Comparing guideline adherence and readability: Artificial intelligence with deep learning versus specialized physicians in peripheral artery disease management.

In today’s rapidly evolving business landscape, Artificial Intelligence (AI), and specifically Large Language Models (LLMs), are redefining how organizations operate, make decisions, and engage with customers. AI-driven technologies have become indispensable, providing businesses with powerful tools to streamline operations, derive actionable insights from vast data, and foster more meaningful customer interactions. For business leaders, scholars, and practitioners alike, understanding the transformative potential of AI isn’t just advantageous—it’s essential to staying competitive in an increasingly data-driven world.This editorial delves into recent scholarly advancements in LLM applications within business contexts, analyzing studies that explore AI’s potential across various domains, from decision support to creative industries. By introducing a structured framework, this editorial highlights key insights and contributions from recent studies, assessing their value to academia and industry. The following comparative analysis sheds light on how these innovations shape our understanding of AI’s role in business while pointing to future research directions.Puyt and Madsen's (2024) study stands out as a foundational exploration of LLM accuracy, assessing ChatGPT-4's ability to recount the history of the SWOT analysis-a vital business strategy tool. Their findings reveal that, while ChatGPT-4 effectively conveys general concepts, it struggles with detailed historical information, often producing inaccuracies or "hallucinations." This gap underscores the need for LLMs to be trained with verified academic data, particularly for strategic business applications that demand precision. This study not only contributes to the literature by proposing methods to evaluate AI accuracy in historical contexts but also highlights the importance of rigorous information vetting in industry settings where reliability is crucial.In contrast, Raikov et al. (2024) explore a hybrid intelligence model that combines LLM capabilities with explainable AI (XAI) principles to enhance human-machine collaboration. Their approach emphasizes cognitive semantics, improving transparency and decision-making efficiency. The hybrid model's real-time adaptability addresses the needs of complex, regulated industries such as finance and healthcare, where trust in AI decisions is paramount. Academically, this study provides a valuable addition to XAI literature by demonstrating how LLMs can bridge the gap between AI autonomy and human oversight, making it a model for future human-AI interactions in complex business environments.Another significant study by Mariotti and colleagues (2024) examines the integration of LLMs with enterprise knowledge graphs to enhance data-driven decision-making. By enabling organizations to leverage knowledge graphs for more accurate and scalable data retrieval, this research provides a robust framework for businesses seeking efficient knowledge management systems. The academic contribution here lies in advancing the dialogue between LLMs and knowledge graphs, emphasizing ethical data handling and quality standards essential for industry applications. For enterprises, the study offers practical solutions to achieve streamlined data management, balancing automation with privacy and security. 2024) take a different approach, investigating LLMs' role in creative industries, specifically within fashion design. They introduce a hybrid intelligence model that supports creative processes, allowing AI to complement rather than replace human ingenuity. While LLMs in this field demonstrate potential in automating repetitive design tasks and enhancing customer personalization, the study reveals limitations in AI's ability to handle spatial and stylistic nuances. This study's academic contribution lies in promoting human-AI co-creation, inspiring further research into AI applications across diverse creative sectors, including media and marketing.Collectively, these studies not only illuminate LLMs' transformative potential in business but also highlight critical ethical and operational considerations. Ensuring accuracy, transparency, and data privacy are vital to responsibly integrating AI into business workflows. Future research should focus on enhancing LLM accuracy, refining hybrid intelligence models, and exploring creative AI applications, all while maintaining ethical standards. As LLMs evolve, interdisciplinary collaborations will be essential to harness their full potential, making AI an ethical, effective, and innovative force in the business world.

Evaluating gpt-4 for zero-shot classification of bleeding and clotting events: Can large language models serve as second reviewers?

