ABSTRACT The integration of large language models, particularly ChatGPT, into healthcare has attracted increasing attention due to their potential to support medical education, clinical decision‐making, administrative workflows, patient communication and clinical documentation. However, their adoption in healthcare also raises important concerns related to accuracy, reliability, privacy, professional supervision and validation in real clinical settings. This paper presents a systematic literature review (SLR) on the applications of ChatGPT in the health sector. The review follows established SLR guidelines and analyzes 25 primary studies selected from ACM Digital Library, IEEE Xplore and PubMed. The selected studies were examined according to four research questions focused on application areas, reported benefits, limitations and challenges and validation methods. The results show that ChatGPT has been mainly explored in medical education, diagnostic support, administrative task automation, oral health and medical research. Reported benefits include faster access to information, support for documentation, personalization, cost reduction and assistance in decision‐making. Nevertheless, the review also identifies relevant limitations, including hallucinations, inconsistent accuracy, context loss, ethical and legal risks, privacy concerns and dependence on prompt engineering. The analysis of validation methods shows that most studies rely on quantitative metrics, expert‐based assessment, qualitative evaluation or hybrid approaches, although real‐world clinical validation remains limited. This review provides a structured overview of current evidence and identifies research gaps that should be addressed to support the safe, reliable and effective use of ChatGPT and related LLM‐based tools in healthcare.

Clinical practice guidelines (CPGs) are a formalization of specific clinical knowledge that states the best evidence-based clinical practices for treating pathologies. However, CPGs are limited because they are usually expressed as text. This gives rise to a certain level of ambiguity, subjective interpretation of the actions to be performed, and variability in clinical practice by different health professionals facing the same circumstances. The inherent complexity of CPGs is also a challenge for software engineers designing, developing, and maintaining software systems and clinical decision support system to manage and digitize them. This challenge stems from the need to evolve CPGs and design software systems capable of allowing their evolution. This paper proposes a model-driven, human-centric and tool-supported framework (called IDE 4 ICDS) for improving digitisation of CPG in practical environments. This framework is designed from a human-centric perspective to be used by mixed teams of clinicians and software engineers. It was also validated with the type 2 diabetes mellitus CPG in the Andalusian Public Health System (Spain) involving 89 patients and obtaining a kappa-based analysis. The recommendations were acceptable (0.61–0.80) with a total kappa index of 0.701, leading to the conclusion that the proposal provided appropriate recommendations for each patient.

Over the last decade, clinical practice guidelines (CPGs) have become an important asset for daily life in healthcare organizations. Efficient CPG management and digitization can improve the quality of patient care and healthcare by reducing variability. CPG digitization, however, is a difficult, complex task because such guidelines are usually expressed as text, and this often results in the development of partial software solutions. There are currently many CPG suites (CPGS) for managing the CPG lifecycle, but they do not all provide full support for this lifecycle, making it more difficult to choose the one which will best meet the specific needs and requirements of a healthcare organization. This paper proposes a quality model which makes it possible to compare CPGs by highlighting each phase of the lifecycle. The research was conducted using a methodology that combined a systematic literature review with quality models. The paper also discusses how the proposed model was instantiated to evaluate and compare several current CPG-based execution systems.

Healthcare institutions is an ever-innovative field, in which modernization is moving forward taking giant steps. This modernization, so called “digitization”, brings up some concerns that should be carefully consid ered. Currently, the most sensible concerning in this field is the management of Electronic Health Record and patients’ data privacy. Health-related data in healthcare systems are under strict regulations, such as the EU’s General Data Protection Regulation (GDPR), whose non-compliance imposes huge penalties and fines. Cy bersecurity in healthcare plays an important role at protecting these sensitive data, which are highly valuable for criminals. Security experts follow already existing security frameworks to orchestrate the security assess ment process, so that the auditing process is as complete and as organized as possible. This study extends the lifecycle of a security assessment framework and conducts an exploitation and vulnerabilities’ analysis on an actual industrial scenario. The results of this security audit shows that even if the system is heavily fortified, there can be still some vulnerabilities.

