UNLEARN Efficient Removal of Knowledge in Large Language Models

Aim/Purpose: The study investigates the factors influencing the acceptance and utilisation of large language models (LLMs) (predictor variables of LLM usage), such as ChatGPT, in Learning design by instructional designers and university-teaching academics from various countries. Background: Large language models (LLMs) have exploded onto the scene, transforming the landscape of learning design. Instructional designers and university teaching academics have been overburdened with content creation for their teaching programmes, and the arrival of LLM models will help in this regard by developing more interactive content that drives student engagement and, in turn, contributes to student success. Since LLMs are a relatively new phenomenon, little is known about the factors influencing their acceptance in learning design; therefore, this research is needed, as learning design principles are the bedrock of student engagement and success. Methodology: A cross-sectional correlational quantitative study was employed. Data was collected using an online questionnaire posted on social media, including LinkedIn, from 203 instructional designers and university teaching academics. Purposive and snowball sampling methods were used to target instructional designers and university teaching academics at colleges and universities worldwide. Participants were asked to share the survey link with fellow instructional designers and university-teaching academics in their communities. The factor structure of the data was determined using exploratory factor analysis. Nonetheless, the factor structure derived from the LLMs did not entirely reflect the original configuration of the Unified Theory of Acceptance and Use of Technology (UTAUT3), as certain predictors appeared to coalesce, indicating LLMs’ unique nature in learning design. Confirmatory factor analysis was used to verify the fit of the data on the measurement model. First-order and second-order structural modelling were used to identify the structural relationships among the variables. Contribution: The study determines significant factors for the acceptance of LLMs by instructional designers and academic teaching staff in learning design, enabling possible opportunities for best practices in the field through interventions to optimize LLM usage. The study applies the technology acceptance model to the emerging LLM technology and extends the technology acceptance model by adding the trust construct as a predictor variable. Findings: The structural analysis results indicated that the ingrained LLM practices, LLM peer-driven expectations, innovative propensity towards LLM adoption, reliability and provider trust in LLMs, and ease of use and support influenced perceived LLM benefits and usage, but community standards and infrastructure had no influence. The second-order structural equation modelling indicated that perceived LLM benefits and usage and ingrained LLM habits contributed most to the learning design. Recommendations for Practitioners: Teaching academics and instructional designers must use LLMs in designing content, assessments, and interactive learning activities, and attend LLM training workshops on prompting and best practices in integrating LLMs into learning and teaching to see their benefits; hence, regular use of LLMs will then lead to trust and innovation in LLMs usage, enhancing learning design and improving student learning outcomes. Recommendation for Researchers: Researchers must use mixed methods approaches to have a deeper understanding of the factors influencing LLMs. Since habit and perceived LLM benefits and usage contributed the most variance to learning design, researchers must investigate strategies that optimise these factors in learning design, such as effective intervention strategies that can help form positive LLM habits. In addition, the findings provide researchers with a starting point for future research. Further researchers must investigate interventions that optimise the influence of personal innovativeness and trust that contributed the least variance to learning design, hence unlocking the potential of LLMs in learning design through innovation, responsible, and ethical use. Impact on Society: The use of LLMs in learning design has a high possibility of transforming education, specifically the learning design landscape. Using LLMs will free up more time for teaching academics and instructional designers so that they spend more time on higher-order thinking skill demands. Consequently, the students will be exposed to more engaging and interactive content, resulting in improved learning outcomes. Future Research: Future research must include context-derived external variables in technology acceptance models, such as levels of prompting competencies, to provide a deeper understanding of LLMs. In addition, future research must be based on the application and impact of LLMs on student engagement and success, and their attainment of 21st-century skills.

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

Purpose This study aims to explore the integration of large language models (LLMs) and vision-language models (VLMs) in robotics, highlighting their potential benefits and the safety challenges they introduce, including robustness issues, adversarial vulnerabilities, privacy concerns and ethical implications. Design/methodology/approach This survey conducts a comprehensive analysis of the safety risks associated with LLM- and VLM-powered robotic systems. The authors review existing literature, analyze key challenges, evaluate current mitigation strategies and propose future research directions. Findings The study identifies that ensuring the safety of LLM-/VLM-driven robots requires a multi-faceted approach. While current mitigation strategies address certain risks, gaps remain in real-time monitoring, adversarial robustness and ethical safeguards. Originality/value This study offers a structured and comprehensive overview of the safety challenges in LLM-/VLM-driven robotics. It contributes to ongoing discussions by integrating technical, ethical and regulatory perspectives to guide future advancements in safe and responsible artificial intelligence-driven robotics.

