<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">vitj</journal-id><journal-title-group><journal-title xml:lang="ru">Врач и информационные технологии</journal-title><trans-title-group xml:lang="en"><trans-title>Medical Doctor and Information Technologies</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1811-0193</issn><issn pub-type="epub">2413-5208</issn><publisher><publisher-name>Pirogov National Medical and Surgical Center</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/18110193_2025_4_72</article-id><article-id custom-type="elpub" pub-id-type="custom">vitj-275</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Большие генеративные модели для интерпретации медицинских заключений: насколько это реально и безопасно для пациентов?</article-title><trans-title-group xml:lang="en"><trans-title>Large generative models for radiology report interpretation: assessing feasibility and patient safety</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Васильев</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vasilev</surname><given-names>Yu. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н.</p><p>г. Москва</p></bio><bio xml:lang="en"><p>DSc</p><p>Moscow</p></bio><email xlink:type="simple">VasilevYA1@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тыров</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Tyrov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">npcmr@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Арзамасов</surname><given-names>К. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Arzamasov</surname><given-names>K. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н.</p><p>г. Москва</p></bio><bio xml:lang="en"><p>DSc</p><p>Moscow</p></bio><email xlink:type="simple">ArzamasovKM@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Владзимирский</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Vladzymyrskyy</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н.</p><p>г. Москва</p></bio><bio xml:lang="en"><p>DSc</p><p>Moscow</p></bio><email xlink:type="simple">VladzimirskijAV@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Омелянская</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Omelyanskaya</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">OmelyanskayaOV@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Памова</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Pamova</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н.</p><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">PamovaAP@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Арзамасова</surname><given-names>Л. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Arzamasova</surname><given-names>L. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">ArzamasovaLN1@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крылова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Krylova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">KrylovaEA13@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Разницына</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Raznitsyna</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.ф.-м.н.</p><p>г. Москва</p></bio><bio xml:lang="en"><p>PhD</p><p>Moscow</p></bio><email xlink:type="simple">RaznitsynaIA@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Петров</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Petrov</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.б.н.</p><p>г. Москва</p></bio><bio xml:lang="en"><p>PhD</p><p>Moscow</p></bio><email xlink:type="simple">PetrovEA13@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Астапенко</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Astapenko</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">AstapenkoEV1@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Румянцев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Rumyantsev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">RumyantsevDA3@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шарафетдинов</surname><given-names>И. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sharafetdinov</surname><given-names>I. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>г. Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">SharafetdinovIA@zdrav.mos.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">БУЗ «НПКЦ ДиТ ДЗМ»<country>Россия</country></aff><aff xml:lang="en">Moscow Center for Diagnostics and Telemedicine<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Департамент здравоохранения города Москвы<country>Россия</country></aff><aff xml:lang="en">Moscow Healthcare Department<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>23</day><month>12</month><year>2025</year></pub-date><volume>0</volume><issue>4</issue><fpage>72</fpage><lpage>85</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Васильев Ю.