{"id":"https://openalex.org/W7225600139","doi":"https://doi.org/10.64898/2026.11.06.26367316","title":"Accounting for Insulin-on-board in Large Language Model Advice about Pediatric Hyperglycemia","display_name":"Accounting for Insulin-on-board in Large Language Model Advice about Pediatric Hyperglycemia","publication_year":2026,"publication_date":"2026-11-08","ids":{"openalex":"https://openalex.org/W7225600139","doi":"https://doi.org/10.64898/2026.11.06.26367316"},"language":"en","primary_location":{"id":"doi:10.64898/2026.11.06.26367316","doi":"https://doi.org/10.64898/2026.11.06.26367316","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.06.26367316","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/08/2026.11.06.26367316.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/08/2026.11.06.26367316.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5064033579","display_name":"Elizabeth Healey","orcid":"https://orcid.org/0000-0002-7307-8429","observed_orcids":["https://orcid.org/0000-0002-7307-8429"]},"institutions":[{"id":"https://openalex.org/I1288882113","display_name":"Boston Children's Hospital","ror":"https://ror.org/00dvg7y05","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1288882113"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Elizabeth Healey","raw_affiliation_strings":["Boston Children's Hospital"],"raw_orcid":"https://orcid.org/0000-0002-7307-8429","affiliations":[{"raw_affiliation_string":"Boston Children's Hospital","institution_ids":["https://openalex.org/I1288882113"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5125350411","display_name":"Sadie Lee","orcid":"https://orcid.org/0009-0002-2431-7427","observed_orcids":["https://orcid.org/0009-0002-2431-7427"]},"institutions":[{"id":"https://openalex.org/I1288882113","display_name":"Boston Children's Hospital","ror":"https://ror.org/00dvg7y05","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1288882113"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sadie Lee","raw_affiliation_strings":["Boston Children's Hospital"],"raw_orcid":"https://orcid.org/0009-0002-2431-7427","affiliations":[{"raw_affiliation_string":"Boston Children's Hospital","institution_ids":["https://openalex.org/I1288882113"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027173936","display_name":"Christina M. Astley","orcid":"https://orcid.org/0000-0002-5063-8470","observed_orcids":["https://orcid.org/0000-0002-5063-8470"]},"institutions":[{"id":"https://openalex.org/I1288882113","display_name":"Boston Children's Hospital","ror":"https://ror.org/00dvg7y05","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1288882113"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Christina M Astley","raw_affiliation_strings":["Boston Children's Hospital"],"raw_orcid":"https://orcid.org/0000-0002-5063-8470","affiliations":[{"raw_affiliation_string":"Boston Children's Hospital","institution_ids":["https://openalex.org/I1288882113"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5018662278","display_name":"Kenneth D. Mandl","orcid":"https://orcid.org/0000-0002-9781-0477","observed_orcids":["https://orcid.org/0000-0002-9781-0477"]},"institutions":[{"id":"https://openalex.org/I1288882113","display_name":"Boston Children's Hospital","ror":"https://ror.org/00dvg7y05","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1288882113"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Kenneth D Mandl","raw_affiliation_strings":["Boston Children's Hospital"],"raw_orcid":"https://orcid.org/0000-0002-9781-0477","affiliations":[{"raw_affiliation_string":"Boston Children's Hospital","institution_ids":["https://openalex.org/I1288882113"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5018662278"],"corresponding_institution_ids":["https://openalex.org/I1288882113"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9824000000953674,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9824000000953674,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.002899999963119626,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11396","display_name":"Artificial Intelligence in Healthcare","score":0.0027000000700354576,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/large-language-models","display_name":"large language models","score":0.9750000238418579},{"id":"https://openalex.org/keywords/pediatric-type-1-diabetes","display_name":"type 1 diabetes in children","score":0.9309999942779541},{"id":"https://openalex.org/keywords/hyperglycemia","display_name":"hyperglycemia","score":0.949999988079071},{"id":"https://openalex.org/keywords/insulin-on-board","display_name":"insulin on board","score":0.9769999980926514},{"id":"https://openalex.org/keywords/insulin-dose","display_name":"insulin dose","score":0.6800000071525574},{"id":"https://openalex.org/keywords/safety-failures","display_name":"safety failures","score":0.5350000262260437},{"id":"https://openalex.org/keywords/guardrails","display_name":"guardrails","score":0.5569999814033508},{"id":"https://openalex.org/keywords/chatbots","display_name":"chatbots","score":0.3449999988079071},{"id":"https://openalex.org/keywords/diabetes-self-management","display_name":"diabetes self-management","score":0.5059999823570251}],"concepts":[{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.7240999937057495},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5163000226020813},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.515500009059906},{"id":"https://openalex.org/C2777180221","wikidata":"https://www.wikidata.org/wiki/Q3025883","display_name":"Type 2 diabetes","level":3,"score":0.398499995470047},{"id":"https://openalex.org/C555293320","wikidata":"https://www.wikidata.org/wiki/Q12206","display_name":"Diabetes mellitus","level":2,"score":0.37630000710487366},{"id":"https://openalex.org/C2987496018","wikidata":"https://www.wikidata.org/wiki/Q1860","display_name":"English