{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T11:21:08Z","timestamp":1790940068202,"version":"4.1.0"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Peripheral artery disease (PAD) is a global health challenge. Advances in artificial intelligence (AI), such as large language models (LLMs) and chain-of-thought (CoT) reasoning, offer novel approaches for clinical recommendations. This study compared the readability and guideline adherence of responses from physicians and AI for a standardized PAD case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This cross-sectional study gathered responses from 30 specialized physicians (11 cardiologists, 19 vascular surgeons) across seven Latin American countries and 13 LLM systems (10 standard, three CoT). Both groups addressed diagnosis, treatment, risks, and prognosis; LLMs responded as vascular specialists. Responses were blindly evaluated with five validated Spanish readability indices and compared to the 2024 ACC\/AHA multisocietal PAD guideline. Three experts scored guideline adherence; nonparametric tests were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Guideline adherence did not differ significantly between physicians (median 5.8 [3.4\u20137.6]) and LLMs (7.3 [4.7\u20139.7],\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.169), though CoT-LLMs achieved the highest scores (9.7 [8.5\u201311.0]). LLMs more often recommended supervised exercise (84.6% vs 30.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002) and revascularization for quality of life (69.2% vs 20.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.004), whereas physicians favored cilostazol (60.0% vs 30.8%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.104). LLM responses had lower Readability \u03bc values (46.9 vs 51.4,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012). Inter-rater reliability was highest for CoT-LLMs (intraclass correlation coefficient [ICC] = 0.98) versus physicians (ICC = 0.76).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>LLM showed comparable guideline adherence to physicians although CoT models achieved the highest scores. The difference in physician and AI treatment preferences suggest the potential of AI as adjunct clinical tools and warrants further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1358863x251386394","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:59:42Z","timestamp":1766051982000},"page":"70-78","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparing guideline adherence and readability: Artificial intelligence with deep learning versus specialized physicians in peripheral artery disease management"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7243-4663","authenticated-orcid":false,"given":"Alfredo","family":"Verastegui","sequence":"first","affiliation":[{"name":"Tecnol\u00f3gico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico"},{"name":"Department of Surgery, Mayo Clinic Florida, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4735-6609","authenticated-orcid":false,"given":"Regina","family":"Castaneda","sequence":"additional","affiliation":[{"name":"Tecnol\u00f3gico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9456-8366","authenticated-orcid":false,"given":"Oliver Antonio","family":"G\u00f3mez-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Tecnol\u00f3gico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5101-1541","authenticated-orcid":false,"given":"Mauricio","family":"Gonzalez-Urquijo","sequence":"additional","affiliation":[{"name":"Tecnol\u00f3gico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico"},{"name":"Departamento de Cirug\u00eda Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1795-3313","authenticated-orcid":false,"given":"Oscar","family":"de la Torre","sequence":"additional","affiliation":[{"name":"Tecnol\u00f3gico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Herrera Vegas","sequence":"additional","affiliation":[{"name":"Centro de Estudios M\u00e9dicos e Investigaciones Cl\u00ednicas (CEMIC), Saavedra campus, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"August","family":"Ysa","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Hospital de Cruces, Barakaldo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Garc\u00eda-Toca","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy, Grady Memorial Hospital, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8548-6833","authenticated-orcid":false,"given":"Mario Alejandro","family":"Fabiani","sequence":"additional","affiliation":[{"name":"Tecnol\u00f3gico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the International Cooperative Vascular Consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30255-4"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2018.05.033"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.seps.2014.12.002"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.010"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X19893003"},{"key":"e_1_3_3_8_2","first-page":"699","article-title":"Impact of internet use on health-related behaviors and the patient-physician relationship: A survey-based study and review","volume":"108","author":"Iverson SA","year":"2008","unstructured":"Iverson SA, Howard KB, Penney BK. 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