Introduction

Background

Urology has historically been among the first medical specialties to adopt new technologies, and the rapid integration of generative artificial intelligence (AI) into medical literature is no exception [1,2]. Nevertheless, the use of AI methods in research presents numerous challenges, including algorithmic bias, scientific monoculture, and risks of technological error [3]. In response, publishers and urology journals have increasingly released AI guidance statements to direct authors during the manuscript submission process.

Objectives

These guidance statements have significant implications for both the creation and quality of AI-generated urology research. Thus, it is essential to understand the current position of urology research regarding AI. Our study describes the present landscape of AI guidance statements among urology journals.

Methods

Ethics statement

No human subjects were involved in this study; therefore, neither institutional review board approval nor informed consent was required.

Study design and setting

This study is a descriptive analysis of information publicly available on the websites of urology journals. Data were collected in September 2024 from the official websites of urology journals.

Subjects

The PubMed Journal List [4], which catalogs all journals indexed on PubMed, was searched using common keywords to identify all urology journals. Journals were excluded if they were not relevant to urology, not actively publishing, unavailable online, or not published in English.

Variables

Journal websites were reviewed for AI guidance statements for authors during the manuscript submission process. Specific aspects assessed included whether AI use was permitted at all and, if so, whether AI was allowed for content generation, manuscript writing, or manuscript editing. These features were classified as “yes,” “no,” or “unknown” (when no explicit guidance was provided). The requirement for an AI disclaimer in the manuscript was also noted. Additional variables, including journal region, impact factor, urologic subspecialty, and society affiliation, were collected for descriptive purposes.

Data sources/measurement

A member of the research team systematically visited the websites of included urology journals to determine the presence or absence of AI guidance statements. For journals with such statements, further details were recorded regarding the permissibility of AI use for content generation, writing, and editing, again categorized as “yes,” “no,” or “unknown.” The same process was followed for documenting whether an AI disclaimer was required. Information on journal region, impact factor, subspecialty, and society affiliation was also obtained from each journal’s website.

Bias

There may be reporting bias in how journals present their guidance statements online. For example, not all journals place guidance statements under author guidelines. To minimize this, a thorough search of each website, including all tabs and supplemental materials available prior to submission, was performed. Additionally, the risk of interpretation bias was mitigated by having a separate research team member establish data collection criteria beforehand. Consistency and transparency in decision-making were maintained throughout the process.

Study size

All available English-language journals indexed on PubMed and related to urology were included. No sample size calculation was conducted, as this is a descriptive study designed to highlight the landscape of AI guidance statements among all eligible urology journals.

Statistical methods

Data were recorded using REDCap (Vanderbilt University). Chi-square analysis was performed for categorical variables, and the two-sample t-test was applied to continuous variables, with an α of 0.05. Statistical analyses were conducted using ChatGPT 4o (OpenAI).

Results

Out of 36,678 journals indexed on PubMed, 257 were initially identified as candidates for analysis. After an Internet search, 145 journals were excluded due to irrelevance, lack of active publication, absence of a website, or the unavailability of an English-language version. A total of 112 journals were included in the study (Fig. 1).

Approximately half of all urology journals (n=61, 54.5%) displayed an AI guidance statement on their website. Society affiliation (P=0.32), region (P=0.07), and subspecialty (P=0.96) were not significantly associated with the presence of an AI guidance statement. Among journals with AI guidance statements, most permitted the use of AI for manuscript editing (n=58, 95.1%), and none definitively prohibited AI for this purpose. Most also allowed AI to be used for manuscript writing (n=53, 86.9%). Twenty-three journals (37.7%) with AI guidance statements allowed the use of AI for generating manuscript content, while 11 (18.0%) explicitly did not allow this. For 27 journals (44.3%), the stance on using AI to generate content remained unclear. Sixty journals (98.4%) required a disclaimer if AI was used at any stage in the manuscript creation process, whereas one journal (1.6%) provided no guidance on this requirement (Fig. 2). The mean impact factors for journals with and without guidance statements were 3.13 and 2.13, respectively (P=0.22).

