences between predatory and legitimate publications.37

Figure 3. Wiley’s Early Screening Tool for Paper-Mill Detection

Reprinted with permission from Wiley from its State of the Future 2024: Digital Transformation Series report: Upholding Research Integrity in the Age of AI. Not currently available online.

“Going on Offense” Against Predatory Practices

Traditional deterrents, such as manual editorial screening, expert peer review, retraction, and deindexing are proving ineffective against predatory practices. Papers published in deindexed journals continue to appear in some literature databases, and retractions remain relatively infrequent, despite the estimated number of suspected paper mill publications.7 In addition, the process to ensure careful, evidence-based vetting to uncover and document predatory practices can take a long time to enact. Confusion between truly predatory journals and non-indexed, low-tier journals is pervasive, even among publications professionals.38 Complicating matters is that gray zone along the continuum of legitimate and predatory, whereby some publishers with suspect practices have a portfolio of both Medline-indexed and non-indexed journals. Although Medline (US National Library of Medicine) is a rigorously curated database of journal citations, indexing on Medline is not a guarantee of good journal editorial practices.38 (Imagine being asked by a managing editor of a Medline-indexed journal to increase a submitted brief communication from 1,000 to 4,000 words, because “full articles will help the journal’s citations,” author personal correspondence). Further, PubMed Central, an open-access digital archive of the NLM, is not the same as Medline indexing, another mistake commonly made when researching journals.38

Publication integrity and forensic bibliometric researchers have proposed new actions.7–11 For example, there is a call for journals to invest in independent integrity checks.8 Although perhaps difficult to enforce, banning scientists who commit misconduct from publishing, at least temporarily, has also been suggested.9 “We need to stop making it profitable to game the system,” implores Dr. Oransky.9

Established in 2023, United2Act, a joint project of the Committee on Publication Ethics (COPE) and the International Association of Scientific, Technical & Medical Publishers (STM),39 is conducting research projects into combatting the problem of paper mills. Similar to the naming of the Good Publication Practice (GPP) in 2003, we are putting forth a new acronym in publications ethics—Protection from Predatory Publication Practices (“Quad P”). The Quad P framework provides a structured approach to safeguarding against predatory and fraudulent publishing activities across the publication lifecycle, including risks associated with paper mills, review mills, paper mines, and misuse or unintended use of AI. Rather than serving as a standalone checklist, Quad P organizes protective measures into four domains: Prevention, Probing, Protection, and Preservation (Figure 4). Above all else, Prevention remains the best way to remedy predatory activities.

Figure 4. Protection from Predatory Publication Practices — The Quad P Framework for Identifying Predatory and Fraudulent Publishing Activities

The following activities are potential signals of predatory or fraudulent publishing and applicable when vetting predatory journals or congresses, paper mills, paper mines, review mills, or other fraudulent organizations or endeavors. In some cases, a single disqualifying red flag should be sufficient cause to avoid a journal, publisher, or predatory agent. In other cases, additional scrutiny may be warranted.

Acknowledgments: The authors thank Doreen Valentine, CMPP™ (ISMPP), for editorial review and assistance with figure graphics, as well as Katie Kirkpatrick, a medical illustrator and graphic artist, for graphical design support for Figure 1.

Author Disclosures: All authors are members of the International Society for Medical Publication Professional (ISMPP) and its Publications Ethics and Standards Subcommittee on Predatory Practices. The authors employed OpenAI and ChatGPT 5.3 for editorial refinement and structuring of Figure 2 based on author-developed concepts. All content was reviewed, edited, and approved by the authors for intent, accuracy, and writing issues. Michael Nissen, ELS, a 30-year veteran of the pharmaceutical industry, is a freelance medical communications consultant and medical publications planner and writer/editor for pharmaceutical and academic clients. Michelle Parrish, CMPP™, and Jennifer Bodkin, CMPP™, are employees of leading medical communications agencies (MEDiSTRAVA and Envision Pharma Group, respectively) supporting life-science clients across a broad range of publishing and scientific communication projects. Anna Santoramita, PMP, CMPP™, is an employee of Natera, Inc., a global leader in cell-free DNA (cfDNA) testing and owns stock and/or stock options. Sam Cavana is the head of the Publishing Solutions Group at the Taylor & Francis Group, a leading publisher of medical journals.

Disclaimer: This article provides a synthesis of current knowledge and emerging concerns regarding paper mills and fraud in medical publishing. It is intended as an informational overview rather than a statement of individual opinion, and the content does not necessarily reflect the views, policies, or positions of the authors’ employers or of ISMPP.

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