Medical publication policies and guidelines offer a framework for best practices, but there may be situations when more than one approach seems reasonable. The primary purpose of “What Would You Do?” is to explore examples of such situations. With the limited information provided to interpret the scenarios, you may find yourself agreeing with one, more than one, or none of the proposed actions. And that’s the point ‒ you should debate, contemplate, and communicate (with a comment) before selecting your “best” answer.
Now let’s find out how you responded and read through some commentary (for context only; not meant to be comprehensive) to the below scenario:
You are a researcher working on a groundbreaking clinical study that could potentially lead to a significant advancement in the treatment of a complex disease. Some members of the research team want to use artificial intelligence (AI) to develop the first draft of the manuscript. Other team members are concerned about accuracy, interpretation, and potential bias in the content.
- If your target journal allows AI-generated content, embrace AI to generate the first draft of the manuscript. Your rationale is that AI can process vast amounts of data efficiently and may uncover patterns and insights that humans might overlook. You reassure your team members that you will implement careful oversight and review, so that any inaccuracies or biases can be corrected during the review and revision process.
- Reject AI and rely solely on the expertise of the human researchers to draft the manuscript. You argue that AI can assist in data analysis, but a nuanced understanding of the research findings, context, and implications requires human insight. You prioritize the human touch and interpretative skills in crafting the manuscript.
- Use AI to assist in generating the first draft (for example, developing the Methods and Results sections), but leverage the strengths of human writers to develop the contextual sections (Introduction and Discussion) and to oversee and validate the AI-generated content, ensuring accuracy, and addressing potential biases. Ensure that the role of AI in the draft development is recorded and appropriately acknowledged.
- Based on concerns that AI may include potential biases ingrained in the algorithms and risk of misinterpretation of complex medical data, wait until a thorough review of AI-generated content has been conducted to identify these biases before using AI to generate your manuscript. It may be that AI is not appropriate for this manuscript but could be used in the future.
A total of 95 people replied to this poll.
ICMJE recommendations about how AI should be used in the development of medical publications is as follows [1]:
“At submission, journals should require authors to disclose whether they used Artificial Intelligence (AI)–assisted technologies (such as Large Language Models [LLMs], chatbots, or image creators) in the production of submitted work. Authors who use such technology should describe, in both the cover letter and the submitted work in the appropriate section if applicable, how they used it… If AI was used for data collection, analysis, or figure generation, authors should describe this use in the methods. Chatbots (such as ChatGPT) should not be listed as authors because they cannot be responsible for the accuracy, integrity, and originality of the work, and these responsibilities are required for authorship. Therefore, humans are responsible for any submitted material that included the use of AI-assisted technologies. Authors should carefully review and edit the result because AI can generate authoritative-sounding output that can be incorrect, incomplete, or biased. Authors should not list AI and AI-assisted technologies as an author or co-author, nor cite AI as an author. Authors should be able to assert that there is no plagiarism in their paper, including in text and images produced by the AI. Humans must ensure there is appropriate attribution of all quoted material, including full citations.”
Most of the top clinical journals accept AI-assisted manuscripts if the above criteria are followed; there should be minimal concerns about identifying suitable journals that accept the involvement of AI (Option A). Members of the research (and presumably authorship) team are in favor of exploring the use of AI, so the team should probably not reject the consideration of AI outright if the technology is available (Option B). In terms of potential bias ingrained and other concerns/limitations with AI (Option D), this is an expected by-product of the technology at this time, and it is the responsibility of authors, medical writers, and reviewers to scrutinize the content and edit or remove any inappropriate biases (although this type of careful review should be undertaken regardless of whether the content was generated by authors, medical writers, or AI). Thus, Option C appears to represent a balanced approach and likely describes how AI is currently used in the development of clinical research manuscripts. Any specific company guidelines and policies regarding the utilization of AI should be followed.
Until we gain more experience and AI technologies become more mature, it is natural to have concerns or discomfort using AI in the development of scientific publications, but as the learning curve improves and best practices are shared, it can be expected that the role of AI to assist in the development of medical publications, clinical study reports, regulatory documents, etc., will increase. However, AI remains a tool and publication professionals must remain diligent to ensure authors thoroughly review the content to ensure it describes and communicates the data accurately.
Eric Y. Wong, PhD, MBA, ISMPP CMPPTM, Johnson & Johnson Innovative Medicine
This article was prepared by the author in his personal capacity. The opinions expressed within are the author’s own and do not necessarily reflect the views of Johnson & Johnson Innovative Medicine.
References
- Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (updated January 2025): http://www.icmje.org/icmje-recommendations.pdf