Abstract
Systematic reviews provide the highest level of evidence but remain resource-intensive. We evaluated the performance of a large language model (LLM; ChatGPT, OpenAI) in a PRISMA-guided review of randomized controlled trials on vaginal vault prolapse surgery. Prompts were carefully designed to minimize errors, and outputs were verified. Each task was completed within minutes. For title/abstract screening, recall was 69.8% and precision 85.7% (κ = 0.77); full-text agreement 94.1–100% (κ = 0.82–1); data extraction accuracy 87.5–99.7%. From 18 RCTs (1668 women), sacrocolpopexy (SC) showed higher anatomic success than sacrospinous fixation (SSF) (OR 1.42, 95% CI 0.71–2.84). Transvaginal mesh improved 3-year objective success compared with SSF (OR 1.84, 95% CI 1.13–2.99) but had higher reoperation rates (5–16% vs 2–4%) than SC. We did not find conclusive evidence that any single technique is superior; most comparisons were underpowered, with wide confidence intervals and substantial heterogeneity. All LLM-derived statistical results were identical to those from conventional R analyses, confirming robustness. Validated LLM workflows can enable more efficient and scalable evidence synthesis.
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Data availability
All data analyzed in this study were derived from published randomized controlled trials included in the systematic review and meta-analysis. No new raw patient-level data were generated. The datasets supporting screening decisions, extracted variables, and ChatGPT-assisted workflow outputs are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors acknowledge the Yonsei University Medical Library for support with the literature search. ChatGPT (OpenAI, San Francisco, CA, USA) was used to assist with English language refinement, under the authors’ supervision.
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Y.P. - Conceptualization, literature search, study selection, data extraction, quality assessment, preparation of figures and tables, drafting of the manuscript H.Z. - Statistical analysis, data synthesis, preparation of figures and tables, methodological consultation S.W.B. - Literature search, data extraction, validation, interpretation of findings, Project administration.
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Park, Y., Zhang, HS. & Bai, S.W. Large language models in systematic review and meta-analysis of surgical treatments for vaginal vault prolapse. npj Digit. Med. (2026). https://doi.org/10.1038/s41746-026-02431-w
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DOI: https://doi.org/10.1038/s41746-026-02431-w