The paper studies the problem of software code migration during the transition from the old version of the SAP ERP 6.0 system to modern ERP platforms, in particular SAP S/4HANA. The necessity of automation of the migration process using artificial intelligence methods and tools is substantiated. A comprehensive analysis of existing academic and industrial case studies confirmed the feasibility of using large language models for code migration. A number of advantages of the approach based on large language models are revealed, in particular, the ability to handle various migration scenarios. The key risks and limitations common in the enterprise environment are highlighted, including data security, privacy, high cost of API calls and limited knowledge of models regarding the subject area. A method is developed for selecting a large open source language model that can be safely used in the enterprise landscape, thereby mitigating the risks associated with cloud solutions. The method is based on the developed system of criteria, including: model size, context window size, license type, support for fine-tuning training, focus on code quality (measured using a reference dataset), support for model quantization and community support. The hybrid AHP-TOPSIS method is proposed for systematic ranking of candidate models. The AHP method was used to check the weights of the criteria, while TOPSIS was used to rank the models based on their proximity to the ideal solution. Based on the developed method, three large language models were selected: Qwen 2.5 Coder 14B, DeepSeek-Coder-V2 16B and Llama 3.1 8B. A comprehensive testing plan for the selected models was developed for further experimental studies. The scientific novelty of the work lies in the development of a method for selecting large language models for custom code migration tasks, which differs from the existing system of model selection criteria and the use of a hybrid AHP-TOPSIS approach for ranking candidate models. The practical value of the work is that the developed method allows you to select a model taking into account the constraints of the corporate environment and information security requirements, which will increase the level of automation in the migration of AVAP when switching to new versions of ERP systems from SAP SE. The developed method can be applied to the selection of large language models when upgrading any large computer systems developed in both open source and proprietary programming languages.

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

LLMs application to clinical practice is growing fast. However, LLMs are less studied in geriatrics practice but are urgently needed. This symposium will address whether LLMs allocation to geriatric practice can be trusted via five approaches. 1) LLMs generated gender and race-biased outputs. We will demonstrate whether LLMs generated age-biased output by assessing their geriatric attitude evaluated by social workers. 2). LLMs passed USMLE and other examinations. We will demonstrate whether LLMs can pass geriatrics knowledge competence tests evaluated by geriatricians 3). LLMs performed well on clinical vignettes from different clinical disciplines. We will demonstrate whether LLMs can perform well on geriatrics 5M-based vignettes of older adults evaluated by clinical providers and trainees 4) LLMs reviewed and summarized clinical charts. We will demonstrate whether LLMs can review geriatrics and general medicine notes to extract Mobility (one of Geriatrics 5Ms) documentation evaluated by geriatricians 5). LLMs can generate deprescribing recommendations, tapering schedules, and patient education materials. We will demonstrate their accuracy, safety, and appropriateness compared to recommendations from a multidisciplinary team of pharmacists, geriatricians, and nurses. Specifically, this symposium will address the following topics: 1) Geriatric Attitude of ChatGPT4.o and Its Evaluation by Social Workers. 2) ChatGPT4.o Geriatrics Knowledge Competency and Its Evaluation by Geriatricians. 3) LLMs application to geriatrics 5Ms evaluated by clinical providers and trainees. 4) Using LLMs to Extract and Assess Mobility Documentation for Age-Friendly Health System evaluated by geriatricians. 5) Using LLMs to generate medication deprescribing recommendations compared to clinician-led deprescribing recommendations.

