We appreciate the consideration Najafali et al gave our work regarding utilization of ChatGPT (OpenAI, San Francisco, CA) for assistance with creation of novel systematic review ideas.1–3 As they pointed out, there are several potential tasks the software can perform in the conception of systematic reviews within plastic surgery. Furthermore, like Najafali et al, we believe that the role ChatGPT plays at this time should be limited to the formulation of systematic review ideas. It is remarkable to witness the potential applications of ChatGPT in medicine, particularly within plastic surgery. The most recent publication by Najafali et al indirectly raises a critical issue regarding the extent to which ChatGPT should be employed within academic medicine. Based on our previous works, ChatGPT has limitations of its knowledge, and with Najafali et al's publication there is a heightened concern for ethical issues. Our premier concern is that ChatGPT is unable to fulfill the ethical responsibilities of an author as outlined by the International Committee of Medical Journal Editors (ICMJE), which include the following criteria: Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND Drafting the work or revising it critically for important intellectual content; AND Final approval of the version to be published; AND Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.4 Najafali and colleagues demonstrate the ability of ChatGPT and potentially other sources of artificial intelligence (AI) to construct a manuscript in its entirety. The major limitation is the AI's ability to satisfy ICMJE authorship criteria, particularly in accepting accountability for the work. Tools utilizing AI are unable to assume responsibility, which may be a crucial reason that several plastic surgery journals have taken steps to put in place strict consequences for authors who are deemed to be applying AI in an unethical manner. Furthermore, authors that utilize AI sources such as ChatGPT may be paralleling plagiarism due to the lack of formal acknowledgment by the software. Other concerns with ChatGPT composing an entire manuscript include issues that have been discussed in our previous papers, including an overdue data update or instillation, limited trained parameters when compared to those of GPT-4, and unreliability due to the software's inclination to respond to commands with nonsensical information. We believe ChatGPT is an incredible application of AI—it is easy to use, contains advanced architecture, continuously learns, and responds to users in a humanistic fashion. ChatGPT has several unprecedented uses. As pioneers in our field, we must realize that ChatGPT is a tool designed to assist clinicians rather than a substitute for human expertise. All in all, the ethical accountability of utilizing tools such as ChatGPT lies with its user, who is responsible for designing the study, collecting data, and formulating a manuscript. The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article. The authors received no financial support for the research, authorship, and publication of this article.
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Gupta et al. (2023) studied this question.
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