Artificial Intelligence in Medical Writing: Is It an Exception to Evidence-Based Medicine?

Generative artificial intelligence (GenAI) is now widely used in medicine, including medical writing. Its merits and demerits have been discussed; however, such discussion has not been based on evidence-based medicine (EBM). Here, I focus primarily on GenAI use in medical writing, illustrating how it has already spread before its safety-especially long-term safety-has been confirmed by EBM. I therefore make several modest proposals. Assuming GenAI is a new drug, its use has not yet cleared even the first step of a phase I trial. Assuming it is a new procedure, it remains at the "experience" or "case report" phase. EBM requires the completion of phase I-III trials and randomized controlled trials or meta-analyses before any drug or procedure is confirmed safe and effective. Emergency evacuation can be applied for life-threatening medical conditions; however, it does not apply to "writing." Nevertheless, the current publication world has already gone far beyond: GenAI use is already considerable in medical publication. Thus, three propositions have been made. First, we must recognize that the use of GenAI for writing operates outside the usual EBM framework. Second, we should conduct trials, even if they are difficult and time-consuming, to evaluate the safety and effectiveness of GenAI in writing. Third, we should use GenAI in writing only modestly until safety is confirmed. What is true becomes evident long after, and thus, I believe that we should take a cautious stance toward GenAI use in writing. How cautious should be discussed widely. This viewpoint may contribute to the discussion of GenAI use more generally, beyond medical writing.