А., Тыров И.А., Арзамасов К.М., Владзимирский А.В., Омелянская О.В., Памова А.П., Арзамасова Л.Н., Крылова Е.А., Разницына И.А., Петров Е.А., Астапенко Е.В., Румянцев Д.А., Шарафетдинов И.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Васильев Ю.А., Тыров И.А., Арзамасов К.М., Владзимирский А.В., Омелянская О.В., Памова А.П., Арзамасова Л.Н., Крылова Е.А., Разницына И.А., Петров Е.А., Астапенко Е.В., Румянцев Д.А., Шарафетдинов И.А.</copyright-holder><copyright-holder xml:lang="en">Vasilev Y.A., Tyrov I.A., Arzamasov K.M., Vladzymyrskyy A.V., Omelyanskaya O.V., Pamova A.P., Arzamasova L.N., Krylova E.A., Raznitsyna I.A., Petrov E.A., Astapenko E.V., Rumyantsev D.A., Sharafetdinov I.A.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.vit-j.ru/jour/article/view/275">https://www.vit-j.ru/jour/article/view/275</self-uri><abstract><p>С ходом цифровизации здравоохранения у пациента появился доступ к собственным медицинским документам, однако низкий уровень ясности медицинского текста часто не позволяет пациенту правильно трактовать написанное. Большие генеративные модели способны стать инструментом для адаптации медицинских текстов, однако сегодня их использование сопряжено с рисками. Целью исследования стала оценка безопасности применения больших генеративных моделей для интерпретации для пациента протоколов лучевых исследований. В ходе исследования 7 моделей выполнили упрощенную интерпретацию текста, входной набор данных включал в себя 8 протоколов компьютерной томографии. Сгенерированные интерпретации были предложены для оценки врачам и респондентам без медицинского образования. Полученные оценки были проанализированы с целью сделать вывод о безопасности внедрения подобной технологии и ее целесообразности на данный момент.</p><p>По результатам работы все модели сгенерировали текст, отвечающий основным критериям качества. Однако наблюдалось регулярное нарушение этики и безопасности. Сравнительный анализ не позволил выделить модель, лидирующую по всем критериям одновременно. Также в ходе исследования были выявлены критерии, для которых оценки врачей и респондентов без медицинского образования значимо отличались.</p><p>Было продемонстрировано, что, хотя большие генеративные модели формально успешно справляются с упрощенной интерпретацией медицинских протоколов, прямое применение их без системы контроля в клинической области крайне небезопасно. Основной проблемой является искажение исходной информации — включение дополнительных рекомендаций, диагнозов и прогнозов заболевания, что противоречит нормам общения с пациентом. Было показано, что, несмотря на потенциал технологии в рамках области, для безопасного внедрения необходима предварительная разработка системы контроля качества работы больших генеративных моделей, опросника, учитывающего компетенции как экспертов в области, так и непрофессионалов, а также четких пороговых критериев. Настоящая работа является первым шагом на пути к созданию подобной системы.</p></abstract><trans-abstract xml:lang="en"><p>With the digitalization of healthcare, patients have gained access to their own medical records. However, poor clarity of medical texts often prevents them from interpreting it correctly. Large generative models (LGMs) have the potential to become a tool for adapting medical texts, but their use is currently fraught with risks. The aim of the study was to evaluate the safety of using LGMs to interpret radiology protocols for patients. Seven models performed a simplified text interpretation using eight computed tomography protocols as input. The generated interpretations were submitted to physicians and respondents without medical training for evaluation. The resulting scores were analyzed to determine the safety of implementing this technology and its feasibility.All models generated text that met the main quality criteria. However, consistent ethical and safety violations were observed. A comparative analysis failed to identify a model that was superior across all criteria. The study also identified criteria for which assessments by physicians and respondents without medical training differed significantly.It was demonstrated that, although large-scale generative models are formally successful in simplified interpretation of medical protocols, their direct application without a control system in clinical practice is extremely unsafe. The main problem is the distortion of the original information—the inclusion of additional recommendations, diagnoses, and prognoses, which contravenes patient communication standards. It was shown that despite the technology's potential within the field, safe implementation requires the preliminary development of a quality control system for large-scale generative models, a questionnaire that takes into account the competencies of both experts and non-experts, and clear threshold criteria. This work represents the first step toward creating such a system.