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This study did not involve the prospective recruitment of human participants. It was conducted entirely on the publicly available, fully de-identified LUNA16 dataset, which is derived from the LIDC-IDRI collection; no new patient data were collected, and no procedures were performed on human participants by the authors.","order":1,"name":"Ethics","label":"Ethics Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. The study uses a public, de-identified secondary dataset.","order":2,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. No identifiable individual data or images are reported.","order":3,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Conflict of Interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No large language model or generative AI tool was used for any analytic or generative task in this study. All attribution methods, metrics, and statistical analyses were implemented directly by the authors in Python.","order":5,"name":"Ethics","label":"Use of AI Tools","group":{"name":"EthicsHeading","label":"Declarations"}}]}}