How current is “current” in biomedical publishing? An analysis published in the Christmas issue of the BMJ suggests that the answer ranges from genuinely recent to several decades old. References described by authors as “current” are often years and sometimes decades out of date.

The analysis was conducted by Alejandro Díez-Vidal, MD, Department of Internal Medicine, and Jose R. Arribas, MD, Infectious Diseases Unit, Department of Internal Medicine, both at La Paz University Hospital, Madrid, Spain.

Findings showed wide variation in how authors applied the term “current.”

Measuring ‘Current’

To determine how recent “current” references truly are, researchers analyzed 1000 biomedical papers that contained 20 predefined “current” terms and were linked to a citation. The analysis showed that the age of the cited “recent” studies varied widely. The citation lag ranged from 0 to 37 years (mean age, 5.53 years; median age, 4 years).

The most frequent lag was 1 year, with 159 references (15.9%), and 177 references (17.7%) were at least 10 years old. Twenty-six articles had a lag of 20 years or longer, and four cited references that were at least 30 years old.

Citation patterns varied across medical specialties: Critical care, infectious diseases, genetics, immunology, and radiology showed shorter median lags (approximately 2 years), while nephrology, veterinary medicine, and dentistry displayed substantially longer lags (8.5-14 years).

When ‘Latest’ Is Not New

Among the expressions, “recent approach,” “recent discovery,” and “recent study” were linked to older references, whereas “recent publication” and “recent article” had many fresher citations.

The citation lag was similar across world regions and gradually decreased over time, with the most recent publications showing the shortest lags. Journals with high impact factors (≥ 12) cited more up-to-date work.

Articles published before 2000 tended to cite considerably older references, with median lags of 6-8 years. This lag has progressively shortened in recent decades, reaching a median of 2.5 years for articles published between 2020 and 2025.

“The term ‘recent’ in biomedical literature can refer to anything from last month’s preprint to a study published before the invention of the mobile phone. Despite the rhetorical urgency that such expressions convey, actual citation lag often suggests a more relaxed interpretation of time. Although some fields and phrases showed more temporal discipline than others, the overall picture is one of creative elasticity,” wrote the authors.

The authors emphasized that their findings did not assess the quality or relevance of the cited work, only its age. “Readers and reviewers should take ‘recent’ claims with a grain of chronological salt,” they added.

Chatbots as Confidants

The Christmas issue of the BMJ also featured whether artificial intelligence (AI) chatbots are becoming the preferred sources of emotional support.

Susan C. Shelmerdine, MD, consultant radiologist from the Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, England, and Matthew M. Nour, MD, consultant psychiatrist from the Department of Psychiatry, University of Oxford, Oxford, England, reported the increasing use of AI chatbot systems such as ChatGPT, Claude, and Copilot as confidants of choice.

Among younger people, one study found that one third of teenagers used AI companions for social interaction, with 1 in 10 reporting that AI conversations are more satisfying than human conversations, and 1 in 3 reporting that they would choose AI companions over humans for serious conversations.

Loneliness is a significant public health concern. In the UK, nearly half of adults (25.9 million) report feeling lonely occasionally, sometimes, always, or often, with almost 1 in 10 experiencing chronic loneliness (defined as feeling lonely “often or always”).

In 2023, the US Surgeon General declared that the nation was experiencing a loneliness epidemic, which is a public health concern comparable to smoking and obesity.

“Thus, a worrying possibility is that we might be witnessing a generation learning to form emotional bonds with entities that, despite their seemingly conscious responses, lack capacities for human-like empathy, care, and relational attunement,” wrote the authors.

For example, ChatGPT has approximately 810 million weekly active users worldwide, and some reports have identified therapy and companionship as the top reasons for its use.

The authors emphasized that the “empirical studies are needed to characterize the prevalence and nature of risks of human-chatbot interactions, to develop clinical competencies in assessing patients’ AI use, to implement evidence-based interventions for problematic dependency, and to advocate for regulatory frameworks that prioritize long-term well-being over superficial and myopic engagement metrics.”

The authors concluded that problematic chatbot use should be considered a new environmental risk factor when assessing a patient with mental state disturbances and that focusing on and building evidence-based strategies for reducing social isolation and loneliness is paramount.

This story was translated from Medscape’s German edition.