Artificial Intelligence

The journal supports the responsible, transparent, and accountable use of artificial intelligence (AI), generative AI, large language models (LLMs), and other AI-assisted technologies in research and scholarly publishing. AI tools may support legitimate research and publishing activities, but they do not replace human scientific judgment, responsibility, or accountability.

This policy applies to authors, reviewers, editors, and other persons involved in the editorial and publication process.

AI and Authorship

Artificial intelligence systems, large language models, chatbots, and other AI-assisted technologies cannot be listed as authors or co-authors.

Authorship requires responsibilities that AI systems cannot fulfil, including approval of the final manuscript, accountability for the accuracy and integrity of the work, management of conflicts of interest, and responsibility for responding to questions concerning the published article.

Human authors remain fully responsible for all content submitted to and published by the journal, including content prepared, revised, translated, analysed, or otherwise assisted by AI technologies. This is consistent with the current ICMJE Recommendations.

Disclosure of AI Use

Authors must transparently disclose substantive use of AI or AI-assisted technologies in preparing or conducting work submitted to the journal.

The disclosure should identify, where relevant:

  • the name of the AI tool or system used;
  • the version or model, where known and relevant;
  • the purpose for which it was used;
  • the stage of the research or manuscript-preparation process in which it was used;
  • how AI-generated or AI-assisted outputs were reviewed and verified by the authors.

Use of AI that materially contributes to study design, data collection, data processing, statistical analysis, coding, modelling, image processing, interpretation, literature analysis, manuscript drafting, translation, or other substantive scientific or editorial content must be disclosed in an appropriate section of the manuscript.

Where AI forms part of the research methodology, its use should be described in sufficient detail in the Methods section to allow readers to understand how the technology contributed to the study.

AI disclosure does not transfer responsibility to the AI system. Human authors remain accountable for the entire manuscript.

Accuracy, References and Originality

AI-generated content may contain incorrect, incomplete, biased, fabricated, or misleading information. Authors must independently review and verify all AI-assisted content before submission.

Authors are responsible for:

  • verifying factual and scientific accuracy;
  • checking calculations, statistical interpretations, and methodological statements;
  • verifying every reference against the original source;
  • ensuring that references, quotations, DOIs, and bibliographic details have not been fabricated;
  • ensuring appropriate attribution of ideas and materials derived from other sources;
  • preventing plagiarism and inappropriate text recycling;
  • obtaining any permissions required for copyrighted or otherwise protected material.

AI-generated output should not be treated as a primary scientific source or substitute for the original literature. Authors should locate, evaluate, and cite the original reliable sources supporting scientific statements.

ICMJE specifically emphasizes that humans remain responsible for the accuracy of AI-assisted content, appropriate attribution, permissions, and prevention of plagiarism.

AI, Research Data and Images

AI tools must not be used to fabricate, falsify, selectively manipulate, or misrepresent research data, clinical findings, statistical results, images, or other scientific evidence.

Generative AI must not create or alter data or images in a manner that causes synthetic information to be presented as an actual patient observation, experimental result, clinical finding, laboratory finding, radiological image, pathological image, or other genuine research evidence.

Where AI-assisted image processing, computational modelling, automated classification, prediction, or data analysis forms a legitimate part of the research methodology, authors must describe its use transparently and retain responsibility for validation of the resulting outputs.

Such use is also subject to the journal’s Data and Image Integrity Policy.

Confidentiality and Patient Data

Authors must exercise particular caution when using external AI systems with confidential, personal, clinical, or sensitive research information.

Identifiable patient information, confidential research records, unpublished sensitive data, or other protected information must not be uploaded to publicly accessible or external AI systems unless such processing is permitted by applicable ethical approval, informed consent where required, data-protection requirements, institutional rules, and applicable law.

This requirement is especially important for research involving newborns, infants, children, adolescents, and other vulnerable participants.

AI use must not compromise participant privacy, confidentiality, informed consent, or applicable data-protection obligations.

Editors, Reviewers and AI

Submitted manuscripts and peer-review materials are confidential scholarly communications.

Editors and reviewers must not upload a submitted manuscript, supplementary material, peer-review report, unpublished data, figures, images, or other confidential editorial information into an external AI system where confidentiality cannot be assured, unless explicit appropriate authorization has been obtained.

Any permitted substantive use of AI in editorial assessment or peer review must be transparent to the journal. The editor or reviewer remains fully responsible for the evaluation, comments, recommendations, and decisions made with AI assistance.

AI must not replace the independent professional judgment expected from editors and reviewers.

The current ICMJE Recommendations specifically state that editors, reviewers, and publishers should not upload submitted manuscripts to AI systems where confidentiality cannot be assured without the authors’ explicit permission, and that AI use in the editorial process should be transparent.

Human Oversight and Responsibility

Decisions concerning:

  • scientific validity;
  • methodological quality;
  • ethical acceptability;
  • peer-review recommendations;
  • editorial decisions;
  • acceptance, revision, or rejection;
  • corrections, expressions of concern, or retractions

must remain under meaningful human oversight.

An AI system must not independently determine the final editorial decision on a manuscript.

Undisclosed or Inappropriate AI Use

Failure to disclose material AI use, fabrication of content or references using AI, manipulation of research data or images, breach of confidentiality, submission of fabricated peer reviews, or other deceptive use of AI may be treated as a potential research or publication ethics violation.

Where inappropriate AI use is suspected, the journal may request:

  • an explanation from the authors, reviewers, or editors concerned;
  • original data, files, images, analysis documentation, or other supporting materials;
  • information about the AI tool and how it was used;
  • correction or revision of the manuscript;
  • independent scientific or ethical assessment.

Depending on the evidence and seriousness of the case, the journal may reject a manuscript, discontinue the involvement of a reviewer, correct the published record, issue an expression of concern or retraction, or refer serious concerns to an appropriate institution or other responsible body.

The journal may update this policy as AI technologies, ethical standards, and scholarly publishing practices evolve.

ISSN 2181-3353 (Print)
ISSN 2181-3353 (Online)