Editorial
Writing and reviewing for us in AI times
The launch of ChatGPT in November 2022 caused a lot
of excitement, but also trepidation, about the potential
use or abuse of the tool, including in scientific and
medical publishing. Would this artificial intelligence (AI)
tool, and/or other applications based on large language
models (LLMs), help researchers, peer reviewers, editors,
and publishers deal with the ever increasing need to
write, assess, publish, and digest research? Would it
mitigate some of the disadvantages for people whose
first language is not English? Or would it fuel paper mills,
plagiarism, copyright infringement, and fraud? There
are no clear answers to these questions, or the answers
keep changing as tools and usage evolve. Nevertheless,
almost 1·5 years later, we can take stock on how LLMs
have affected us so far.
LLMs can write scientific text, including abstracts,
summaries, or even whole papers. Related tools can also
generate figures or data. As such, the first question was
whether LLMs could or should be authors. Eventually,
most publishers who released guidelines prohibited
LLMs from being an author (see information for
authors). Authorship comes with responsibility and
oversight for the content, which LLMs cannot provide. If
authors use LLMs to draft or refine their articles, they are
still responsible for what is written. In particular, LLMs
(similar to humans) are prone to biases, blind spots,
and sometimes make up content. For example, when
we asked ChatGPT “who gets mpox?”, the reply was
individuals in central and west Africa, people in close
contact with infected animals, health-care workers,
close contacts of infected individuals (family, caregiver,
household), and travellers to endemic areas. There was
no mention of men who have sex with men, nor the
particular risk of sexual contact. Another problematic
issue is fictious references generated by LLMs. Therefore,
we require authors to carefully review and edit AI-
generated text.
Furthermore, authors should declare this use in a
statement at the end of the article, similar to how the
involvement of medical writers should be declared. So
far, we have seen only few such declarations (potentially
because authors do not know about this requirement).
For example, we checked all submissions we received
during February 2024 and only 0·6% of articles
www.thelancet.com/infection Vol 24 April 2024
declared the use of ChatGPT; 0·6% used Grammarly,
an AI-powered grammar checker; and 1·8% used AI as
Flickr – Matthew Hurst
a tool in their research (which is allowed and should
be elaborated on in the methods). By contrast, 3·6%
reported involvement of medical writers. We suspect the
small numbers reporting AI use represent the tip of the For our information for authors
see https://www.thelancet.com/
iceberg and would like to encourage transparency. AI use pb-assets/Lancet/authors/tlid-
is not a criterion for rejection, although a poorly written info-for-authors.pdf
and inaccurate paper written by ChatGPT would be, as For Elsevier’s reviewer
information see https://www.
would be a poorly written and inaccurate paper written elsevier.com/en-gb/reviewer/
by a human. Of note, we currently do not use tools to how-to-review
See Correspondence
check for AI writing as none are validated, and a high Lancet Infect Dis 2023; 23: 781
false-positive rate might disadvantage certain authors.
We check for plagiarism, which, together with copyright
infringement, can be a problem for LLM-generated text,
as exemplified by several lawsuits filed by, for example,
the New York Times, against OpenAI, the maker of
ChatGPT.
Besides authorship, peer review is another area
one could imagine using LLMs. However, similar to
authorship, LLMs cannot take on the responsibility
for the critical appraisal of an article. For example, one
of our authors experimented with one of their own
papers, generating a peer review report, and although
on the surface it looked like an actual report, ChatGPT
made up statistical feedback and non-existent
references (see correspondence). Thus, we currently
do not permit the use of AI for peer reviewing (see
reviewer information). Furthermore, peer review is
confidential, and privacy and proprietary rights cannot
be guaranteed if reviewers upload parts of an article
or their report to an LLM. We as editors also do not
use AI to assess a manuscript during peer review or to
conduct peer review. We have a tool based on Scopus
data to recommend peer reviewers (based on their
publication history and their peer review history with
Elsevier). Of course, we also invite peer reviewers from
our network, but the tool can be helpful to broaden
the diversity, expertise, and background of our peer
reviewer pool.
To conclude, AI is shaking up scientific publishing,
slowly and not in a linear fashion, but human expertise
and judgement is and will be more important than ever.
■ The Lancet Infectious Diseases
329