Introduction Advances in large language models (LLMs) have opened new avenues for healthcare applications. Recently, ChatGPT-4 successfully achieved the pass mark >80% in 5 of 10 sleep medicine examination domains, indicating a strong foundational knowledge of sleep medicine. However, the ability to answer USMLE-type multiple-choice questions may not equate to the capacity to offer accurate and comprehensive answers to clinical queries or real-world case scenarios. Current literature exhibits a significant gap in validation research examining the clinical utility of LLMs in evidence-based medicine practice. This investigation aims to evaluate the potential usefulness and reliability of LLMs as adjunctive clinical decision-support tools (namely, “curbside consultants”) in sleep medicine. Methods Six clinical sleep queries and six case scenarios were presented to 6 LLMs including 3 general-purpose LLMs (ChatGPT-4o, Gemini-1.5-Pro, and Llama-3.1-405B) and 3 medical-specialized LLMs (OpenEvidence, Clara AI, and MediGPT). Performance assessment was conducted independently utilizing two independently developed 5-point Likert scales evaluating two primary domains: answer content (accuracy, relevance, comprehensiveness/depth, clarity/coherence, and unique insightfulness) and reference quality (accuracy, relevance, currentness, comprehensiveness/depth, and searchability). Benchmark answers were established through consensus among four sleep medicine specialists. Analysis of variance was used to compare the performance of the LLMs. Results The medical LLMs demonstrated superior overall performance compared to the general LLMs (P< 0.001). The primary distinction was observed in reference quality metrics, where medical LLMs significantly outperformed general LLMs across all parameters: accuracy, relevance, and searchability (p< 0.001), currentness (p=0.001), and comprehensiveness/depth (p=0.010). Notably, Open Evidence achieved the highest reference quality (p< 0.001). In contrast, the answer content analysis revealed no significant overall differences between medical and general LLMs (p=0.659). Most answer content-related metrics, including accuracy, relevance, or unique insightfulness, did not differ significantly (p>0.050). An exception was clarify/coherence, where medical LLMs were superior to general LLMs (p=0.030). Furthermore, MediGPT and ChatGPT-4o displayed better content comprehensiveness/depth relative to other LLMs (p< 0.001). These two LLMs exhibited comparable performance in overall metrics (p=0.615), answer contents (p=0.922), and reference quality (p=0.621). Conclusion Both medical-specialized and general-purpose LLMs show promise as adjunctive decision-support tools in clinical practice. However, substantial improvements in reference quality are critically needed across most LLM platforms. Support (if any)

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.

Large Language Models (LLMs) have garnered increasing attention in neurosurgery and possess significant potential to improve the field. However, the breadth and performance of LLMs across diverse neurosurgical tasks have not been systematically examined, and LLMs come with their own challenges and unique terminology. We seek to identify key models, establish reporting guidelines for replicability, and highlight progress in key application areas of LLM use in the neurosurgical literature. We searched PubMed and Google Scholar using terms related to LLMs and neurosurgery ("large language model" OR "LLM" OR "ChatGPT" OR "GPT-3" OR "GPT3" OR "GPT-3.5" OR "GPT3.5" OR "GPT-4" OR "GPT4" OR "LLAMA" OR "MISTRAL" OR "BARD") AND "neurosurgery". The final set of articles was reviewed for publication year, application area, specific LLM(s) used, control/comparison groups used to evaluate LLM performance, whether the article reported specific LLM prompts, prompting strategy types used, whether the LLM query could be reproduced in its entirety (including both the prompt used and any adjoining data), measures of hallucination, and reported performance measures. Fifty-one articles met inclusion criteria, and were categorized into six application areas, with the most common being Generation of Text for Direct Clinical Use (n = 14, 27.5%), Answering Standardized Exam Questions (n = 12, 23.5%), and Clinical Judgement and Decision-Making Support (n = 11, 21.6%). The most frequently used LLMs were GPT-3.5 (n = 30, 58.8%), GPT-4 (n = 20, 39.2%), Bard (n = 9, 17.6%), and Bing (n = 6, 11.8%). Most studies (n = 43, 84.3%) used LLMs directly out-of-the-box, while 8 studies (15.7%) conducted advanced pre-training or fine-tuning. Large language models show advanced capabilities in complex tasks and hold potential to transform neurosurgery. However, research typically addresses basic applications and overlooks enhancing LLM performance, facing reproducibility issues. Standardizing detailed reporting, considering LLM stochasticity, and using advanced methods beyond basic validation are essential for progress.