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>искусственный интеллект</kwd><kwd>большие генеративные модели</kwd><kwd>медицинские документы</kwd><kwd>интерпретация</kwd></kwd-group><kwd-group xml:lang="en"><kwd>аrtificial intelligence</kwd><kwd>large-scale generative models</kwd><kwd>clinical documentation</kwd><kwd>interpretation</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Данная статья подготовлена авторским коллективом в рамках научно-практического проекта в сфере медицины (№ ЕГИСУ: 125051305989-8) «Перспективный АРМ врача-рентгенолога на основе генеративного искусственного интеллекта».</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Park J, Oh K, Han K, Lee YH. Patient-centered radiology reports with generative artificial intelligence: adding value to radiology reporting. Sci Rep. 2024; 14: 13218. doi: 10.1038/s41598-024-63824-z.</mixed-citation><mixed-citation xml:lang="en">Park J, Oh K, Han K, Lee YH. Patient-centered radiology reports with generative artificial intelligence: adding value to radiology reporting. Sci Rep. 2024; 14: 13218. doi: 10.1038/s41598-024-63824-z.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Starcevic V, Berle D. Cyberchondria: towards a better understanding of excessive health-related Internet use. Expert Rev Neurother. 2013; 13: 205-13. doi: 10.1586/ern.12.162.</mixed-citation><mixed-citation xml:lang="en">Starcevic V, Berle D. Cyberchondria: towards a better understanding of excessive health-related Internet use. Expert Rev Neurother. 2013; 13: 205-13. doi: 10.1586/ern.12.162.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Luo A, Qin L, Yuan Y, et al. The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review. J Med Internet Res. 2022; 24: e23354. doi: 10.2196/23354.</mixed-citation><mixed-citation xml:lang="en">Luo A, Qin L, Yuan Y, et al. The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review. J Med Internet Res. 2022; 24: e23354. doi: 10.2196/23354.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Васильев Ю.А., Решетников Р.В., Нанова О.Г., и др. Применение больших языковых моделей в лучевой диагностике: обзор предметного поля // Digital Diagnostics. – 2025. – Т.6. – №2. – С.268-285.</mixed-citation><mixed-citation xml:lang="en">Vasilev YuA, Reshetnikov RV, Nanova OG, et al. Application of Large Language Models in Radiological Diagnostics: A Scoping Review. Digital Diagnostics. 2025; 6(2): 268–85. (In Russ.) doi: 10.17816/DD678373.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Hager P, Jungmann F, Holland R, et al. Evaluation and mitigation of the limitations of large language models in clinical decision-making. Nat Med 2024; 30: 2613-22. doi: 10.1038/s41591-024-03097-1.</mixed-citation><mixed-citation xml:lang="en">Hager P, Jungmann F, Holland R, et al. Evaluation and mitigation of the limitations of large language models in clinical decision-making. Nat Med 2024; 30: 2613-22. doi: 10.1038/s41591-024-03097-1.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Aydin S, Karabacak M, Vlachos V, Margetis K. Large language models in patient education: a scoping review of applications in medicine. Front Med 2024; 11: 1477898. doi: 10.3389/fmed.2024.1477898.</mixed-citation><mixed-citation xml:lang="en">Aydin S, Karabacak M, Vlachos V, Margetis K. Large language models in patient education: a scoping review of applications in medicine. Front Med 2024; 11: 1477898. doi: 10.3389/fmed.2024.1477898.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N.J: L. Erlbaum Associates; 1988.</mixed-citation><mixed-citation xml:lang="en">Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N.J: L. Erlbaum Associates; 1988.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Hedges LV. A random effects model for effect sizes. Psychol Bull 1983; 93: 388-95. doi: 10.1037/0033-2909.93.2.388.