Hepatology's AI Policy: AASLD and Wolters Kluwer Rules for Liver Disease Authors

Wolters Kluwer publishes many medical journals. Their company-wide AI policy provides a baseline, and Hepatology's instructions add the following:

The AASLD overlay matters most for clinical content. Hepatology publishes AASLD Practice Guidelines, such as the treatment of chronic hepatitis B and adult liver transplantation. Hepatology's instructions say AI tools should not replace researcher responsibilities such as producing scientific insights, analyzing and interpreting data, or drawing conclusions, which applies with particular force to clinical recommendations.

Research AI vs. writing AI

Hepatology publishes active research on Full Review tools, elastography interpretation, serum biomarker panels (FIB-4, APRI, ELF), and AI-assisted ultrasound analysis. When AI is your research subject, keep the descriptions separate from your writing-AI disclosure:

• Research AI: Standard Methods section with architecture details, training/validation data, performance metrics

• Writing AI: Dedicated disclosure paragraph naming the tool and its purpose

MASH clinical trials

Hepatology publishes practice-changing MASH trials (resmetirom, FXR agonists, thyroid hormone receptor-beta agonists). For trial reports, AI can help with language. It should not help with interpreting histologic response rates, characterizing adverse event profiles, or drawing conclusions about clinical benefit. Reviewers include hepatologists who run these trials and serve on DSMB committees, they'll notice the hedged, overly balanced quality that AI tools produce when discussing clinical outcomes.

Transplant registry data

Never process transplant registry data (UNOS, Eurotransplant) through external AI tools. Even de-identified data creates compliance issues when uploaded to a cloud service. This is both an AI policy concern and a data governance issue your IRB and registry access agreement would prohibit.

The fibrosis staging problem

Large language models sometimes introduce subtle inaccuracies in fibrosis staging descriptions, conflating F2 and F3 Metavir criteria or mischaracterizing elastography cutoffs. Have a hepatologist specifically review any AI-edited text about fibrosis staging, whether from biopsy (Metavir, NASH CRN), elastography, or serum markers.

Coordinate international author teams

Hepatology papers often involve collaborations spanning multiple continents. A multicenter MASH trial might include investigators from the US, Europe, Asia, and Latin America. Language barriers make AI tools particularly useful for non-English-speaking co-authors, and that's exactly what the policy permits. But coordinate the disclosure: the corresponding author should ask every co-author about their AI tool use before submission.

Supplementary materials and statistical code

The AI disclosure covers supplementary content. If AI helped edit supplementary methods or generate figure legends, include it in the disclosure. If GitHub Copilot or ChatGPT helped write R or SAS code for survival analysis, propensity score matching, or competing risk analyses, that's AI-assisted code generation and needs disclosure too. Hepatology's original manuscripts have a 6,000-word limit (including references but excluding title page, abstract, figure legends, and tables), so the disclosure won't cost you much space.

For an original research article (e.g., MASH biomarker study):

"During the preparation of this manuscript, the authors used ChatGPT (GPT-4o, OpenAI) to improve the clarity of the Introduction and Discussion sections. All AI-generated suggestions were reviewed and edited by the corresponding author (A.B.) and the senior hepatologist (C.D.). No AI tools were used in study design, sample analysis, biomarker validation, or clinical interpretation. The authors take full responsibility for the content of this article."

For a clinical trial report:

"The authors used Claude (Claude 3.5, Anthropic) to improve the English language of the Methods section. No AI tools were used for trial design, statistical analysis, histologic assessment, efficacy evaluation, safety reporting, or interpretation of clinical outcomes. All clinical conclusions were drawn by the study investigators based on the pre-specified statistical analysis plan reviewed by the Data Safety Monitoring Board. The authors take full responsibility for the published content."

For a transplant outcomes study:

"ChatGPT (GPT-4, OpenAI) was used to improve the readability of the Results and Discussion sections. No patient-level data from the transplant registry was processed through any external AI tool. Statistical analyses were performed using SAS 9.4 (SAS Institute) and R (v4.3.2) by the study biostatisticians. The authors take full responsibility for the published content."

Each disclosure follows the same pattern: name the tool, describe the scope, state what wasn't AI-assisted, and assert responsibility. For clinical papers, the explicit disclaimer about clinical interpretation is what reviewers and editors look for.

Two common mistakes to avoid. First, don't bury the disclosure in the Acknowledgements, because both Hepatology's instructions and Wolters Kluwer's general policy place it in the Materials and Methods (or similar section), and Hepatology also asks for a description in the cover letter. Second, don't write a vague statement like "AI tools were used to assist with manuscript preparation." Name the tool, give the version if you know it, and describe exactly which sections it touched.

Wolters Kluwer is a COPE member and follows its recommendations on publication ethics. Hepatology does not publish a penalty schedule for undisclosed AI use, so the points below describe how that framework can work in practice:

During peer review. Reviewers increasingly flag prose that reads like AI output. The telltale signs they look for: unnaturally smooth transitions, hedged language on every claim, and the absence of the confident assertions that experienced hepatologists typically make about their own data. If flagged, the editor asks for clarification. You're now defending your integrity instead of discussing your science.

After acceptance. The paper can be held in production while you provide a disclosure statement and explain why it wasn't included. This delays publication and creates an editorial record.

After publication. Wolters Kluwer's policy allows an erratum, an expression of concern, or a retraction to alert readers to a change in the publication record, and editors contact the authors' institution when the authors' response to serious concerns is unsatisfactory.

The practical differences are smaller than the table suggests. All five journals prohibit AI authorship and require Methods disclosure, and four of them ban AI-generated images while Hepatology permits them with disclosure. The main differentiator is submission infrastructure: Hepatology uses Wolters Kluwer's ScholarOne Manuscripts, Journal of Hepatology uses Elsevier's system, and the disclosure workflows differ accordingly.

Hepatology and Journal of Hepatology are the two primary competitors in liver disease research. Both draw from different societies (AASLD (North American) and EASL (European)) but the policy substance is nearly identical. If you're deciding between the two, the AI disclosure won't be the differentiator. The IF gap is the more notable difference: Journal of Hepatology at 33.0 versus Hepatology at 15.8.

Gastroenterology (AGA/Elsevier) also publishes hepatology research, particularly MASH/NAFLD studies, hepatitis trials, and liver cancer screening. Its Elsevier framework produces equivalent AI requirements. Liver International (APASL/Wiley) aligns on core rules, though its moderate guideline sensitivity reflects the different emphasis of the Asia-Pacific society.

Comply proactively if:

• You used any AI tool (ChatGPT, Grammarly, Copilot) during manuscript preparation

• The journal requires AI use disclosure in the Methods (or similar) section and the cover letter

• Your institution has its own AI use policy that may be stricter

Less concerned if:

• You used AI only for grammar/spell checking (some journals exempt this; Hepatology's instructions define no exemption)

• The journal does not have a formal AI policy yet

• Your use was limited to literature search or reference management