Objective: The rapid expansion of digital healthcare has heightened the volume of patient communication, thereby increasing the workload for healthcare professionals. Large Language Models (LLMs) hold promises for offering automated responses to patient questions relayed through eHealth platforms, yet concerns persist regarding their effectiveness, accuracy, and limitations in healthcare settings. This study aims to evaluate the current evidence on the performance and perceived suitability of LLMs in healthcare, focusing on their role in supporting clinical decision-making and patient communication. Materials and methods: A systematic search in PubMed and Embase up to June 11, 2025 identified 330 studies, of which 20 met the inclusion criteria for comparing the accuracy and adequacy of medical information provided by LLMs versus healthcare professionals and guidelines. The search strategy combined terms related to LLMs, healthcare professionals, and patient questions. The ROBINS-I tool assessed the risk of bias. Results: A total of nineteen studies focused on medical specialties and one on the primary care setting. Twelve studies favored the responses generated by LLMs, six reported mixed results, and two favored the healthcare professionals’ response. Bias components generally scored moderate to low, indicating a low risk of bias. Discussion and conclusions: The review summarizes current evidence on the accuracy and adequacy of medical information provided by LLMs in response to patient questions, compared to healthcare professionals and clinical guidelines. While LLMs show potential as supportive tools in healthcare, their integration should be approached cautiously due to inconsistent performance and possible risks. Further research is essential before widespread adoption.

Objective
This study aims to develop hip morphology-based radiographic hip osteoarthritis (RHOA) risk prediction models and investigates the added predictive value of hip morphology measurements and the generalizability to different populations.

Methods
We combined data from nine prospective cohort studies participating in the Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) consortium. RHOA grades were harmonized, and incident RHOA was defined as hips without definite RHOA at baseline that developed definite RHOA within four to eight years. Baseline hip morphology was quantified with automatically and uniformly determined lateral center edge angle and alpha angle measurements on anteroposterior radiographs. Discriminative performance of generalized linear mixed model (GLMM) definitions with and without hip morphology measurements was determined with stratified cross-validation. With leave-one-cohort-out cross-validation, the generalizability to unseen populations of hip morphology–based GLMMs and random forest (RF) models was evaluated.

Results
From the included 35,984 hips without definite RHOA at baseline, 4.7% developed incident RHOA within four to eight years. The GLMM with cohort-specific intercept, considering baseline demographics, RHOA grade, and hip morphology measurements, showed a mean area under the receiver operating characteristic curve (AUC) of 0.80 (±0.01) in stratified cross-validation. Using a marginal intercept decreased performance by 0.1 in AUC. Similar results were found for a GLMM without hip morphology measurements. Leave-one-cohort-out cross-validation showed comparable discrimination (AUC between 0.56–0.88) and calibration performance for hip morphology-based GLMMs and RF models.

Conclusion
In hips free of definite RHOA, our AUCs for the incident RHOA models showed good predictive performance in similar populations. However, the added predictive value of the morphology measurements was small, and model performance was heterogeneous in leave-one-cohort-out cross-validation.

Objective To assess the relationship between cam morphology and the development of radiographic hip osteoarthritis (RHOA), overall and in subgroups based on age, biological sex and body mass index (BMI). Methods Hips with no RHOA at baseline and with available follow-up during 4–8 years were selected from the Worldwide Collaboration on Osteoarthritis PrediCtion for the Hip (World COACH) consortium. Alpha angles were uniformly measured on anteroposterior radiographs, with a threshold of 60° used to define cam morphology. Incident RHOA was defined as the transition from an RHOA-free state at baseline to definite diagnosis of RHOA at follow-up. The association between baseline cam morphology and the development of RHOA was assessed using a three-level mixed-effects logistic regression model, accounting for hip side, individual and cohort-level variation. Results A total of 23 886 hips were included (mean age: 62.2±8.4 years; 70.6% female; BMI: 27.4±4.5; mean time to follow-up: 6.1±3.0 years). Cam morphology was associated with RHOA (OR: 1.87, 95%CI 1.36 to 2.59), as was a greater alpha angle (OR 1.02, 95%CI 1.01 to 1.03 for every degree increase). The overall relative risk of developing RHOA in hips with cam morphology was 1.62 (95%CI 1.26 to 2.07), greatest for those aged 51–60 years (2.15, 95%CI 1.55 to 2.98) and higher in males (2.50, 95%CI 1.67 to 3.73), compared with females (1.75,95%CI 1.24 to 2.48). Conclusion Hips with cam morphology have higher odds of developing RHOA within 4–8 years compared with hips without cam morphology. The relative risk was highest in subgroups of participants aged 51–60 years and in males, making cam morphology a potential target for primary or secondary prevention of RHOA.

Purpose Hip osteoarthritis (OA) is a major cause of pain and disability worldwide. Lack of effective therapies may reflect poor knowledge on its aetiology and risk factors, and result in the management of end-stage hip OA with costly joint replacement. The Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH) consortium was established to pool and harmonise individual participant data from prospective cohort studies. The consortium aims to better understand determinants and risk factors for the development and progression of hip OA, to optimise and automate methods for (imaging) analysis, and to develop a personalised prediction model for hip OA. Participants World COACH aimed to include participants of prospective cohort studies with ≥200 participants, that have hip imaging data available from at least 2 time points at least 4 years apart. All individual participant data, including clinical data, imaging (data), biochemical markers, questionnaires and genetic data, were collected and pooled into a single, individual-level database. Findings to date World COACH currently consists of 9 cohorts, with 38 021 participants aged 18–80 years at baseline. Overall, 71% of the participants were women and mean baseline age was 65.3±8.6 years. Over 34 000 participants had baseline pelvic radiographs available, and over 22 000 had an additional pelvic radiograph after 8–12 years of follow-up. Even longer radiographic follow-up (15–25 years) is available for over 6000 of these participants.

Objective: The objective is to determine the association and absolute risk of femoroacetabular impingement syndrome (FAIS) for the development of radiographic hip osteoarthritis (RHOA). Methods: This is a nationwide, multicentre prospective cohort study (Cohort Hip and Cohort Knee) with 1002 individuals aged between 45 and 65 years. Hips without definitive RHOA (Kellgren-Lawrence (KL) grade≤1) at baseline and with anteroposterior pelvic radiographs at baseline and 10-year follow-up available (n=1386 hips) were included. FAIS was defined by the baseline presence of a painful hip, limited internal hip rotation≤25° and cam morphology defined by an alpha angle>60°. The outcomes were incident RHOA (KL grade≥2 or total hip replacement (THR)) and incident end-stage RHOA (KL≥3 or THR) within 10 years. Results: Of the 1386 included hips (80% women; mean age 55.7±5.2 years), 21 hips fulfilled criteria for FAIS and 563 hips did not fulfil any of the FAIS criteria (reference group; no symptoms, no signs, no cam morphology). Within 10-year follow-up, 221 hips (38%) developed incident RHOA and 15 hips (3%) developed end-stage RHOA (including 9 hips with THR). Adjusted for sex, age and body mass index, FAIS with cam morphology resulted in an OR of 6.85 (95% CI 2.10 to 22.35) for incident RHOA and 47.82 (95% CI 12.51 to 182.76) for incident end-stage RHOA, compared with hips not having any FAIS criteria. The absolute risk of FAIS was 81% for incident RHOA and 33% for incident end-stage RHOA. Conclusion: FAIS was strongly associated with the development of RHOA within 10 years. Although the baseline prevalence of FAIS was low, the high absolute risk of FAIS for RHOA warrants further studies to determine preventive strategies.