Background: The introduction of large language models (LLMs) into clinical practice promises to improve patient education and empowerment, thereby personalizing medical care and broadening access to medical knowledge. Despite the popularity of LLMs, there is a significant gap in systematized information on their use in patient care. Therefore, this systematic review aims to synthesize current applications and limitations of LLMs in patient care. Methods: We systematically searched 5 databases for qualitative, quantitative, and mixed methods articles on LLMs in patient care published between 2022 and 2023. From 4349 initial records, 89 studies across 29 medical specialties were included. Quality assessment was performed using the Mixed Methods Appraisal Tool 2018. A data-driven convergent synthesis approach was applied for thematic syntheses of LLM applications and limitations using free line-by-line coding in Dedoose. Results: We show that most studies investigate Generative Pre-trained Transformers (GPT)-3.5 (53.2%, n = 66 of 124 different LLMs examined) and GPT-4 (26.6%, n = 33/124) in answering medical questions, followed by patient information generation, including medical text summarization or translation, and clinical documentation. Our analysis delineates two primary domains of LLM limitations: design and output. Design limitations include 6 second-order and 12 third-order codes, such as lack of medical domain optimization, data transparency, and accessibility issues, while output limitations include 9 second-order and 32 third-order codes, for example, non-reproducibility, non-comprehensiveness, incorrectness, unsafety, and bias. Conclusions: This review systematically maps LLM applications and limitations in patient care, providing a foundational framework and taxonomy for their implementation and evaluation in healthcare settings.

Structured reporting (SR) has long been a goal in radiology to standardize and improve the quality of radiology reports. Despite evidence that SR reduces errors, enhances comprehensiveness, and increases adherence to guidelines, its widespread adoption has been limited. Recently, large language models (LLMs) have emerged as a promising solution to automate and facilitate SR. Therefore, this narrative review aims to provide an overview of LLMs for SR in radiology and beyond. We found that the current literature on LLMs for SR is limited, comprising ten studies on the generative pre-trained transformer (GPT)-3.5 (n = 5) and/or GPT-4 (n = 8), while two studies additionally examined the performance of Perplexity and Bing Chat or IT5. All studies reported promising results and acknowledged the potential of LLMs for SR, with six out of ten studies demonstrating the feasibility of multilingual applications. Building upon these findings, we discuss limitations, regulatory challenges, and further applications of LLMs in radiology report processing, encompassing four main areas: documentation, translation and summarization, clinical evaluation, and data mining. In conclusion, this review underscores the transformative potential of LLMs to improve efficiency and accuracy in SR and radiology report processing. Key Points: Question How can LLMs help make SR in radiology more ubiquitous? Findings Current literature leveraging LLMs for SR is sparse but shows promising results, including the feasibility of multilingual applications. Clinical relevance LLMs have the potential to transform radiology report processing and enable the widespread adoption of SR. However, their future role in clinical practice depends on overcoming current limitations and regulatory challenges, including opaque algorithms and training data.

The European Union’s recently adopted Artificial Intelligence (AI) Act is the first comprehensive legal framework specifically on AI. This is particularly important for the healthcare domain, as other existing harmonisation legislation, such as the Medical Device Regulation, do not explicitly cover medical AI applications. Given the far-reaching impact of this regulation on the medical AI sector, this commentary provides an overview of the key elements of the AI Act, with easy-to-follow references to the relevant chapters.

Background: The successful integration of artificial intelligence (AI) in healthcare depends on the global perspectives of all stakeholders. This study aims to answer the research question: What are the attitudes of medical, dental, and veterinary students towards AI in education and practice, and what are the regional differences in these perceptions? Methods: An anonymous online survey was developed based on a literature review and expert panel discussions. The survey assessed students' AI knowledge, attitudes towards AI in healthcare, current state of AI education, and preferences for AI teaching. It consisted of 16 multiple-choice items, eight demographic queries, and one free-field comment section. Medical, dental, and veterinary students from various countries were invited to participate via faculty newsletters and courses. The survey measured technological literacy, AI knowledge, current state of AI education, preferences for AI teaching, and attitudes towards AI in healthcare using Likert scales. Data were analyzed using descriptive statistics, Mann–Whitney U-test, Kruskal–Wallis test, and Dunn-Bonferroni post hoc test. Results: The survey included 4313 medical, 205 dentistry, and 78 veterinary students from 192 faculties and 48 countries. Most participants were from Europe (51.1%), followed by North/South America (23.3%) and Asia (21.3%). Students reported positive attitudes towards AI in healthcare (median: 4, IQR: 3–4) and a desire for more AI teaching (median: 4, IQR: 4–5). However, they had limited AI knowledge (median: 2, IQR: 2–2), lack of AI courses (76.3%), and felt unprepared to use AI in their careers (median: 2, IQR: 1–3). Subgroup analyses revealed significant differences between the Global North and South (r = 0.025 to 0.185, all P < .001) and across continents (r = 0.301 to 0.531, all P < .001), with generally small effect sizes. Conclusions: This large-scale international survey highlights medical, dental, and veterinary students' positive perceptions of AI in healthcare, their strong desire for AI education, and the current lack of AI teaching in medical curricula worldwide. The study identifies a need for integrating AI education into medical curricula, considering regional differences in perceptions and educational needs. Trial registration: Not applicable (no clinical trial).