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The authors agree on the ethical risks of drafting, editing, or approving sensitive information without human supervision, while arguing that using publicly available exam items enables evaluation. They suggest ChatGPT could become a teaching tool for setting difficulty or generating question databases, and may extend to clinical documentation, decision support, and research. The letter also emphasizes privacy concerns and proposes in-house, specialty chatbots trained on facility data to reduce limitations and risks.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/reply-to-comment-on-chatgpt-failed-taiwans-family-medicine-board-exam/436861/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/reply-to-comment-on-chatgpt-failed-taiwans-family-medicine-board-exam/436861.png","ImageObject",300,407,{"name":92,"@type":93},"Putri","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-02","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How do the authors address the ethical concern raised about ChatGPT?","Question",{"text":112,"@type":113},"They fully agree that sensitive information should not be drafted, edited, or approved by ChatGPT without human supervision. They emphasize ethical oversight while discussing how their evaluation was conducted.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What approach did the authors use to evaluate ChatGPT’s performance?",{"text":117,"@type":113},"They used only publicly available exam items to evaluate ChatGPT’s performance in answering questions for the study under discussion.",{"name":119,"@type":110,"acceptedAnswer":120},"How do the authors propose reducing privacy risks when using ChatGPT in healthcare?",{"text":121,"@type":113},"They recommend caution about exposing private data and suggest healthcare facilities could deploy in-house servers and build domain- or specialty-specific chatbots trained on internal data.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},436861,1790915669,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},962085571259,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","J Chin MedAssoc  \nLetter to the editor  \nReply to “Comment on ChatGPT failed Taiwan’s Family Medicine Board Exam”  \nTzu-Ling Wenga,b, Tzeng-Ji Chenc,d,e,*  \naCenter for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bInstitute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cDepartment of Family Medicine, Taipei Veterans General Hospital Hsinchu Branch, Hsinchu, Taiwan, ROC; dDepartment of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; eDepartment of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung, Taiwan, ROC  \nDEAR EDITOR,  \nWe thank Mungmunpuntipantip andWiwanitkit1 for their valuable comments on our study named “ChatGPT failed Taiwan’s Family Medicine Board Exam” published in the Journal of the Chinese Medical Association.2 The author comments are discussed below.  \nWe fully agree with the importance of the ethical issue of Chat Generative Pre-trained Transformer’s (ChatGPT’s) drafting, editing, or approving sensitive information without human supervision. In our study, we use only the publicly available exam items to evaluate ChatGPT’s performance in answering questions. Although the result was far from satisfactory at the current stage, we believe that ChatGPT and other related products can be further developed to successfully serve as good teaching tools, either to verify the difficulty level of tests ex ante or to generate a database of questions for selection.3 Of course, the utility of ChatGPT can be extended to other areas of clinical practice, from medical documentation to decision support,4 in addition to academic research.5  \nMungmunpuntipantip and Wiwanitkit1 also cautioned against exposing private data to ChatGPT. Many people and companies share the same concerns, and information technology enterprises see business opportunities. For example, Microsoft Corporation (Redmond, WA, USA) announced in March 2023 that it will release a privacy-focused version of ChatGPT running on dedicated cloud servers.6 In the  \nforeseeable future, healthcare facilities may seek to deploy the in-house servers incorporating the large language models, that is, to construct domain-or specialty-specific chatbots trained on in-house data to answer questions relevant to the daily healthcare services. This is just the beginning. Artificial intelligence with natural language processing will accelerate the transformation of workflows. Every effort should be made to fully understand the applications, benefits, limitations, and risks of the new technology.  \nREFERENCES  \n1. Mungmunpuntipantip R, Wiwanitkit V. Comment on “ChatGPT failed Taiwan’s Family Medicine Board Exam”. J Chin Med Assoc 2023;86:775 .  \n2. Weng TL, Wang YM, Chang S, Chen TJ, Hwang SJ. ChatGPT failed Taiwan’s Family Medicine Board Exam. J Chin Med Assoc 2023;86:762–6 .  \n3. Agarwal M, Sharma P, Goswami A. Analysing the applicability of ChatGPT, Bard, and Bing to generate reasoning-based multiple-choice questions in medical physiology. Cureus 2023;15:e40977 .  \n4. Liu J, Wang C, Liu S. Utility of ChatGPT in clinical practice. J Med Internet Res 2023;25:e48568 .  \n5. Chen TJ. ChatGPT and other artificial intelligence applications speed up scientific writing. J Chin Med Assoc 2023;86:351–3 .  \n6. Boyd E. ChatGPT is now available in Azure OpenAI Service [posted on March 9, 2023]. Available at [https://azure.microsoft.com/en-us/](https://azure.microsoft.com/en-us/)[ ](https://azure.microsoft.com/en-us/)[blog/chatgpt-is-now-available-in-azure-openai-service/. Accessed July 5](blog/chatgpt-is-now-available-in-azure-openai-service/. Accessed July 5), 2023.  \n*Address correspondence. Dr Tzeng-Ji Chen, Department of Family Medicine, Taipei Veterans General Hospital Hsinchu Branch, 81, Section 1, Zhongfeng Road, Zhudong, Hsinchu 310, Taiwan, ROC. E-mail address: [tjchen@vhct.gov.tw](tjchen@vhct.gov.tw)[ ](tjchen@vhct.gov.tw)(T.-J. Chen).  \nConflicts o","cbCaiex3nFlIDnNn","https://ap.wps.com/l/cbCaiex3nFlIDnNn","pdf",283999,"English","# Letter to the editor\n## Response to the comment\n## Ethical considerations and teaching utility\n## Privacy concerns and in-house deployment","[{\"question\":\"How do the authors address the ethical concern raised about ChatGPT?\",\"answer\":\"They fully agree that sensitive information should not be drafted, edited, or approved by ChatGPT without human supervision. They emphasize ethical oversight while discussing how their evaluation was conducted.\"},{\"question\":\"What approach did the authors use to evaluate ChatGPT’s performance?\",\"answer\":\"They used only publicly available exam items to evaluate ChatGPT’s performance in answering questions for the study under discussion.\"},{\"question\":\"How do the authors propose reducing privacy risks when using ChatGPT in healthcare?\",\"answer\":\"They recommend caution about exposing private data and suggest healthcare facilities could deploy in-house servers and build domain- or specialty-specific chatbots trained on internal data.\"}]","Reply to “Comment on ChatGPT failed Taiwan’s Family Medicine Board Exam” | PDF",1790679254]