language","level":2,"score":0.35569998621940613},{"id":"https://openalex.org/C206179267","wikidata":"https://www.wikidata.org/wiki/Q188952","display_name":"Medical history","level":2,"score":0.34209999442100525},{"id":"https://openalex.org/C2994071780","wikidata":"https://www.wikidata.org/wiki/Q2019180","display_name":"Warning signs","level":2,"score":0.3305000066757202},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.3271999955177307},{"id":"https://openalex.org/C187155963","wikidata":"https://www.wikidata.org/wiki/Q629029","display_name":"Occupational safety and health","level":2,"score":0.321399986743927},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.3138999938964844},{"id":"https://openalex.org/C2776510742","wikidata":"https://www.wikidata.org/wiki/Q6806456","display_name":"Medical advice","level":2,"score":0.3124000132083893},{"id":"https://openalex.org/C2781232474","wikidata":"https://www.wikidata.org/wiki/Q124407","display_name":"Type 1 diabetes","level":3,"score":0.30709999799728394},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.29829999804496765},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.28459998965263367},{"id":"https://openalex.org/C166735990","wikidata":"https://www.wikidata.org/wiki/Q1750812","display_name":"Human factors and ergonomics","level":3,"score":0.27709999680519104},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.2720000147819519},{"id":"https://openalex.org/C2779306644","wikidata":"https://www.wikidata.org/wiki/Q2002370","display_name":"Insulin","level":2,"score":0.2644999921321869},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2635999917984009},{"id":"https://openalex.org/C190385971","wikidata":"https://www.wikidata.org/wiki/Q373494","display_name":"Injury prevention","level":3,"score":0.25769999623298645},{"id":"https://openalex.org/C2779955035","wikidata":"https://www.wikidata.org/wiki/Q4686785","display_name":"Advice (programming)","level":2,"score":0.25450000166893005},{"id":"https://openalex.org/C2780009758","wikidata":"https://www.wikidata.org/wiki/Q6804172","display_name":"Measure (data warehouse)","level":2,"score":0.2524999976158142},{"id":"https://openalex.org/C526869908","wikidata":"https://www.wikidata.org/wiki/Q3298118","display_name":"Suicide prevention","level":3,"score":0.2522999942302704},{"id":"https://openalex.org/C29825287","wikidata":"https://www.wikidata.org/wiki/Q1427940","display_name":"Warning system","level":2,"score":0.25029999017715454}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.11.06.26367316","doi":"https://doi.org/10.64898/2026.11.06.26367316","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.06.26367316","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/08/2026.11.06.26367316.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.11.06.26367316","doi":"https://doi.org/10.64898/2026.11.06.26367316","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.06.26367316","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/08/2026.11.06.26367316.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"score":0.979200005531311,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G3644498288","display_name":null,"funder_award_id":"1-26-ACE-0997","funder_id":"https://openalex.org/F4320306089","funder_display_name":"American Diabetes Association"}],"funders":[{"id":"https://openalex.org/F2294704616","display_name":"Advanced Research Projects Agency for Health","ror":"https://ror.org/01r532x50"},{"id":"https://openalex.org/F4320306089","display_name":"American Diabetes Association","ror":"https://ror.org/04f6cgz95"},{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320332815","display_name":"Advanced Research Projects Agency","ror":"https://ror.org/02caytj08"},{"id":"https://openalex.org/F4320337611","display_name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","ror":"https://ror.org/04byxyr05"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225600139.pdf","grobid_xml":"https://content.openalex.org/works/W7225600139.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7141363489","https://openalex.org/W7154734399","https://openalex.org/W7204726870","https://openalex.org/W4417315754","https://openalex.org/W7167153934","https://openalex.org/W7224858109","https://openalex.org/W7222567278","https://openalex.org/W6948197928","https://openalex.org/W7170410238","https://openalex.org/W4413799511"],"abstract_inverted_index":{"Large":[0],"language":[1],"models":[2],"(LLMs)":[3],"can":[4],"be":[5],"used":[6],"by":[7],"patients":[8,127],"and":[9,15,89,113,116],"caregivers":[10],"to":[11,40,60,70,133],"answer":[12],"medical":[13],"questions":[14,42],"the":[16,52,64,78,99,110],"characterization":[17],"of":[18,31,54,66,77,98],"safety":[19,57,80,101],"concerns":[20],"in":[21,45,63],"LLM":[22,38],"outputs":[23],"for":[24,72,124,126],"patient-facing":[25],"applications":[26],"is":[27],"an":[28],"active":[29],"area":[30],"research.":[32],"In":[33],"this":[34],"work,":[35],"we":[36],"study":[37],"responses":[39],"caregiver":[41],"about":[43,109],"hyperglycemia":[44],"pediatric":[46],"type":[47],"1":[48],"diabetes.":[49],"We":[50,74],"measure":[51],"frequency":[53],"a":[55,67,122],"potential":[56,79,100],"failure:":[58],"advice":[59],"dose":[61],"insulin":[62,114],"absence":[65],"clear":[68],"warning":[69],"account":[71],"insulin-on-board.":[73],"found":[75],"occurrences":[76],"failure":[81,102],"across":[82],"four":[83],"LLMs":[84,91,132],"tested":[85,92],"through":[86,93],"programmatic":[87],"endpoints":[88],"two":[90],"chat":[94],"interfaces.":[95],"The":[96],"rates":[97],"varied":[103],"when":[104],"different":[105],"context":[106],"was":[107],"given":[108],"patient's":[111],"meal":[112],"history":[115],"treatment":[117],"regimen.":[118],"These":[119],"results":[120],"highlight":[121],"need":[123],"guardrails":[125],"with":[128],"diabetes":[129],"who":[130],"use":[131],"manage":[134],"their":[135],"care.":[136]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-09T00:00:00"}