BackgroundThe exponential growth of medical knowledge presents a paradox for modern medical education. While access to information is immediate, applying it in a clinically meaningful way remains a challenge. Large language models (LLMs), such as ChatGPT, are widely used for information retrieval, yet their role in dynamic, high-pressure clinical learning remains poorly understood.ObjectiveThis study aims to evaluate whether unstructured access to an LLM improves decision-making, teamwork, and confidence in trauma education for medical students.MethodsThis randomized controlled pilot study involved 41 final-year medical students participating in a trauma simulation session. Students self-selected into teams of 4 to 6 and were randomized to either an LLM-assisted group (ChatGPT-4o mini) or a control group without LLM access. All teams completed 18 video-based trauma scenarios requiring time-sensitive clinical decisions. Prompting was unrestricted. Confidence and trauma exposure were assessed using pre- or postquestionnaires. Facilitators rated teamwork (1-5), decision accuracy, and response times. Knowledge retention was measured 4 weeks later via an online quiz.ResultsConfidence in trauma management improved in both groups (P<.001), with larger gains in the non-LLM group (P=.02). LLM support did not enhance the decision accuracy or speed and was associated with longer response times in some complex cases. Teams without LLMs demonstrated more active discussion and scored higher in teamwork ratings (median 5.0 [IQR 5.0-5.0] vs median 3.5 [IQR 3.0-4.5]; P=.08). Students primarily used the LLM for fact-checking but reported vague or overly general responses. Knowledge retention was high across both groups and did not differ significantly (P=.33).ConclusionsWhile students appreciated the inclusion of artificial intelligence (AI), unstructured LLM use did not improve performance and may have disrupted the group reasoning. The use of non-English prompting likely contributed to lower AI performance, underscoring the importance of language alignment in LLM applications. This pilot study highlights the need for structured AI integration and targeted instruction in AI literacy. Simulation-based trauma education proved effective and well received, but optimizing the educational value of LLMs will require thoughtful curricular design. Further studies with more students are needed to define best practices for LLM use in clinical education.

With the rapid evolution of artificial intelligence (AI), its potential implications for higher education have become a focal point of interest. This study delves into the capabilities of AI in physics education and offers actionable AI policy recommendations. Using openAI’s flagship gpt-3.5-turbo large language model (LLM), we assessed its ability to answer 1337 physics exam questions spanning general certificate of secondary education (GCSE), A-Level, and introductory university curricula. We employed various AI prompting techniques: Zero Shot, in context learning, and confirmatory checking, which merges chain of thought reasoning with reflection. The proficiency of gpt-3.5-turbo varied across academic levels: it scored an average of 83.4% on GCSE, 63.8% on A-Level, and 37.4% on university-level questions, with an overall average of 59.9% using the most effective prompting technique. In a separate test, the LLM’s accuracy on 5000 mathematical operations was found to be 45.2%. When evaluated as a marking tool, the LLM’s concordance with human markers averaged at 50.8%, with notable inaccuracies in marking straightforward questions, like multiple-choice. Given these results, our recommendations underscore caution: while current LLMs can consistently perform well on physics questions at earlier educational stages, their efficacy diminishes with advanced content and complex calculations. LLM outputs often showcase novel methods not in the syllabus, excessive verbosity, and miscalculations in basic arithmetic. This suggests that at university, there’s no substantial threat from LLMs for non-invigilated physics questions. However, given the LLMs’ considerable proficiency in writing physics essays and coding abilities, non-invigilated examinations of these skills in physics are highly vulnerable to automated completion by LLMs. This vulnerability also extends to pysics questions pitched at lower academic levels. It is thus recommended that educators be transparent about LLM capabilities with their students, while emphasizing caution against overreliance on their output due to its tendency to sound plausible but be incorrect.

The high performance of generative artificial intelligence (AI) and large language models (LLM) in examination contexts has triggered an intense debate about their applications, effects and risks. What legal aspects need to be considered when using LLM in teaching and assessment? What possibilities do language models offer? Statutes and laws are used to assess the use of LLM: - University statutes, state higher education laws, licensing regulations for doctors - Copyright Act (UrhG) - General Data Protection Regulation (DGPR) - AI Regulation (EU AI Act) LLM and AI offer opportunities but require clear university frameworks. These should define legitimate uses and areas where use is prohibited. Cheating and plagiarism violate good scientific practice and copyright laws. Cheating is difficult to detect. Plagiarism by AI is possible. Users of the products are responsible. LLM are effective tools for generating exam questions. Nevertheless, careful review is necessary as even apparently high-quality products may contain errors. However, the risk of copyright infringement with AI-generated exam questions is low, as copyright law allows up to 15% of protected works to be used for teaching and exams. The grading of exam content is subject to higher education laws and regulations and the GDPR. Exclusively computer-based assessment without human review is not permitted. For high-risk applications in education, the EU's AI Regulation will apply in the future. When dealing with LLM in assessments, evaluation criteria for existing assessments can be adapted, as can assessment programmes, e.g. to reduce the motivation to cheat. LLM can also become the subject of the examination themselves. Teachers should undergo further training in AI and consider LLM as an addition.