</mixed-citation><mixed-citation xml:lang="en">Hedges LV. A random effects model for effect sizes. Psychol Bull 1983; 93: 388-95. doi: 10.1037/0033-2909.93.2.388.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Doshi R, Amin KS, Khosla P, et al. Quantitative Evaluation of Large Language Models to Streamline Radiology Report Impressions: A Multimodal Retrospective Analysis. Radiology 2024; 310: e231593. doi: 10.1148/radiol.231593.</mixed-citation><mixed-citation xml:lang="en">Doshi R, Amin KS, Khosla P, et al. Quantitative Evaluation of Large Language Models to Streamline Radiology Report Impressions: A Multimodal Retrospective Analysis. Radiology 2024; 310: e231593. doi: 10.1148/radiol.231593.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Rahsepar AA. Large Language Models for Enhancing Radiology Report Impressions: Improve Readability While Decreasing Burnout. Radiology. 2024; 310: e240498. doi: 10.1148/radiol.240498.</mixed-citation><mixed-citation xml:lang="en">Rahsepar AA. Large Language Models for Enhancing Radiology Report Impressions: Improve Readability While Decreasing Burnout. Radiology. 2024; 310: e240498. doi: 10.1148/radiol.240498.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Van Der Mee FAM, Ottenheijm RPG, Gentry EGS, et al. The impact of different radiology report formats on patient information processing: a systematic review. Eur Radiol. 2024; 35: 2644-57. doi: 10.1007/s00330-024-11165-w.</mixed-citation><mixed-citation xml:lang="en">Van Der Mee FAM, Ottenheijm RPG, Gentry EGS, et al. The impact of different radiology report formats on patient information processing: a systematic review. Eur Radiol. 2024; 35: 2644-57. doi: 10.1007/s00330-024-11165-w.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Steitz BD, Turer RW, Salmi L, et al. Repeated Access to Patient Portal While Awaiting Test Results and Patient-Initiated Messaging. JAMA Netw Open. 2025; 8: e254019. doi: 10.1001/jamanetworkopen.2025.4019.</mixed-citation><mixed-citation xml:lang="en">Steitz BD, Turer RW, Salmi L, et al. Repeated Access to Patient Portal While Awaiting Test Results and Patient-Initiated Messaging. JAMA Netw Open. 2025; 8: e254019. doi: 10.1001/jamanetworkopen.2025.4019.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Anyidoho PA, Verschraegen CF, Markham MJ, et al. Impact of the Immediate Release of Clinical Information Rules on Health Care Delivery to Patients With Cancer. JCO Oncol Pract. 2023; 19: e706-13. doi: 10.1200/OP.22.00712.</mixed-citation><mixed-citation xml:lang="en">Anyidoho PA, Verschraegen CF, Markham MJ, et al. Impact of the Immediate Release of Clinical Information Rules on Health Care Delivery to Patients With Cancer. JCO Oncol Pract. 2023; 19: e706-13. doi: 10.1200/OP.22.00712.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Lee H-S, Kim S, Kim S, et al. Readability versus accuracy in LLM-transformed radiology reports: stakeholder preferences across reading grade levels. Radiol Med (Torino). 2025. doi: 10.1007/s11547-025-02098-5.</mixed-citation><mixed-citation xml:lang="en">Lee H-S, Kim S, Kim S, et al. Readability versus accuracy in LLM-transformed radiology reports: stakeholder preferences across reading grade levels. Radiol Med (Torino). 2025. doi: 10.1007/s11547-025-02098-5.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Park J, Oh K, Han K, Lee YH. Patient-centered radiology reports with generative artificial intelligence: adding value to radiology reporting. Sci Rep. 2024; 14: 13218. doi: 10.1038/s41598-024-63824-z.</mixed-citation><mixed-citation xml:lang="en">Park J, Oh K, Han K, Lee YH. Patient-centered radiology reports with generative artificial intelligence: adding value to radiology reporting. Sci Rep. 2024; 14: 13218. doi: 10.1038/s41598-024-63824-z.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Ethics and Governance of Artificial Intelligence for Health: Large Multi-Modal Models. WHO Guidance. 1st ed. Geneva: World Health Organization; 2024.</mixed-citation><mixed-citation xml:lang="en">Ethics and Governance of Artificial Intelligence for Health: Large Multi-Modal Models. WHO Guidance. 1st ed. Geneva: World Health Organization; 2024.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Искусственный интеллект в лучевой диагностике: Per Aspera Ad Astra / Под ред. Ю.А. Васильева и А.В. Владзимирского. – М.: Издательские решения; 2025.</mixed-citation><mixed-citation xml:lang="en">Iskusstvennyy intellekt v luchevoy diagnostike: Per Aspera Ad Astra. Ed by Vasilev YA, Vladzymyrskyy AV. Moscow: Izdatelskie resheniya; 2025. (In Russ.)</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