Context: Measuring the Software Development Process (SDP) supports organizations in their endeavor to understand, manage, and improve their development processes and projects. In the last decades, the SDP has evolved to meet the market needs and keep abreast of modern technologies and infrastructures. These changes in the development processes have increased the importance of the measurement and caused changes in the measurement process and the used measures. Objective: This work aims to develop a solution to support the measurement activities throughout the process lifecycle. Method: Study the current state of the art to identify existing gaps. Then, propose a solution to support the process measurement throughout the SDP lifecycle. Results: The proposed solution consists of two main components: (i) Measurement lifecycle, which defines the measurement activities throughout the SDP lifecycle, (ii) Measurement definition metamodel (MDMM), which supports the measurement lifecycle and its integration into the process lifecycle. Conclusion: This proposal allows organizations to define, manage, and improve their processes; the proposed information model supports the unification of the measurement concepts and vocabulary. The defined measurement lifecycle provides a comprehensive guide for the organizations to establish the measurement objectives and carry out the necessary activities to achieve them. The proposed MDMM supports and guides the engineers in the complete and operational definition of the measurement concepts.

The advance in the digital world has caused a growth of complexity in innovation. Traditional approaches to innovation, based on reductionism, face greater difficulties. That is why we have witnessed the growth of those known as System of Systems (SoS). There is a wide variety of methodologies and domains of application in the literature to form framed solutions in the context of SoS, but there is no unified consensus for its use and even less when it comes to agile environments of continuous integration and deployment in which traceability requirements are critical. In recent years, the need to have traceability software that continuously records and monitors the trace of the entities that interact with it has become an essential feature. In addition, over the years there has been evidence of errors caused by poor traceability control. Therefore, this document presents an agile framework that aims to guarantee the traceability of a SoS from the early stages. This framework unifies the discovery, development and operations, providing full coverage in the conformation of the solution. Finally, we present a case study as future work, which is based on the application of our framework on smart laboratories for assisted reproduction.

Over last decade, Assisted Reproductive Treatment (ART) has become a very used health service by more and more people around the world because of problems such as the delay in the maternity age, singleparent couples, etc.In this context, health agencies have performed innovations to improve healthcare processes of ARTs, to optimize the performance of health professionals who work in fertilization laboratories and to improve Biological Sample Management (BSM) and sample traceability in ART.However, there are important handicaps in ART processes from the point of view of quality, safety and management.On the one hand, these processes are mainly based on manual execution tasks and manual control tasks.This excess of manual tasks could lead to

Abstract Today's world economic situation is ruled by issues such as reducing cost, improving quality, maximizing profit, and improving and optimizing processes at organizations. In this context, business process management can be an essential strategy, but it is not usually consolidated at software organizations because software process properties involve a complex business process management application on software lifecycle. Consequently, software organizations often focus on Software Process Modeling (SPM), and each involved role performs process execution and orchestration independently and manually. This fact makes software processes maintenance, monitoring, and measurement become difficult tasks. This paper proposes a model‐based approach for SPM taking into account concepts related to process execution, orchestration, and monitoring. It is framed into a model‐driven engineering‐based and tool‐based framework: Process Lifecycle Management for Business Software (PLM4BS). We present a SPM metamodel and its concrete syntax (through Unified Modeling Language profiles) that lays the foundation for extending PLM4BS. Its underlying metamodel allows managing processes automatically. Furthermore, PLM4BS improves current state‐of‐the‐art proposals in 6 dimensions: expressiveness, understandability, granularity, measurability, orchestrability, and business variables and rules. Also, PLM4BS has been evaluated in a multiple‐case study, in which the 6 mentioned dimensions were already validated.

