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Research Article: Evaluation of large language models for nursing support in maternal venous thromboembolism care

Date Published: 2026-04-24

Abstract:
Venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality, and nursing plays a central role in prevention, patient education, and follow-up. Large language models (LLMs) have attracted increasing attention in healthcare; however, their comparative performance in maternal VTE nursing contexts remains insufficiently explored. Five representative LLMs—DeepSeek, GPT-4.1, Claude 3.7, Huatuo, and Kimi—were evaluated across six clinical domains (etiology, diagnosis, treatment, prognostic assessment, home care, prevention) and five performance dimensions (accuracy, comprehensibility, logical coherence, reliability, safety). An expert-informed Delphi framework comprising 41 items guided the evaluation. Three nursing experts independently rated each model’s responses, and inter-rater reliability was assessed using Fleiss’s Kappa. GPT-4.1, Claude 3.7, and DeepSeek demonstrated superior overall performance, particularly in patient education, individualized care planning, and preventive guidance. Huatuo and Kimi showed limitations in treatment and prognostic reasoning. Inter-rater reliability was excellent (Kappa?=?0.892). The findings highlight relative strengths and limitations of different LLMs across nursing-relevant domains in maternal VTE care. While certain models performed better in educational and supportive contexts, the current study does not assess clinical adequacy or readiness for real-world nursing deployment. Future research incorporating patient perspectives and real-world validation is needed to inform the safe and appropriate integration of LLMs into nursing practice.

Introduction:
Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, is a major cause of maternal morbidity and mortality worldwide. Physiological changes during pregnancy, including hypercoagulability, venous stasis, and vascular injury, markedly increase the risk of VTE during both pregnancy and the postpartum period ( 1 , 2 ). Early recognition and effective management are essential to improve maternal outcomes. However, clinical decision-making remains challenging due to heterogeneous…

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