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      Human-Written vs AI-Generated Texts in Orthopedic Academic Literature: Comparative Qualitative Analysis

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          Abstract

          Background

          As large language models (LLMs) are becoming increasingly integrated into different aspects of health care, questions about the implications for medical academic literature have begun to emerge. Key aspects such as authenticity in academic writing are at stake with artificial intelligence (AI) generating highly linguistically accurate and grammatically sound texts.

          Objective

          The objective of this study is to compare human-written with AI-generated scientific literature in orthopedics and sports medicine.

          Methods

          Five original abstracts were selected from the PubMed database. These abstracts were subsequently rewritten with the assistance of 2 LLMs with different degrees of proficiency. Subsequently, researchers with varying degrees of expertise and with different areas of specialization were asked to rank the abstracts according to linguistic and methodological parameters. Finally, researchers had to classify the articles as AI generated or human written.

          Results

          Neither the researchers nor the AI-detection software could successfully identify the AI-generated texts. Furthermore, the criteria previously suggested in the literature did not correlate with whether the researchers deemed a text to be AI generated or whether they judged the article correctly based on these parameters.

          Conclusions

          The primary finding of this study was that researchers were unable to distinguish between LLM-generated and human-written texts. However, due to the small sample size, it is not possible to generalize the results of this study. As is the case with any tool used in academic research, the potential to cause harm can be mitigated by relying on the transparency and integrity of the researchers. With scientific integrity at stake, further research with a similar study design should be conducted to determine the magnitude of this issue.

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          Most cited references32

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          ChatGPT Utility in Healthcare Education, Research, and Practice: Systematic Review on the Promising Perspectives and Valid Concerns

          ChatGPT is an artificial intelligence (AI)-based conversational large language model (LLM). The potential applications of LLMs in health care education, research, and practice could be promising if the associated valid concerns are proactively examined and addressed. The current systematic review aimed to investigate the utility of ChatGPT in health care education, research, and practice and to highlight its potential limitations. Using the PRIMSA guidelines, a systematic search was conducted to retrieve English records in PubMed/MEDLINE and Google Scholar (published research or preprints) that examined ChatGPT in the context of health care education, research, or practice. A total of 60 records were eligible for inclusion. Benefits of ChatGPT were cited in 51/60 (85.0%) records and included: (1) improved scientific writing and enhancing research equity and versatility; (2) utility in health care research (efficient analysis of datasets, code generation, literature reviews, saving time to focus on experimental design, and drug discovery and development); (3) benefits in health care practice (streamlining the workflow, cost saving, documentation, personalized medicine, and improved health literacy); and (4) benefits in health care education including improved personalized learning and the focus on critical thinking and problem-based learning. Concerns regarding ChatGPT use were stated in 58/60 (96.7%) records including ethical, copyright, transparency, and legal issues, the risk of bias, plagiarism, lack of originality, inaccurate content with risk of hallucination, limited knowledge, incorrect citations, cybersecurity issues, and risk of infodemics. The promising applications of ChatGPT can induce paradigm shifts in health care education, research, and practice. However, the embrace of this AI chatbot should be conducted with extreme caution considering its potential limitations. As it currently stands, ChatGPT does not qualify to be listed as an author in scientific articles unless the ICMJE/COPE guidelines are revised or amended. An initiative involving all stakeholders in health care education, research, and practice is urgently needed. This will help to set a code of ethics to guide the responsible use of ChatGPT among other LLMs in health care and academia.
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            Tools such as ChatGPT threaten transparent science; here are our ground rules for their use

            (2023)
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              Comparing scientific abstracts generated by ChatGPT to real abstracts with detectors and blinded human reviewers

              Large language models such as ChatGPT can produce increasingly realistic text, with unknown information on the accuracy and integrity of using these models in scientific writing. We gathered fifth research abstracts from five high-impact factor medical journals and asked ChatGPT to generate research abstracts based on their titles and journals. Most generated abstracts were detected using an AI output detector, ‘GPT-2 Output Detector’, with % ‘fake’ scores (higher meaning more likely to be generated) of median [interquartile range] of 99.98% ‘fake’ [12.73%, 99.98%] compared with median 0.02% [IQR 0.02%, 0.09%] for the original abstracts. The AUROC of the AI output detector was 0.94. Generated abstracts scored lower than original abstracts when run through a plagiarism detector website and iThenticate (higher scores meaning more matching text found). When given a mixture of original and general abstracts, blinded human reviewers correctly identified 68% of generated abstracts as being generated by ChatGPT, but incorrectly identified 14% of original abstracts as being generated. Reviewers indicated that it was surprisingly difficult to differentiate between the two, though abstracts they suspected were generated were vaguer and more formulaic. ChatGPT writes believable scientific abstracts, though with completely generated data. Depending on publisher-specific guidelines, AI output detectors may serve as an editorial tool to help maintain scientific standards. The boundaries of ethical and acceptable use of large language models to help scientific writing are still being discussed, and different journals and conferences are adopting varying policies.
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                Author and article information

                Contributors
                Journal
                JMIR Form Res
                JMIR Form Res
                JFR
                JMIR Formative Research
                JMIR Publications (Toronto, Canada )
                2561-326X
                2024
                16 February 2024
                : 8
                : e52164
                Affiliations
                [1 ] Center of Orthopaedics and Trauma Surgery University Clinic of Brandenburg Brandenburg Medical School Brandenburg an der Havel Germany
                [2 ] Faculty of Health Sciences University Clinic of Brandenburg Brandenburg an der Havel Germany
                [3 ] Center of Evidence Based Practice in Brandenburg, a JBI Affiliated Group Brandenburg an der Havel Germany
                [4 ] Center of Health Services Research Faculty of Health Sciences University Clinic of Brandenburg Rüdersdorf bei Berlin Germany
                [5 ] Faculty of Orthopaedics University Hospital Merkur Zagreb Croatia
                [6 ] Departement of Orthopaedics University Hospital Mostar Mostar Bosnia and Herzegovina
                Author notes
                Corresponding Author: Hassan Tarek Hakam hassantarek.hakam@ 123456mhb-fontane.de
                Author information
                https://orcid.org/0009-0008-5957-0848
                https://orcid.org/0000-0002-4916-1206
                https://orcid.org/0000-0002-1515-6441
                https://orcid.org/0000-0003-3765-1483
                https://orcid.org/0000-0002-0108-5750
                https://orcid.org/0000-0003-4669-8187
                https://orcid.org/0000-0001-8571-7286
                Article
                v8i1e52164
                10.2196/52164
                10907945
                38363631
                dabdafbc-228f-41a0-801a-c38b89317d36
                ©Hassan Tarek Hakam, Robert Prill, Lisa Korte, Bruno Lovreković, Marko Ostojić, Nikolai Ramadanov, Felix Muehlensiepen. Originally published in JMIR Formative Research (https://formative.jmir.org), 16.02.2024.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.

                History
                : 24 August 2023
                : 12 October 2023
                : 9 November 2023
                : 13 December 2023
                Categories
                Original Paper
                Original Paper

                artificial intelligence,ai,large language model,llm,research,orthopedic surgery,sports medicine,orthopedics,surgery,orthopedic,qualitative study,medical database,feedback,detection,tool,scientific integrity,study design

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