Today's world economic situation is ruled by issues such as reducing cost, improving quality, maximizing profit and improving and optimizing production processes at any kind of organization. In this context, BPM (Business Processes Management) can be an essential strategy. However, there are business situations where is necessary to define innovation solutions to apply BPM in a proper way (e.g., needs of interoperability between process modeling languages, mechanisms to generate the executable model of the process maintaining the traceability with the definition model of the process, mechanisms to manage the measurement of processes from early stages, etc.). This paper describes and analysis some of these situations and proposes a framework based on MDE (Model-Driven Engineering) to support these needs. This MDE-based framework is also supported by the EMPOWER platform which has been developed in an innovation project carried out by Servinform Company and our research group (IWT2, University of Seville, Spain). This platform allows applying advanced MDE techniques to improve the application of BPM in business environments.

Within the development of software systems, the development of web applications may be one of the most widespread at present due to the great number of advantages they provide such as: multiplatform, speed of access or the not requiring extremely powerful hardware among others. The fact that so many web applications are being developed, makes grotesque the volume of information that it is generated daily. In the management of all this information, it appears the entity reconciliation problem, which is to identify objects referring to the same real-world entity. This paper proposes to give a solution to this problem through a web perspective. To this end, the NDT methodology has been taken as a reference and has been extended adding new activities, artefacts and documents to cover this problem.

Model-Driven Web Engineering approaches have become an attractive research and technology solution for Web application development. However, for more than 20 years of development, the industry has not adopted them due to the mismatch between technical versus research requirements. In the context of this joint work between academia and industry, the authors conduct a survey among hundreds of engineers from different companies around the world and, by statistical analysis, they present the current problems of these approaches in scale. Then, a set of guidelines is provided to improve Model-Driven Web Engineering approaches in order to make them viable industry solutions.

REP (Requirements Engineering Process) is one of the most essential processes within the software project life cycle because it allows describing software product requirements. This specification should be as consistent as possible to enable estimating in a suitable manner the effort required to obtain the final product. REP is complex in itself, but this complexity is greatly increased in big, distributed and heterogeneous projects with multiple analyst teams and high integration among functional modules. This paper presents an approach for the systematic conciliation of functional requirements in big projects dealing with a modelbased approach. It also explains how this approach may be implemented in the context of NDT (Navigational Development Techniques) methodology and finally, it describes a preliminary evaluation of our proposal in CALIPSOneo project by analyzing the improvements obtained with our approach.

Model Driven development approaches are being adopted by the software industry due to a core set of benefits such as raising the level of abstraction and reducing coding errors. However, their underlying modelling languages tend to be quite rigid, making their evolution hard, specifically when the corresponding metamodel do not support primitives and/or functionalities required in specific business domains. In this work, we present an approach for fast evolution of the modelling language that is “self reflective”, allowing modellers to abstract new language concepts from the primitives. The main advantage of our approach is that it provides zero application downtime and automatic tool evolution. As a consequence, applications created with our approach are able to adapt quicker to the business needs than those based on traditional Web modelling languages. We compare our approach with existing modelling languages in a case study providing a proof of its ability to adapt faster than to new business needs.

The effective application of test phases has been one of the most relevant, critical and cost phases in the life cycle of software projects in the last years. During the test phase, the test team has to assure the quality of the system and the concordance with the initial requirements of the system. The model driven paradigm is offering suitable results in some areas and the test phase could be one of them. This paper presents how the application of this paradigm can help to improve this aspect in the functional test generation and it analyses the experience in a real project developed under this approach.

Requirements conciliation can result one of the most expensive and critical tasks in Web development. It particularly depends on analysts' experiences since very frequently they have to use manual solution to cope with requirements conciliation. After some previous work presenting an approach oriented towards Web requirements conciliation, this paper proposes a tool for executing this task. It is based on the Model-driven paradigm and it is included in the context of NDT (Navigational Development Techniques) methodology.