{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:12:11Z","timestamp":1790629931335,"version":"4.1.0"},"reference-count":46,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100005191","name":"Craig H. Neilsen Foundation","doi-asserted-by":"crossref","award":["UW2025-2028"],"award-info":[{"award-number":["UW2025-2028"]}],"id":[{"id":"10.13039\/100005191","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Neurotrauma Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Access to high-quality health information (HI) is critical for everyone involved in the research and management of medical conditions such as spinal cord injury (SCI). Recently, the use of Large Language Models (LLMs) through AI-based chatbots like ChatGPT has become increasingly integral to how people seek and consume HI. While LLMs have been evaluated in various clinical and health domains, there remains a notable gap in the literature regarding their use for SCI-specific questions. We conducted a narrative synthesis to identify the opportunities, challenges, and risks of using LLMs in SCI-related HI tasks, and to provide future direction for researchers, clinicians, and policymakers to better understand this fast-evolving landscape. We searched PubMed, Embase, and Google Scholar up to December 2025 and identified nine primary articles that investigated LLMs in the context of SCI-related queries. Our synthesis of the literature revealed that although there are promising results, these should be taken with caution due to mixed evidence for LLM\u2019s capability to effectively answer SCI-related questions. In addition, the LLM outputs were challenging to read, typically requiring an education level equivalent to a college-level student (grades 14\u201315) to be adequately understood. We recognize that LLMs can serve as valuable tools for accessing HI in SCI. However, LLMs can also pose significant risks, including the spread of mis- or dis-information that may be inaccurate or even dangerous, which can mislead individuals and caregivers, potentially resulting in detrimental health outcomes. Finally, methodological rigour needs to be improved to produce higher levels of evidence.<\/jats:p>","DOI":"10.1177\/2689288x261425900","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:52:32Z","timestamp":1777359152000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Can Large Language Models Answer Questions about Spinal Cord Injury? Risks, Challenges, and Opportunities\u2014A Narrative Review"],"prefix":"10.1177","volume":"7","author":[{"given":"Rahul K.","family":"Desai","sequence":"first","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran","family":"Saggu","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masha","family":"Panahi","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kealey L.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parisa","family":"Razavi Yeganeh","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornell","family":"Douglas","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzieh","family":"Mussavi Rizi","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Fallah","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, Canada."},{"name":"University of British Columbia, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Chernesky","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa K.","family":"Noonan","sequence":"additional","affiliation":[{"name":"Praxis Spinal Cord Institute, Vancouver, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-8738","authenticated-orcid":false,"given":"Abel","family":"Torres-Esp\u00edn","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Canada."},{"name":"Department of Neurological Surgery, University of California San Francisco, San Francisco, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.technovation.2024.103002"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s43856-023-00370-1"},{"issue":"1","key":"e_1_3_3_4_2","doi-asserted-by":"crossref","first-page":"e002602","DOI":"10.1136\/fmch-2023-002602","article-title":"Potential applications and implications of large language models in primary care","volume":"12","author":"Andrew A","year":"2024","unstructured":"Andrew A. Potential applications and implications of large language models in primary care. Fam Med Community Health, 2024; 12(Suppl 1):e002602.","journal-title":"Fam Med Community Health"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.softx.2024.102029"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iotcps.2023.04.003"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.2196\/54633"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.21.287654"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.2487"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4006"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-021-00618-4"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41394-024-00634-5"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fresc.2022.904716"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-023-00903-4"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2025.101821"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-00314-2"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03425-5"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2023.11.062"},{"key":"e_1_3_3_20_2","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2024","unstructured":"R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing: Vienna, Austria; 2024."},{"key":"e_1_3_3_21_2","volume-title":"RStudio: Integrated Development for R","author":"RStudio Team","year":"2018","unstructured":"RStudio Team. RStudio: Integrated Development for R. RStudio, Inc., Boston, MA; 2018. Available from: http:\/\/www.rstudio.com\/"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24277-4"},{"key":"e_1_3_3_23_2","volume-title":"Patchwork: The Composer of Plots","author":"Pedersen TL","year":"2020","unstructured":"Pedersen TL. Patchwork: The Composer of Plots. CRAN; 2020."},{"key":"e_1_3_3_24_2","volume-title":"DiagrammeR: Graph\/Network Visualization","author":"Iannone R","year":"2024","unstructured":"Iannone R, , Roy O. DiagrammeR: Graph\/Network Visualization. DiagrammeR; 2024."},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2024.2361551"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-025-02170-7"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.2196\/70339"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2025.2554013"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2024.0301"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251321837"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/0142159X.2024.2430365"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.46998\/IJCMCR.2023.33.000817"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.14749"},{"key":"e_1_3_3_34_2","article-title":"A proposed S.C.O.R.E. evaluation framework for large language models : Safety, consensus, objectivity","author":"Tan TF","year":"2024","unstructured":"Tan TF, , Elangovan K, , Ong J, et al. A proposed S.C.O.R.E. evaluation framework for large language models : Safety, consensus, objectivity. Reproducibility and Explainability, 2024; doi: 10.48550\/arXiv.2407.07666","journal-title":"Reproducibility and Explainability"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2004.00273.x"},{"key":"e_1_3_3_36_2","unstructured":"Kffalexm. KFF Health Misinformation Tracking Poll: Artificial Intelligence and Health Information. 2024. Available from: https:\/\/www.kff.org\/public-opinion\/kff-health-misinformation-tracking-poll-artificial-intelligence-and-health-information\/ [Last accessed: December12 2025]."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/20552076251394287"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocae186"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000308"},{"key":"e_1_3_3_40_2","first-page":"358","article-title":"Health literacy","volume":"253","author":"Weiss BD","year":"2003","unstructured":"Weiss BD. Health literacy. Am Med Assoc, 2003; 253:358.","journal-title":"Am Med Assoc"},{"key":"e_1_3_3_41_2","unstructured":"National Institutes of Health (NIH). Clear & Simple. 2025. Available from: https:\/\/www.nih.gov\/institutes-nih\/nih-office-director\/office-communications-public-liaison\/clear-communication\/clear-simple [Last accessed: September17 2025]."},{"key":"e_1_3_3_42_2","unstructured":"Anonymous. CAN-ASC-6.2:2025-Accessible and Equitable Artificial Intelligence Systems - Accessibility Standards Canada. n.d. Available from: https:\/\/accessible.canada.ca\/creating-accessibility-standards\/asc-62-accessible-equitable-artificial-intelligence-systems?utm_source=newsletter&utm_medium=email&utm_campaign=AI_standard_publication_Dec2025 [Last accessed: December12 2025]."},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1310\/sci1301-1"},{"key":"e_1_3_3_44_2","article-title":"Retrieval-augmented generation for knowledge-intensive NLP tasks","author":"Lewis P","year":"2020","unstructured":"Lewis P, , Perez E, , Piktus A, et al. Retrieval-augmented generation for knowledge-intensive NLP tasks. medRxiv, 2020; doi: 10.48550\/ARXIV.2005.11401","journal-title":"medRxiv"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2023.104580"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1101\/2025.07.13.25331222"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.24598"}],"container-title":["Neurotrauma Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2689288X261425900","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2689288X261425900","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2689288X261425900","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T09:14:23Z","timestamp":1784884463000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2689288X261425900"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":46,"alternative-id":["10.1177\/2689288X261425900"],"URL":"https:\/\/doi.org\/10.1177\/2689288x261425900","relation":{},"ISSN":["2689-288X","2689-288X"],"issn-type":[{"value":"2689-288X","type":"print"},{"value":"2689-288X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"2689288X261425900"}}