Background and Aims Large language models (LLMs) have gained significant attention in the field of natural language processing (NLP), marking a shift from traditional techniques like Term Frequency-Inverse Document Frequency (TF-IDF). We developed a traditional NLP model to predict arteriovenous fistula (AVF) failure within next 30 days using clinical notes. The goal of this analysis was to investigate whether LLMs would outperform traditional NLP techniques, specifically in the context of predicting AVF failure within the next 30 days using clinical notes. Method We defined AVF failure as the change in status from active to permanently unusable status or temporarily unusable status. We used data from a large kidney care network from January 2021 to December 2021. Two models were created using LLMs and traditional TF-IDF technique. We used “distilbert-base-uncased”, a distilled version of BERT base model [1], and compared its performance with traditional TF-IDF-based NLP techniques. The dataset was randomly divided into 60% training, 20% validation and 20% test dataset. The test data, comprising of unseen patients’ data was used to evaluate the performance of the model. Both models were evaluated using metrics such as area under the receiver operating curve (AUROC), accuracy, sensitivity, and specificity. Results The incidence of 30 days AVF failure rate was 2.3% in the population. Both LLMs and traditional showed similar overall performance as summarized in Table 1. Notably, LLMs showed marginally better performance in certain evaluation metrics. Both models had same AUROC of 0.64 on test data. The accuracy and balanced accuracy for LLMs were 72.9% and 59.7%, respectively, compared to 70.9% and 59.6% for the traditional TF-IDF approach. In terms of specificity, LLMs scored 73.2%, slightly higher than the 71.2% observed for traditional NLP methods. However, LLMs had a lower sensitivity of 46.1% compared to 48% for traditional NLP. However, it is worth noting that training on LLMs took considerably longer than TF-IDF. Moreover, it also used higher computational resources such as utilization of graphics processing units (GPU) instances in cloud-based services, leading to higher cost. Conclusion In our study, we discovered that advanced LLMs perform comparably to traditional TF-IDF modeling techniques in predicting the failure of AVF. Both models demonstrated identical AUROC. While specificity was higher in LLMs compared to traditional NLP, sensitivity was higher in traditional NLP compared to LLMs. LLM was fine-tuned with a limited dataset, which could have influenced its performance to be similar to that of traditional NLP methods. This finding suggests that while LLMs may excel in certain scenarios, such as performing in-depth sentiment analysis of patient data for complex tasks, their effectiveness is highly dependent on the specific use case. It is crucial to weigh the benefits against the resources required for LLMs, as they can be significantly more resource-intensive and costly compared to traditional TF-IDF methods. This highlights the importance of a use-case-driven approach in selecting the appropriate NLP technique for healthcare applications.

The subject of the study is the analysis and improvement of methods for determining the relevance of project names to the information content of purchases using large language models. The object of the study is a database containing the names of projects and purchases in the field of electric power industry, collected from open sources. The author examines in detail such aspects of the topic as the use of TF-IDF and cosine similarity metrics for primary data filtering, and also describes in detail the integration and evaluation of the effectiveness of large language models such as GigaChat, GPT-3.5, and GPT-4 in text data matching tasks. Special attention is paid to the methods of clarifying the similarity of names based on reflection introduced into the prompta of large language models, which makes it possible to increase the accuracy of data comparison. The study uses TF-IDF and cosine similarity methods for primary data analysis, as well as large GigaChat, GPT-3.5 and GPT-4 language models for detailed verification of the relevance of project names and purchases, including reflection in model prompta to improve the accuracy of results. The novelty of the research lies in the development of a combined approach to determining the relevance of project names and purchases, combining traditional methods of processing text information (TF-IDF, cosine similarity) with the capabilities of large language models. A special contribution of the author to the research of the topic is the proposed methodology for improving the accuracy of data comparison by clarifying the results of primary selection using GPT-3.5 and GPT-4 models with optimized prompta, including reflection. The main conclusions of the study are confirmation of the prospects of using the developed approach in the tasks of information support for procurement processes and project implementation, as well as the possibility of using the results obtained for the development of text data mining systems in various sectors of the economy. The study showed that the use of language models makes it possible to improve the value of the F2 measure to 0.65, which indicates a significant improvement in the quality of data comparison compared with basic methods.

Several recent works seek to develop foundation models specifically for medical applications, adapting general-purpose large language models (LLMs) and vision-language models (VLMs) via continued pretraining on publicly available biomedical corpora.These works typically claim that such domain-adaptive pretraining (DAPT) improves performance on downstream medical tasks, such as answering medical licensing exam questions.In this paper, we compare seven public "medical" LLMs and two VLMs against their corresponding base models, arriving at a different conclusion: all medical VLMs and nearly all medical LLMs fail to consistently improve over their base models in the zero-/few-shot prompting regime for medical question-answering (QA) tasks.For instance, across the tasks and model pairs we consider in the 3-shot setting, medical LLMs only outperform their base models in 12.1% of cases, reach a (statistical) tie in 49.8% of cases, and are significantly worse than their base models in the remaining 38.2% of cases.Our conclusions are based on (i) comparing each medical model head-to-head, directly against the corresponding base model; (ii) optimizing the prompts for each model separately; and (iii) accounting for statistical uncertainty in comparisons.While these basic practices are not consistently adopted in the literature, our ablations show that they substantially impact conclusions.Our findings suggest that state-of-the-art generaldomain models may already exhibit strong medical knowledge and reasoning capabilities, and offer recommendations to strengthen the conclusions of future studies.