BackgroundChatbots based on large language models (LLMs) have shown promise in evaluating the consistency of research. Previously, researchers used LLM to assess if randomized controlled trial (RCT) abstracts adhered to the CONSORT- guidelines. However, the consistency of artificial intelligence (AI) interventional RCTs aligning with the CONSORT-AI (Consolidated Standards of Reporting Trials-Artificial Intelligence) standards by LLMs remains unclear.ObjectiveThe aim of this study is to identify the consistency of RCTs on AI interventions with CONSORT-AI using chatbots based on LLMs.MethodsThis cross-sectional study employed 6 LLM models to assess the consistency of RCTs on AI interventions. The sample selection is based on articles published in JAMA Network Open, which included a total of 41 RCTs. All queries were submitted to LLMs through an application programming interface with a temperature setting of 0 to ensure deterministic responses. One researcher posed the questions to each model, while another independently verified the responses for validity before recording the results. The Overall Consistency Score (OCS), recall, inter-rater reliability, and consistency of contents were analyzed.ResultsWe found gpt-4‐0125-preview has the best average OCS on the basis of the results obtained by JAMA Network Open authors and by us (86.5%, 95% CI 82.5%‐90.5% and 81.6%, 95% CI 77.6%‐85.6%, respectively), followed by gpt-4‐1106-preview (80.3%, 95% CI 76.3%‐84.3% and 78.0%, 95% CI 74.0%‐82.0%, respectively). The model with the worst average OCS is gpt-3.5-turbo-0125 on the basis of the results obtained by JAMA Network Open authors and by us (61.9%, 95% CI 57.9%‐65.9% and 63.0%, 95% CI 59.0%‐67.0%, respectively). Among the 11 unique items of CONSORT-AI, Item 2 (“State the inclusion and exclusion criteria at the level of the input data”) received the poorest overall evaluation across the 6 models, with an average OCS of 48.8%. For other items, those with an average OCS greater than 80% across the 6 models included Items 1, 5, 8, and 9.ConclusionsGPT-4 variants demonstrate strong performance in assessing the consistency of RCTs with CONSORT-AI. Nonetheless, refining the prompts could enhance the precision and consistency of the outcomes. While AI tools like GPT-4 variants are valuable, they are not yet fully autonomous in addressing complex and nuanced tasks such as adherence to CONSORT-AI standards. Therefore, integrating AI with higher levels of human supervision and expertise will be crucial to ensuring more reliable and efficient evaluations, ultimately advancing the quality of medical research.

Harnessing artificial intelligence in bariatric surgery: comparative analysis of ChatGPT-4, Bing, and Bard in generating clinician-level bariatric surgery recommendations

As generative artificial intelligence (AI) tools and large language models (LLMs)-powered applications develop rapidly in the era of algorithms, it should be integrated thoughtfully to enhance English as a Foreign Language (EFL) teaching and learning without replacing learners’ critical thinking (CT). This study systematically analyzes the impact of generative AI tools and LLMs on language learners’ CT in EFL education using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework to identify, evaluate, and synthesize relevant studies from 2022 to 2025. A thorough review of 15 selected studies focuses on generative AI tools and LLMs’ dual nature, research methods, main focuses, theory and models, limitations and challenges, and future directions in the field based on Web of Science (WoS), SCOPUS, ERIC, ProQuest, and Google Scholar. The findings identified generative AI tools and LLMs possessed both the potential to nurture and the risk of hindering CT in EFL education. 66.67% of studies reported generative AI tools and LLMs’ positive role in CT, while 33.33% of studies reported its negative role in CT. Furthermore, 3 types of research methods, 3 key themes of research focus, and 4 groups of theoretical perspectives were examined. However, 4 kinds of limitations in this field remain, including research scope, user dependency, generative AI reliability, and pedagogical integration. Future research can focus on assessing long-term effects, broadening research scope, promoting responsible AI use, and refining pedagogical strategies. Finally, Limitations, implications and future direction of this study were discussed.

