+
Inline citations are now present for almost every framework claim, transforming the text from essay-like to evidence-anchored.
+
A dedicated abstract and a final conclusion now bracket the paper, fixing two ACM formatting gaps.
+
Section 3.5 (Interaction of Factors) provides the cross-dimensional synthesis multiple reviewers requested.
+
Section 3.6 introduces a practical, dimension-mapped checklist with high-risk indicators and a double-check protocol.
+
PRISMA-ScR is explicitly adopted and visualized in Appendix G with full identification, screening, and inclusion counts.
+
The new coding scheme (Appendix H) classifies all 48 sources by Factor, Theme, and Evidence Type, improving transparency.
+
Concrete bias examples (pediatric scans, underrepresented ethnicities, hallucinated diagnoses) now appear in the dentistry use case.
+
The framework diagram (Appendix I) gives a clean visual summary of the four pillars.
−
Only 1 source is labeled "Practice" in the coding scheme; the 3-source minimum is still not visibly met, even though the categorization mechanism now exists.
−
No specific legal frameworks (EU AI Act, GDPR, FDA regulatory pathway, WHO guidance) are cited in the regulation discussion despite three reviewers requesting this.
−
The framework's introduction, abstract, and examples remain heavily healthcare-bound; the title is generalized but the body is not.
−
Iteration/co-design transparency (Reviewer 2) is still not visible — there is no indication of how the framework evolved between submissions.
−
Repetition persists: the black-box concept is re-explained in 3.1, 3.5, and 4.2, and the "support not replace" point recurs across Sections 3.3, 5, and 6.
−
The clinical-error narrative requested by Reviewer 4 (a step-by-step misdiagnosis scenario) is still missing.
−
The reflection on AI-tool limitations in the methodology (hallucination/bias risk in summarization itself) is brief and could be deeper.