The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Perspectives

Garbage In, Garbage Out: The Compounding Risk of Predatory Publishing and Artificial Intelligence in Clinical Medicine

Authors: Malvinder S. Parmar, MB, MS

Abstract

A clinician questioned whether ipsilateral placement of a tunneled central venous catheter relative to an existing pacemaker conferred higher infection risk than contralateral placement, after a cardiologist advised an interventional radiologist to abandon the only available venous access site on that basis. On consulting an artificial intelligence (AI) assistant for supporting evidence, a confident, well-structured response arrived, citing several references. One cited paper to support the increased risk of infection with ipsilateral placement addressed only mechanical complications but made no claim about laterality-dependent infection risk. The citation, although bibliographically real, had been misrepresented in substance. Had the clinician not retrieved and read the original paper, the error would have gone undetected, ingrained in the mind of the interventional radiologist and influencing future decisions. This is not an isolated imperfection of a maturing technology. It is a predictable consequence of two converging crises: the progressive degradation of the published medical literature through predatory and low-quality open-access publishing and the amplification of that degraded evidence by AI systems deployed in clinical settings. Together, these forces create a compounding risk to patient safety that has not yet been squarely named.

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