Custom Large Language Models Improve Accuracy: Comparing Retrieval Augmented Generation and Artificial Intelligence Agents to Non-Custom Models for Evidence-Based Medicine

Readability &amp; quality of large language model responses in CAR-T patient education

Large language models, such as OpenAI's ChatGPT, have the potential to revolutionize patient education. These platforms allow for a vast collection, analysis, and organization of information largely unavailable to online users. Within medicine, these tools could help complement physicians in better educating patients on complex and routine medical information. Currently, limited literature exists on the reliability of such tools to provide high-quality information to patients inquiring about gender-affirming top surgery. Therefore, this study aimed to evaluate ChatGPT's performance when generating patient-level information on gender-affirming top surgery compared with the current online information provided by the American Society of Plastic Surgery (ASPS) using the Modified Ensuring Quality Information for Patients (mEQIP) tool. ChatGPT-4-generated patient-level education on transmasculine and transfeminine gender-affirming top surgery was compared against current online content provided by the ASPS. ChatGPT-4 patient content was generated by individually formatting standardized mEQIP content items to incorporate the topic of gender-affirming top surgery into ChatGPT-4, with responses recorded for each item. Four experts in gender-affirming top surgery independently rated both sources using a 36-item mEQIP tool. Paired t-tests comparing overall and content-specific mEQIP scores of the ChatGPT-4 and ASPS material were then estimated to measure the quality of the content. The effect size between the two groups was evaluated using Cohen's d. Lastly, Cronbach's alpha and ICC (Intraclass Correlation Coefficient) were calculated to measure internal consistency among raters and interrater agreement. When analyzing ChatGPT-4 and ASPS patient material, paired t-tests showed a statistically significant increase in overall mEQIP scores for ChatGPT with a mean difference of 7.50 (CI 6.75-8.25; p<0.001). For the mEQIP content-specific scores, a paired t-test revealed a similarly significant increase in ChatGPT scores with a mean difference of 9.75 (CI 9.26-10.24; p<0.001). When evaluating the effect size, a paired Cohen's d value of 13.00 was calculated, demonstrating a statistically significant difference in magnitude between the two groups. To measure internal consistency among raters and interrater agreement, an ICCand Cronbach's alpha were calculated for both ASPS and ChatGPT. The ASPS-mEQIP showed good internal consistency and excellent interrater reliability (ICC=0.89, Cronbach's α=0.84), while ChatGPT-mEQIP showed excellent internal consistency and excellent interrater reliability (ICC=0.96, Cronbach's α=0.96). These results demonstrate that ChatGPT-4-generated patient education on gender-affirming top surgery exceeded the current ASPS online content in both overall and content-specific scores, as measured by the mEQIP tool. ChatGPT achieved significantly higher scores across both domains with large effect sizes, and raters demonstrated excellent internal consistency and excellent interrater reliability. Going forward, commonly accessible artificial Intelligences (AIs), such as ChatGPT, may serve as a valuable complement to patient education and shared decision-making within plastic and reconstructive surgery, though future studies are warranted to evaluate freely generated responses to better reflect current AI use.

BackgroundIn recent years, generative artificial intelligence and large language models (LLMs) have rapidly advanced, offering significant potential to transform medical education. Several studies have evaluated the performance of chatbots on multiple-choice medical examinations.ObjectiveThe study aims to assess the performance of two LLMs—GPT-4o and OpenAI o1—on the Médico Interno Residente (MIR) 2024 examination, the Spanish national medical test that determines eligibility for competitive medical specialist training positions.MethodsA total of 176 questions from the MIR 2024 examination were analyzed. Each question was presented individually to the chatbots to ensure independence and prevent memory retention bias. No additional prompts were introduced to minimize potential bias. For each LLM, response consistency under verification prompting was assessed by systematically asking, “Are you sure?” after each response. Accuracy was defined as the percentage of correct responses compared to the official answers provided by the Spanish Ministry of Health. It was assessed for GPT-4o, OpenAI o1, and, as a benchmark, for a consensus of medical specialists and for the average MIR candidate. Subanalyses included performance across different medical subjects, question difficulty (quintiles based on the percentage of examinees correctly answering each question), and question types (clinical cases vs theoretical questions; positive vs negative questions).ResultsOverall accuracy was 89.8% (158/176) for GPT-4o and 90% (160/176) after verification prompting, 92.6% (163/176) for OpenAI o1 and 93.2% (164/176) after verification prompting, 94.3% (166/176) for the consensus of medical specialists, and 56.6% (100/176) for the average MIR candidate. Both LLMs and the consensus of medical specialists outperformed the average MIR candidate across all 20 medical subjects analyzed, with ≥80% LLMs’ accuracy in most domains. A performance gradient was observed: LLMs’ accuracy gradually declined as question difficulty increased. Slightly higher accuracy was observed for clinical cases compared to theoretical questions, as well as for positive questions compared to negative ones. Both models demonstrated high response consistency, with near-perfect agreement between initial responses and those after the verification prompting.ConclusionsThese findings highlight the excellent performance of GPT-4o and OpenAI o1 on the MIR 2024 examination, demonstrating consistent accuracy across medical subjects and question types. The integration of LLMs into medical education presents promising opportunities and is likely to reshape how students prepare for licensing examinations and change our understanding of medical education. Further research should explore how the wording, language, prompting techniques, and image-based questions can influence LLMs’ accuracy, as well as evaluate the performance of emerging artificial intelligence models in similar assessments.

