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Article History

Received: 16 June 2026

Accepted: 7 September 2026

First Online: 10 September 2026

Declarations

Competing interests: The authors declare no competing interests.

Ethical approval: This study was conducted as an observational study in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Declaration of Helsinki. It is a comparative analysis study of content generated by large language models (LLMs) and did not involve the collection or use of human subjects, human biological samples, or human data (including health records, personally identifiable information, etc.). The research subjects were solely automated text responses from commercial artificial intelligence models to preset medical questions. According to Article 32 of the Measures for Ethical Review of Life Sciences and Medical Research Involving Human Subjects (Guo Wei Ke Jiao Fa [2023] No. 4) jointly issued by the National Health Commission of the People’s Republic of China and three other ministries, ethical review may be exempted for life sciences and medical research involving human subjects that use human information data or biological samples under the following circumstances, provided that no harm is caused to the human body and no sensitive personal information or commercial interests are involved: (i) research conducted using legally obtained public data or data generated through observation without interfering with public behavior; (ii) research conducted using anonymized information data. As this study did not involve human subjects, human data, or human tissue, no informed consent was required from any individuals. Based on the aforementioned regulations, the requirement for ethical approval and obtaining participant consent was waived by the Medical Ethics Committee of Nanjing University of Chinese Medicine.

Informed consent: This study utilized expert opinions as part of the research methodology. In accordance with Article 32 of the Measures for Ethical Review of Life Science and Medical Research Involving Human Beings (Guowei Kejiao Fa [2023] No. 4), jointly issued by the National Health Commission of China and three other ministries, research involving the use of human information data may be exempted from ethical review if it does not cause harm to the human body, does not involve sensitive personal information or commercial interests, and the data are obtained from legitimate publicly accessible sources or have been anonymized. The expert opinions used in this study were obtained through professional academic exchanges without collection of sensitive personal information, and no commercial interests were involved. Accordingly, the requirement for obtaining informed consent was waived by the Medical Ethics Committee of Nanjing University of Chinese Medicine. All experts participated voluntarily with full awareness of the academic purpose of this study.