Peer-Reviewed Publication
Diagn Interv Radiol2026February 26, 2026Journal Article
Reporting checklist for foundation and large language models in medical research (REFINE): an international consensus guideline.
Ismail Mese1, Tugba Akinci D'Antonoli2,3, Christian Bluethgen4,5, Keno Bressem6,7, Renato Cuocolo8, Akshay Chaudhari5,9, Ali S Tejani10, Amanda Isaac11, Andrea Ponsiglione12, Aymen Meddeb13, Bardia Khosravi14,15, Bastien Le Guellec16, Charles E Kahn17, Chong Hyun Suh18, Daniel Pinto Dos Santos19, Dow-Mu Koh20,21, Eleftherios Tzanis22, Elmar Kotter23, Errol Colak24,25, Felipe Kitamura26, Felix Busch6, Felix Nensa27, Guang Yang28, Henning Müller29,30,31, Jakob Nikolas Kather32,33,34,35, Jawed Nawabi13, Jens Kleesiek27, Jingyu Zhong36,37, João Santinha38,39, Johannes Haubold40, José Guilherme de Almeida41, Karim Lekadir42,43, Kostas Marias44,45, Lara Noelle Reiner13, Lena Maier-Hein46,47,48,49,50, Linda Moy51, Lisa C Adams6, Luis Martí-Bonmatí52, Magdalini Paschali5, Mana Moassefi15, Matthias Dietzel53, Merel Huisman54, Michael Ingrisch55,56,57, Michail E Klontzas22,45, Nikolaos Papanikolaou58,59, Oliver Diaz42, Paulo Kuriki60, Philipp Seeböck61,62, Pouria Rouzrokh14,15, Quirin D Strotzer63, Seong Ho Park18, Shahriar Faghani64,65, Soroosh Tayebi Arasteh5,66,67, Su Hwan Kim6, Vasantha Kumar Venugopal68, Woojin Kim69,70,71, Burak Kocak72
1Uskudar State Hospital, Department of Radiology, Istanbul, Türkiye.
2Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, Basel, Switzerland.
3University Children's Hospital Basel, Department of Pediatric Radiology, Basel, Switzerland.
4Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
5Stanford University, Department of Radiology, Stanford, United States of America.
6Technical University of Munich, School of Medicine and Health, Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, TUM University Hospital, Munich, Germany.
7Technical University of Munich, School of Medicine and Health, Department of Cardiovascular Radiology and Nuclear Medicine, German Heart Center, TUM University Hospital, Munich, Germany.
8Department of Medicine, Surgery, and Dentistry, University of Salerno, Baronissi, Italy.
9Stanford University, Department of Biomedical Data Science, Stanford, United States of America.
10University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, California, United States of America.
11King's College London, School of Biomedical Engineering and Imaging Sciences, LIHE, The London Institute for Healthcare Engineering, London, United Kingdom.
12Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
13Charité-Universitätsmedizin Berlin, Department of Neuroradiology, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin Institute of Health, Berlin, Germany.
14Yale University, Yale School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, Connecticut, United States of America.
15Mayo Clinic, Department of Radiology, Rochester, United States of America.
16Lille University Hospital, Department of Neuroradiology, Lille, France.
17University of Pennsylvania, Philadelphia, PA, United States of America.
18University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Republic of Korea.
19University Medical Center Mainz, Department of Radiology, Mainz, Germany.
20Royal Marsden Hospital, Department of Radiology and AI Imaging Hub, Sutton, United Kingdom.
21Institute of Cancer Research, Division of Radiotherapy and Imaging, Sutton, United Kingdom.
22Artificial Intelligence and Translational Imaging (ATI) Lab, Department of Radiology, University of Crete School of Medicine, Heraklion, Greece.
23Medical Center - University of Freiburg Faculty of Medicine, Department of Diagnostic and Interventional Radiology, Freiburg, Germany.
24St. Michael's Hospital, Department of Medical Imaging, Unity Health Toronto, Toronto, Canada.