Large language models (LLMs) have made a significant impact on the fields of general artificial intelligence. General purpose LLMs exhibit strong logic and reasoning skills and general world knowledge but can sometimes generate misleading results when prompted on specific subject areas. LLMs trained with domain-specific knowledge can reduce the generation of misleading information (i.e. hallucinations) and enhance the precision of LLMs in specialized contexts. Training new LLMs on specific corpora however can be resource intensive. Here we explored the use of a retrieval-augmented generation (RAG) model which we tested on literature specific to a biomedical research area. OpenAI's GPT-3.5, GPT-4, Microsoft's Prometheus, and a custom RAG model were used to answer 19 questions pertaining to diffuse large B-cell lymphoma (DLBCL) disease biology and treatment. Eight independent reviewers assessed LLM responses based on accuracy, relevance, and readability, rating responses on a 3-point scale for each category. These scores were then used to compare LLM performance. The performance of the LLMs varied across scoring categories. On accuracy and relevance, the RAG model outperformed other models with higher scores on average and the most top scores across questions. GPT-4 was more comparable to the RAG model on relevance versus accuracy. By the same measures, GPT-4 and GPT-3.5 had the highest scores for readability of answers when compared to the other LLMs. GPT-4 and 3.5 also had more answers with hallucinations than the other LLMs, due to non-existent references and inaccurate responses to clinical questions. Our findings suggest that an oncology research-focused RAG model may outperform general-purpose LLMs in accuracy and relevance when answering subject-related questions. This framework can be tailored to Q&A in other subject areas. Further research will help understand the impact of LLM architectures, RAG methodologies, and prompting techniques in answering questions across different subject areas.

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.

BackgroundThe launch of ChatGPT (OpenAI) in November 2022 attracted public attention and academic interest to large language models (LLMs), facilitating the emergence of many other innovative LLMs. These LLMs have been applied in various fields, including health care. Numerous studies have since been conducted regarding how to use state-of-the-art LLMs in health-related scenarios.ObjectiveThis review aims to summarize applications of and concerns regarding conversational LLMs in health care and provide an agenda for future research in this field.MethodsWe used PubMed, ACM, and the IEEE digital libraries as primary sources for this review. We followed the guidance of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) to screen and select peer-reviewed research articles that (1) were related to health care applications and conversational LLMs and (2) were published before September 1, 2023, the date when we started paper collection. We investigated these papers and classified them according to their applications and concerns.ResultsOur search initially identified 820 papers according to targeted keywords, out of which 65 (7.9%) papers met our criteria and were included in the review. The most popular conversational LLM was ChatGPT (60/65, 92% of papers), followed by Bard (Google LLC; 1/65, 2% of papers), LLaMA (Meta; 1/65, 2% of papers), and other LLMs (6/65, 9% papers). These papers were classified into four categories of applications: (1) summarization, (2) medical knowledge inquiry, (3) prediction (eg, diagnosis, treatment recommendation, and drug synergy), and (4) administration (eg, documentation and information collection), and four categories of concerns: (1) reliability (eg, training data quality, accuracy, interpretability, and consistency in responses), (2) bias, (3) privacy, and (4) public acceptability. There were 49 (75%) papers using LLMs for either summarization or medical knowledge inquiry, or both, and there are 58 (89%) papers expressing concerns about either reliability or bias, or both. We found that conversational LLMs exhibited promising results in summarization and providing general medical knowledge to patients with a relatively high accuracy. However, conversational LLMs such as ChatGPT are not always able to provide reliable answers to complex health-related tasks (eg, diagnosis) that require specialized domain expertise. While bias or privacy issues are often noted as concerns, no experiments in our reviewed papers thoughtfully examined how conversational LLMs lead to these issues in health care research.ConclusionsFuture studies should focus on improving the reliability of LLM applications in complex health-related tasks, as well as investigating the mechanisms of how LLM applications bring bias and privacy issues. Considering the vast accessibility of LLMs, legal, social, and technical efforts are all needed to address concerns about LLMs to promote, improve, and regularize the application of LLMs in health care.