ICMJE | Recommendations | Preparing a Manuscript for Submission to a Medical Journal

# A. Use of AI by Authors

As described in Section II.A.4, the journal should require authors to disclose at submission whether they used AI-assisted technologies (such as 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 (see Sections II.A.3 and Section IV.A.3.d). Chatbots (such as ChatGPT) and other AI-assisted tools 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 (see Section II.A.1). Therefore, humans are responsible for any submitted material that included the use of AI-assisted technologies. Authors should carefully review and edit the AI-generated content as the output can be incorrect, incomplete, or biased. 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. Referencing AI-generated material as the primary source is not acceptable.

Nondisclosure of AI use may require corrective action and may be construed as misconduct in some circumstances (see Sections III.A and III.B).

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