{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:26:36Z","timestamp":1767194796363,"version":"3.48.0"},"reference-count":48,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Development of Patient-Reported Outcome Measures (PROMs) in ophthalmology is limited by high patient burden during early validation. We propose an In Silico Pre-validation Framework using Large Language Models (LLMs) to stress-test instruments before clinical deployment. Methods: The LLM generated a PROM questionnaire and a synthetic cohort of 500 distinct patient profiles via a Python-based pipeline. Profiles were instantiated as structured JSON objects with detailed attributes for demographics, lifestyle, and health background, including specific clinical parameters like IOL type (Monofocal, Multifocal, EDOF) and dysphotopsia severity. To eliminate memory bias, a stateless simulation approach was used for test\u2013retest reliability; AI agents were re-instantiated without access to prior conversation history. Psychometric validation included Confirmatory Factor Analysis (CFA) using WLSMV estimation and Differential Item Functioning (DIF). Results: The model demonstrated excellent fit (CFI = 0.962, TLI = 0.951, RMSEA = 0.048, SRMR = 0.063), confirming structural validity. DIF analysis detected no significant bias based on age, sex, or IOL type (0\/20 items flagged). Internal consistency was robust (Cronbach\u2019s alpha &gt; 0.80) and stateless test\u2013retest reliability was high (ICC &gt; 0.90), indicating stability independent of algorithmic memory. Convergent validity was established via significant correlations with NEI-VFQ-25 scores (Spearman\u2019s: \u22120.425 to \u22120.652,). While responsive to change, known-groups validity reflected realistic clinical overlap. Conclusions: LLM-based pre-validation effectively mirrors complex human response patterns through \u201calgorithmic fidelity.\u201d By identifying structural failure points in silico, this framework ensures PROMs are robust and unbiased before clinical trials, reducing the ethical and logistical burden on real-world populations.<\/jats:p>","DOI":"10.3390\/jcm15010283","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:05:01Z","timestamp":1767193501000},"page":"283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using Large Language Models for In Silico Development and Simulation of a Patient-Reported Outcome Questionnaire for Cataract Surgery with Various Intraocular Lenses: A Pre-Validation Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5157-6298","authenticated-orcid":false,"given":"Ewelina","family":"Trojacka","sequence":"first","affiliation":[{"name":"Center of Ocular Microsurgery, Professor Jerzy Szaflik\u2019s Clinic in Warsaw, 00-215 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Przybek-Skrzypecka","sequence":"additional","affiliation":[{"name":"SPKSO Ophthalmic University Hospital in Warsaw, 03-709 Warszawa, Poland"},{"name":"Department of Ophthalmology, Medical University of Warsaw, 02-091 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justyna","family":"Izdebska","sequence":"additional","affiliation":[{"name":"Center of Ocular Microsurgery, Professor Jerzy Szaflik\u2019s Clinic in Warsaw, 00-215 Warszawa, Poland"},{"name":"SPKSO Ophthalmic University Hospital in Warsaw, 03-709 Warszawa, Poland"},{"name":"Department of Ophthalmology, Medical University of Warsaw, 02-091 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek P.","family":"Szaflik","sequence":"additional","affiliation":[{"name":"Center of Ocular Microsurgery, Professor Jerzy Szaflik\u2019s Clinic in Warsaw, 00-215 Warszawa, Poland"},{"name":"SPKSO Ophthalmic University Hospital in Warsaw, 03-709 Warszawa, Poland"},{"name":"Department of Ophthalmology, Medical University of Warsaw, 02-091 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Musa Aamir","family":"Qazi","sequence":"additional","affiliation":[{"name":"Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, 02-091 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Azhar","sequence":"additional","affiliation":[{"name":"Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, 02-091 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janusz","family":"Skrzypecki","sequence":"additional","affiliation":[{"name":"Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, 02-091 Warszawa, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1111\/ceo.14535","article-title":"Presbyopia Correction in Lens Replacement Surgery: A Review","volume":"53","author":"Stern","year":"2025","journal-title":"Clin. 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