25University of Toronto Temerty Faculty of Medicine, Department of Medical Imaging, Toronto, Canada.
26Universidade Federal de São Paulo, Department of Diagnostic Imaging, São Paulo, Brazil.
27Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany.
28Shanghai Key Laboratory of Magnetic Resonance, Institute of Magnetic Resonance and Molecular Imaging in Medicine, East China Normal University, China.
29Informatics Institute, University of Applied Sciences Western Switzerland (HES-SO), Sierre, Switzerland.
30University of Geneva, Geneva, Switzerland.
31The Sense Research and Innovation Center, Sion & Lausanne, Switzerland.
32Else Kroener Fresenius Center for Digital Health, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany.
33Department of Medicine I, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany.
34Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.
35Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom.
36Department of Imaging, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
37Shanghai Key Laboratory of Flexible Medical Robotics, Tongren Hospital, Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China.
38Digital Surgery Lab - Breast Cancer Research Program, Champalimaud Foundation, Lisbon, Portugal.
39University of Lisbon Faculty of Medicine, Department of Radiology, Lisbon, Portugal.
40Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
41Champalimaud Foundation, Lisbon, Portugal.
42Universitat de Barcelona, Departament de Matemàtiques i Informàtica, Barcelona, Spain.
43Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
44Hellenic Mediterranean University, Department of Electrical and Computer Engineering, Heraklion, Crete, Greece.
45Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology (FORTH), Crete, Greece.
46German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany.
47National Center for Tumor Diseases (NCT), NCT Heidelberg, a partnership between DKFZ and University Hospital Heidelberg, Heidelberg, Germany.
48Heidelberg University Hospital, Surgical Clinic, Surgical AI Research Group, Heidelberg, Germany.
49Heidelberg University, Faculty of Mathematics and Computer Sciences, Heidelberg, Germany.
50Mohamed Bin Zayed University of Artificial Intelligence (MBZUAI), Abu Dhabi, United Arab Emirates.
51New York University Grossman School of Medicine, United States of America.
52Medical Imaging Department and Biomedical Imaging Research Group at Hospital Universitario y Politécnico La Fe and Health Research Institute, Valencia, Spain.
53Institute of Radiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
54Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands.
55LMU University Hospital, Department of Radiology, Munich, Germany.
56Munich Center for Machine Learning (MCML), Munich, Germany.
57relAI - Konrad Zuse School of Excellence in Reliable AI, Munich, Germany.
58Computational Clinical Imaging Group, Champalimaud Research, Lisbon, Portugal.
59AI Hub, Royal Marsden Hospital, Sutton, United Kingdom.
60UT Southwestern Medical Center, Department of Radiology, Dallas, TX, United States of America.
61Medical Anomaly Detection (MANO) Group, Computational Imaging Research (CIR), Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria.
62Comprehensive Center for AI in Medicine, Medical University of Vienna, Vienna, Austria.
63University Hospital Regensburg, Department of Diagnostic and Interventional Radiology, Regensburg, Germany.
64University of Pennsylvania, Department of Radiology, Philadelphia, United States of America.
65Radiology Informatics Lab, Mayo Clinic, Department of Radiology, Rochester, United States of America.
66Lab for AI in Medicine, Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.
67Stanford University School of Medicine, Department of Urology, Stanford, United States of America.
68Rajiv Gandhi Cancer Institute and Research Center, Department of Radiology, New Delhi, India.
69HOPPR, Illinois, United States of America.
70American College of Radiology Data Science Institute, Virginia, United States of America.
71Palo Alto VA Medical Center, California, United States of America.
72Basaksehir Cam and Sakura City Hospital, Department of Radiology, Istanbul, Türkiye.
Abstract
PURPOSE: To develop the REporting checklist for FoundatIon and large laNguagE models (REFINE), an international reporting guideline for transparent and reproducible reporting of foundation model (FM) and large language model (LLM) studies in medical research, including imaging artificial intelligence (AI) applications.
METHODS: The protocol was prespecified and publicly archived. A modified Delph…
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