Discussion

Key results

While about half of journals specializing in urology research provided guidance regarding the use of AI, an equal number lacked any specific regulations. Notably, journal prestige or impact factor did not correlate with the presence of an AI guidance statement. Among journals that offered guidance, most permitted AI to be used for both editing and writing manuscripts. Interestingly, this is in contrast to most guidance statements that prohibited listing AI as a manuscript author. There was less consensus regarding the use of AI to generate manuscript content; only about one-third of urology journals explicitly permitted this practice. A smaller proportion of journals specifically disallowed AI-generated content, while for approximately 40% of journals, the guidance statement was unclear, which may create confusion for researchers regarding how AI may be integrated into their research process, if at all.

Interpretation/comparison with previous studies

Overall, this snapshot analysis demonstrates a lack of standardization regarding AI use in urology research, with guidance either missing or highly variable across societies, regions, and urology subspecialties. Many urology journals with guidance statements are published by major publishers such as Springer, Wiley, or Elsevier, which may have overarching policies for all their journals. This suggests that the adoption of AI guidance statements may depend significantly on whether a larger publisher has established a position on the use of AI in academic literature.

Current leaders in academic publishing argue that generative AI cannot take responsibility for research contributions or agree to the conditions of authorship [5]. This perspective remains under debate and may change, underscoring the urgent need for clearer guidance on AI use in urology research. The current lack of standardized guidelines, transparency, and agreement regarding software contributions that could otherwise be considered authorship raises important concerns about the quality and reliability of published research.

To our knowledge, this is the first study specifically focusing on AI guidance statements and policies within urology journals for submitted content. Previous studies examining AI guidance have primarily analyzed the policies of major publishers and top journals, often in the context of author guidelines or peer review. Consistent with our findings, these studies report large discrepancies in the existence and content of AI guidance statements among academic journals. Even when guidance is provided, there is considerable variability in what is permitted [6,7].

Limitations

There are several limitations to our analysis. Journals not indexed on PubMed were not included. Additionally, this study may underestimate the number of journals with AI guidance statements if such statements are accessible only after login, or only appear during the manuscript submission process or later stages of review. Finally, our study represents only a snapshot in time, and journal policies may evolve as more is learned about the impact of AI.

Generalizability

The findings of this study describe the current landscape of AI statements among urology journals and are most applicable to the field of urology. They may not be generalizable to other specialties, as patterns of technological adoption can differ. Urology has historically been an early adopter of technological innovations [8]; however, there may be specific challenges related to AI. For example, the American Urological Association currently prohibits uploading its content to AI software, with this policy displayed on a banner across the AUANews homepage [9].

Suggestions

Our study provides a snapshot of how AI guidelines may affect urology research. Future research could track the prevalence and content of AI guidance statements within urology journals over time. Given the current lack of guidance among many journals, consensus policies across urology journals on the use of AI in research are recommended. Following the standard set by journals that already have AI guidance, an emphasis on requiring AI disclaimer statements when AI is used is advised. This would enable the urology community to accurately interpret, evaluate, and apply new research involving AI at any stage of the process.

Conclusions

Although AI has significant potential and has already been used to investigate urologic surgical outcomes, cancer staging and grading, and disease prognosis and survival [10], there is a risk of misleading or inaccurate research and applications [2,3], particularly in the absence of appropriate oversight, guidelines, and disclosures. As this research landscape continues to evolve, it is essential to monitor and reassess how urology journals adapt to ongoing and future innovations in AI.

Notes

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Funding

The authors received no financial support for this article.

Data availability

Dataset file is available from the Harvard Dataverse at https://doi.org/10.7910/DVN/YRH2IT.

Dataset 1. List of 112 urology journals with information about their generative artificial intelligence guidance statements, including manuscript content generation, manuscript writing, and manuscript editing, and journal data, region, subspecialty, society affiliations, and impact factor.

kcse-375-dataset-1.xlsx

Supplementary materials

Fig. 1.

Flowchart of journal search process and analysis. AI, artificial intelligence.

Fig. 2.

Percentage of artificial intelligence (AI) guidance statements in urology journals by feature.

References

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Figure & Data

References

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