Circulation's AI Policy: AHA Journal Rules for Cardiovascular Authors

Most major journals require AI disclosure in one place, usually Methods. The AHA requires it in two:

Methods section disclosure:

"During the preparation of this manuscript, the authors used ChatGPT (GPT-4, OpenAI) to improve the clarity and readability of the Discussion section. All suggestions were reviewed and edited by the clinical investigators (J.R. and S.M.). The authors take full responsibility for the content of this article."

Cover letter mention:

"We wish to disclose that AI tools were used during manuscript preparation, as detailed in the Methods section. ChatGPT (GPT-4, OpenAI) was used for language editing of the Discussion. All content has been reviewed and approved by all authors."

Why two places? The cover letter disclosure ensures the handling editor knows about AI use before the paper enters review. The Methods disclosure ensures readers and reviewers can evaluate the scope. Some editors skim the Methods during initial assessment, and the cover letter catch ensures AI use doesn't get overlooked at the desk review stage.

Circulation publishes clinical trials, observational studies, basic science, and translational research. Each type has different AI disclosure considerations.

For a clinical trial (e.g., a drug efficacy RCT):

"The authors used Claude (Claude 3.5, Anthropic) to improve the language of the Introduction and Discussion sections. No AI tools were used for study design, data collection, statistical analysis, or clinical interpretation. The statistical analysis was performed by the study biostatistician (K.L.) using SAS 9.4 (SAS Institute). All AI-edited text was reviewed against the trial protocol and statistical analysis plan. The authors take full responsibility for the published content."

For an imaging/AI research paper:

"The convolutional neural network described in this study (CardioNet v3) was developed using TensorFlow and trained on the institutional dataset described in Methods. Separately, during manuscript preparation, the authors used ChatGPT (GPT-4, OpenAI) to edit the Results section for clarity. The research methodology and the manuscript editing tool are entirely separate systems. All AI-suggested text edits were reviewed by the senior author (M.P.)."

For a basic science paper:

"During preparation of this manuscript, the authors used GitHub Copilot (Microsoft) to assist with writing Python scripts for single-cell RNA-seq analysis. ChatGPT (GPT-4, OpenAI) was used to improve the readability of the Methods section. All code was validated against manual calculations, and all text edits were reviewed by the authors."

The AHA's enforcement follows the ICMJE and COPE framework:

During peer review:

• Reviewers or editors flag concerns about AI-generated text
• Author asked to add or expand disclosure in Methods and cover letter
• Deliberate concealment can lead to rejection
• If AI use affected clinical data interpretation, additional review by the statistical editor may be required

After publication:

• Correction: For non-clinical AI use (language editing) that was inadvertently undisclosed
• Expression of concern: If the scope of AI use is unclear, particularly in clinical sections
• Retraction: If AI generated clinical claims, fabricated data, or unverifiable findings
• Institutional notification: For serious cases involving clinical trial data

The cardiovascular community factor: Cardiology is a large but interconnected field. Circulation's editorial board includes department chairs and NIH study section members who review grants. A publication ethics issue at Circulation can ripple into grant review and promotion decisions. The practical cost of non-disclosure extends well beyond the single paper.

A specific risk for clinical trials: If your Circulation paper reports outcomes from a cardiovascular clinical trial and you didn't disclose that AI tools helped interpret or present the results, the consequences could extend to the trial sponsor, the Data Safety Monitoring Board, and potentially the FDA if the trial supported a regulatory submission. This isn't theoretical, regulatory agencies are increasingly asking about AI involvement in research processes.

For clinical papers:

• Never input patient data into cloud-based AI tools. This includes de-identified data if re-identification is theoretically possible.
• Keep AI away from Results and Conclusions sections in clinical trial reports. Reviewers expect these sections to reflect the investigators' direct interpretation of the data.
• If your trial involves an AI-based device or algorithm as the intervention, separate the research disclosure from the writing disclosure with clear subheadings.

For basic and translational research:

• If AI helped with bioinformatics code, deposit the code in a public repository and note which portions were AI-assisted.
• For single-cell analyses, proteomics, or genomics pipelines that used AI-assisted code, describe the validation steps clearly.

For reviews and state-of-the-art papers:

• Circulation publishes invited reviews that shape clinical practice. If you use AI to organize or draft sections, the disclosure should reflect this, and the editorial team expects the analytical framework to be your own.
• Don't use AI to generate clinical recommendations in review articles. Circulation's clinical practice recommendations carry significant weight with practicing cardiologists.

Before submission checklist:

• [ ] AI disclosure in Methods section
• [ ] AI use mentioned in cover letter
• [ ] No patient data processed through external AI tools
• [ ] Clinical interpretations are human-generated
• [ ] Statistical code validated independently
• [ ] All co-authors aware of AI disclosure
• [ ] Research AI and writing AI clearly distinguished (if applicable)

Cover letter template for AI disclosure:

"Dear Editors, [standard cover letter content]. We wish to inform you that AI tools were used during manuscript preparation as disclosed in the Methods section. Specifically, [tool name and version] was used for [purpose]. All content has been reviewed and approved by all authors, who take full responsibility for the manuscript."

A free manuscript assessment can help you verify that your Circulation submission meets the AHA's disclosure and formatting requirements before you submit.