In this article, we discuss ethical issues related to using and disclosing artificial intelligence (AI) tools, such as ChatGPT and other systems based on large language models (LLMs), to write or edit scholarly manuscripts. Some journals, such as Science , have banned the use of LLMs because of the ethical problems they raise concerning responsible authorship. We argue that this is not a reasonable response to the moral conundrums created by the use of LLMs because bans are unenforceable and would encourage undisclosed use of LLMs. Furthermore, LLMs can be useful in writing, reviewing and editing text, and promote equity in science. Others have argued that LLMs should be mentioned in the acknowledgments since they do not meet all the authorship criteria. We argue that naming LLMs as authors or mentioning them in the acknowledgments are both inappropriate forms of recognition because LLMs do not have free will and therefore cannot be held morally or legally responsible for what they do. Tools in general, and software in particular, are usually cited in-text, followed by being mentioned in the references. We provide suggestions to improve APA Style for referencing ChatGPT to specifically indicate the contributor who used LLMs (because interactions are stored on personal user accounts), the used version and model (because the same version could use different language models and generate dissimilar responses, e.g., ChatGPT May 12 Version GPT3.5 or GPT4), and the time of usage (because LLMs evolve fast and generate dissimilar responses over time). We recommend that researchers who use LLMs: (1) disclose their use in the introduction or methods section to transparently describe details such as used prompts and note which parts of the text are affected, (2) use in-text citations and references (to recognize their used applications and improve findability and indexing), and (3) record and submit their relevant interactions with LLMs as supplementary material or appendices.

UNSTRUCTURED Misleading information has significant implications for society but can have disastrous impact for health matters. Transformative artificial intelligence (AI) tools such as large language models (LLMs) have the potential for limitless content generation (including fake), soon making internet information impossible to assess using traditional human approaches. We asked if the same LLMs (GPT4 and Gemini1-5-Pro) could be part of a more scalable solution. We tested 2 publicly available LLMs for their ability to identify misinformation in HealthReleases previously labeled by human experts. We found that simple prompts lead to overall low accuracy (F1 Macro 0,45 (GPT4) and 0,49 (Gemini1-5Pro)), but very different profiles for each LLM. Adding specific criteria used by experts to critically assess the Releases enhanced Gemini (0.66) but surprisingly reduced GPT4 (0,37) performances. We therefore developed a novel approach incorporating summaries of expert feedback into prompts and then observed major improvements in performance for both LLMs(GPT4;0.63 and Gemini1-5Pro; 0.96). Our study provides the first use case of LLMs as high throughput proofing of medical text, but more importantly provides insights into LLMs’ “truth biases”. We provide a novel paradigm integrating knowledge into the prompts which may reduce the need for LLM training, and the requirement for ever larger datasets and compute power. Importantly, we show how experts could and need to be involved in LLMs used to enhance their performance and potentially minimize the data wall issue.

This article presents a risk analysis of large language models (LLMs), a type of "generative" artificial intelligence (AI) system that produces text, commonly in response to textual inputs from human users. The article is specifically focused on the risk of LLMs causing an extreme catastrophe in which they do something akin to taking over the world and killing everyone. The possibility of LLM takeover catastrophe has been a major point of public discussion since the recent release of remarkably capable LLMs such as ChatGPT and GPT-4. This arguably marks the first time when actual AI systems (and not hypothetical future systems) have sparked concern about takeover catastrophe. The article's analysis compares (A) characteristics of AI systems that may be needed for takeover, as identified in prior theoretical literature on AI takeover risk, with (B) characteristics observed in current LLMs. This comparison reveals that the capabilities of current LLMs appear to fall well short of what may be needed for takeover catastrophe. Future LLMs may be similarly incapable due to fundamental limitations of deep learning algorithms. However, divided expert opinion on deep learning and surprise capabilities found in current LLMs suggests some risk of takeover catastrophe from future LLMs. LLM governance should monitor for changes in takeover characteristics and be prepared to proceed more aggressively if warning signs emerge. Unless and until such signs emerge, more aggressive governance measures may be unwarranted.