Erela Datuowei

Erin Jacques, Erela Datuowei, Vincent Jones et al.

Health information seeking has fundamentally changed since the onset of Large Language Models (LLM), with nearly one third of ChatGPT's 800 million users asking health questions weekly. Understanding the sources of those AI generated responses is vital, as health organizations and providers are also investing in digital strategies to organically improve their ranking, reach and visibility in LLM systems like ChatGPT. As AI search optimization strategies are gaining maturity, this study introduces an Authority Signals Framework, organized in four domains that reflect key components to health information seeking, starting with "Who wrote it?" (Author Credentials), followed by "Who published it?" (Institutional Affiliation), "How was it vetted?" (Quality Assurance), and "How does AI find it?" (Digital Authority). This descriptive cross-sectional study randomly selected 100 questions from HealthSearchQA which contains 3,173 consumer health questions curated by Google Research from publicly available search engine suggestions. Those questions were entered into ChatGPT 5.2 Pro to record and code the cited sources through the lens of the Authority Signals Framework's four domains. Descriptive statistics were calculated for all cited sources (n=615), and cross tabulations were conducted to examine distinction among organization types. Over 75% of the sources cited in ChatGPT's health generated responses were from established institutional sources, such as Mayo Clinic, Cleveland Clinic, Wikipedia, National Health Service, PubMed with the remaining citations sourced from alternative health information sources that lacked established institutional backing.

Erin T. Jacques, Erela Datuowei, Elizabeth Quaye et al.

This study seeks to determine the authority signals used by Anthropic's Claude AI in its presentation of sources when answering consumer health questions. While there exists a great deal of discourse around the quality of health citations that LLMs produce, there is limited information on the integrity of the sources the citations originate from, and to what extent the sources are, from what health professionals would consider, credible sources. This descriptive cross-sectional study used data from HealthSearchQA, which contains 3,172 consumer health questions curated by Google Research. After exclusions, a final dataset of 3,075 questions yielding 10,038 citations was analyzed. The Authority Signals Framework (Jacques et al., 2026) was applied to examine 10 authority signals across four domains for a disproportionate stratified sample of 542 sources. Established institutional sources accounted for 97.8% of all citations (n = 9,818). Medical Institutions were the most frequently cited organization type (36.5%), followed by Government Resources (31.6%) and Professional Associations (28.4%). Commercial Health Information comprised 2.2% (n = 220). The top 10 organizations accounted for 57.8% of all citations, with Mayo Clinic alone representing 24.7%. Among commercial sources in the focused sample, 86.4% displayed medical review statements, 82.5% used schema markup, and 71.8% had comprehensive content, while traditional institutional sources appeared in Claude's citations with or without these same markers. As Anthropic positions Claude for HIPAA-ready healthcare applications, these findings establish a baseline for Claude's citation behavior and demonstrate the utility of the Authority Signals Framework as a tool for ongoing, cross-platform evaluation of AI-mediated health information.