In the Brave New World of AI, Why Read <i>Pediatrics in Review</i> ?

Abstract

It is easy to be impressed by how fast an artificial intelligence (AI) search engine, using a large language model (LLM), answers a clinical question. Compare the time it takes to get an answer from AI compared to you, yourself, choosing keywords, searching PubMed, and reading peer-reviewed published studies, systematic reviews, meta-analyses, and case reports, that you then evaluate to possibly answer your clinical question.As a journal, we have to ask ourselves, why should people subscribe to Pediatrics in Review (PIR) in an age when, if you have a clinical question, you can ask that question to an AI search engine and receive an answer within seconds without cost? You may ask yourself, what advantage does PIR, a subscription journal, provide?Understanding PIR’s advantage relies on understanding the difference in how AI arrives at its answer and how the journal does.AI generates clinical answers by drawing on the informational resources it has access to, then selecting and rearranging words and phrases into sentences with the highest probability of fitting together coherently. (As Andy Kessler in the Wall Street Journal recently wrote, “AI is still statistical pattern matching.”) Whether the AI- or LLM-generated response is valid is determined by the person who asked the clinical question. In other words, the person asking the question must do their own “peer review.”It is not unusual for AI/LLMs to fabricate (“hallucinate”) answers. Accepting and trusting an AI/LLM answer without checking the accuracy means trust is based not on evidence but on an algorithm that played the odds. A clinician who practices medicine based on unverified AI/LLM answers is likewise gambling: betting that the response reflects evidence-based care rather than fabricated care.In PIR, however, every published article is written by experts in their fields and peer reviewed by at least 2 pediatricians, usually a general pediatrician and a subspecialist, as well as at least 1 member of the executive editorial board.AI search engines are also most often used by clinicians only when an immediate situation raises a question they cannot answer on their own. Perhaps this person seeks new knowledge only when the need is urgent and specific rather than as an effort to be prepared for the unexpected.PIR provides knowledge that is both trustworthy and anticipatory.First, the articles that PIR publishes are truly peer reviewed. Authors, reviewers, and editors assess original studies, meta-analyses, and review articles to finetune articles that provide clinical guidance. Readers can trust the knowledge because our peer-review process assures truth, accuracy, and validity.Second, the journal anticipates future knowledge needs and practice gaps and chooses those subjects/topics that will prepare pediatricians—subjects/topics that are chosen by the PIR editorial board and the American Board of Pediatrics.However, PIR tries to do more. For every article we ask the following:Does it teach?Does it provide practical information?Is it enjoyable to read?Does it inspire?Collectively the PIR editorial board, reviewers, and authors strive to answer yes to each question.Dr Janet Serwint, who retires from her position after 20 years as Associate Editor of In Brief, once wrote, “Within the medical field of pediatrics, it is essential that we remain lifelong learners, so concise, timely, evidence-based reviews and updates, such as are provided with In Briefs, are critically important for us to provide high quality care to patients and families. … When I received my copy I would eagerly read each issue, but I also searched on the relevant topic when I was caring for a patient in either the outpatient or inpatient setting. … What I found is that I often learned a new fact, a new nuance about which I may not have thought about or made me question past dogma which improved the care we were providing for the patient.”1 Jan eloquently summarized what we hope to achieve with our readers. We will miss Jan, although her spirit for sharing knowledge and seeking new knowledge is instilled in all of us at PIR.Each year, our editorial board changes, ensuring that new, forward-thinking pediatricians are always pushing PIR to be better. Besides 7 new members of general pediatricians and subspecialists joining the editorial board, this year Dr Steve Ciciora, a pediatric gastroenterologist, takes the role of Associate Editor, In Brief. Dr Walter Dehority, a general pediatrician and infectious disease subspecialist, is our new Deputy Editor at Large. Dr Hugh Allen, our Deputy Editor, will be guiding Dr Dehority in his new role. Drs Ciciora and Dehority are avidly involved in medical education, and their experience and leadership will add to PIR’s integrity.We promise our readers that subscribing to PIR will provide trusted, evidence-based learning to practice pediatrics today and in the future.

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