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The TRIPOD-LLM reporting guideline for studies using large language models

Jack Gallifant, Majid Afshar, Saleem Ameen, Yindalon Aphinyanaphongs, Shan Chen, G. Cacciamani, Dina Demner-Fushman, D. Dligach et al.

Nature Medicine, 2025

555 citations

Abstract

Large language models (LLMs) are rapidly being adopted in healthcare, necessitating standardized reporting guidelines. We present transparent reporting of a multivariable model for individual prognosis or diagnosis (TRIPOD)-LLM, an extension of the TRIPOD + artificial intelligence statement, addressing the unique challenges of LLMs in biomedical applications. TRIPOD-LLM provides a comprehensive checklist of 19 main items and 50 subitems, covering key aspects from title to discussion. The guidelines introduce a modular format accommodating various LLM research designs and tasks, with 14 main items and 32 subitems applicable across all categories. Developed through an expedited Delphi process and expert consensus, TRIPOD-LLM emphasizes transparency, human oversight and task-specific performance reporting. We also introduce an interactive website (https://tripod-llm.vercel.app/) facilitating easy guideline completion and PDF generation for submission. As a living document, TRIPOD-LLM will evolve with the field, aiming to enhance the quality, reproducibility and clinical applicability of LLM research in healthcare through comprehensive reporting. TRIPOD-LLM (transparent reporting of a multivariable model for individual prognosis or diagnosis–large language model) is a checklist of items considered essential for good reporting of studies that are developing or evaluating an LLM for use in healthcare settings. It is a ‘living guideline’ that emphasizes transparency, human…

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