Sentiment analysis of the medical literature on MACS 2016 to 2025

PubMed search: "Cushing AND ((mild AND autonomous) OR subclinical) AND (treatment OR therapy OR management OR surgery) AND human".Scope: 431 abstracts identified; 200 analyzed (published 2016-2025).Sentiment scoring: AI tools (ChatGPT and Grok) classified abstracts regarding surgical management.+1: Positive (favors surgery).0: Neutral (no clear stance or balanced).-1: Negative (does not favor surgery, e.g., highlights risks or prefers non-surgical options).Irrelevant abstracts: Excluded from scoring.Inter-rater reliability: Cohen's kappa = 0.26 (fair agreement between AI tools).Trend analysis: Abstracts ordered chronologically (reverse: 2025 to 2016). Total scored abstracts: 152/200 (48 irrelevant).Distribution:Positive (+1, favors surgery): 65 (43%).Neutral (0): 78 (51%).Negative (-1, does not favor surgery): 9 (6%). Negative sentiments (-1): Absent pre-2019; emerged thereafterTrend interpretation: No linear increase in negative sentiments, but appearance post-2019 suggests growing scrutiny of surgery or interest in non-surgical