Benchmarking ChatGPT-4 on a radiation oncology in-training exam and Red Journal Gray Zone cases: potentials and challenges for ai-assisted medical education and decision making in radiation oncology.

Gray Zone artificial intelligence clinical decision support (CDS) large language model natural language processing radiotherapy

Journal

Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867

Informations de publication

Date de publication:
2023
Historique:
received: 21 07 2023
accepted: 23 08 2023
medline: 4 10 2023
pubmed: 4 10 2023
entrez: 4 10 2023
Statut: epublish

Résumé

The potential of large language models in medicine for education and decision-making purposes has been demonstrated as they have achieved decent scores on medical exams such as the United States Medical Licensing Exam (USMLE) and the MedQA exam. This work aims to evaluate the performance of ChatGPT-4 in the specialized field of radiation oncology. The 38th American College of Radiology (ACR) radiation oncology in-training (TXIT) exam and the 2022 Red Journal Gray Zone cases are used to benchmark the performance of ChatGPT-4. The TXIT exam contains 300 questions covering various topics of radiation oncology. The 2022 Gray Zone collection contains 15 complex clinical cases. For the TXIT exam, ChatGPT-3.5 and ChatGPT-4 have achieved the scores of 62.05% and 78.77%, respectively, highlighting the advantage of the latest ChatGPT-4 model. Based on the TXIT exam, ChatGPT-4's strong and weak areas in radiation oncology are identified to some extent. Specifically, ChatGPT-4 demonstrates better knowledge of statistics, CNS & eye, pediatrics, biology, and physics than knowledge of bone & soft tissue and gynecology, as per the ACR knowledge domain. Regarding clinical care paths, ChatGPT-4 performs better in diagnosis, prognosis, and toxicity than brachytherapy and dosimetry. It lacks proficiency in in-depth details of clinical trials. For the Gray Zone cases, ChatGPT-4 is able to suggest a personalized treatment approach to each case with high correctness and comprehensiveness. Importantly, it provides novel treatment aspects for many cases, which are not suggested by any human experts. Both evaluations demonstrate the potential of ChatGPT-4 in medical education for the general public and cancer patients, as well as the potential to aid clinical decision-making, while acknowledging its limitations in certain domains. Owing to the risk of hallucinations, it is essential to verify the content generated by models such as ChatGPT for accuracy.

Identifiants

pubmed: 37790756
doi: 10.3389/fonc.2023.1265024
pmc: PMC10543650
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1265024

Informations de copyright

Copyright © 2023 Huang, Gomaa, Semrau, Haderlein, Lettmaier, Weissmann, Grigo, Tkhayat, Frey, Gaipl, Distel, Maier, Fietkau, Bert and Putz.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Int J Radiat Oncol Biol Phys. 2022 Dec 1;114(5):827-828
pubmed: 36395797
Front Oncol. 2023 Jul 17;13:1219326
pubmed: 37529688
Int J Radiat Oncol Biol Phys. 2023 Aug 1;116(5):977-983
pubmed: 37037358
Lancet Oncol. 2018 May;19(5):616-628
pubmed: 29650363
Int J Radiat Oncol Biol Phys. 2017 Jan 1;97(1):1
pubmed: 27979440
Lancet Oncol. 2017 Mar;18(3):336-346
pubmed: 28190762
Nature. 2023 Aug;620(7972):172-180
pubmed: 37438534
Strahlenther Onkol. 2023 May;199(5):485-497
pubmed: 36688953
CA Cancer J Clin. 2017 Mar;67(2):93-99
pubmed: 28094848
Int J Radiat Oncol Biol Phys. 2022 Nov 15;114(4):571-572
pubmed: 36244388
Proc Natl Acad Sci U S A. 2023 Mar 21;120(12):e2214840120
pubmed: 36913582
Ir J Med Sci. 2023 Apr 19;:
pubmed: 37076707
Int J Radiat Oncol Biol Phys. 2022 Mar 1;112(3):581-582
pubmed: 35101189
Lancet Oncol. 2019 Sep;20(9):1273-1285
pubmed: 31345626
Nat Med. 2023 Jun 30;:
pubmed: 37391665
Int J Radiat Oncol Biol Phys. 2022 May 1;113(1):11
pubmed: 35427542
Ann Biomed Eng. 2023 Jun 16;:
pubmed: 37328703
Radiother Oncol. 2016 Jan;118(1):160-6
pubmed: 26780997
Med Phys. 2020 Feb;47(2):753-758
pubmed: 31808948
Med Phys. 2022 Sep;49(9):5773-5786
pubmed: 35833351
Med Phys. 2019 Jan;46(1):e1-e36
pubmed: 30367497
Front Oncol. 2023 Feb 16;13:1115258
pubmed: 36874135
Strahlenther Onkol. 2022 Sep;198(9):765-772
pubmed: 35486128
Strahlenther Onkol. 2022 Feb;198(2):183-193
pubmed: 34817635
Med Image Anal. 2017 Feb;36:61-78
pubmed: 27865153
JAMA Oncol. 2020 May 1;6(5):650-659
pubmed: 32215577
Neuro Oncol. 2016 Oct;18(10):1338-49
pubmed: 27664860
Ochsner J. 2017 Winter;17(4):405-411
pubmed: 29230126
Int J Radiat Oncol Biol Phys. 2022 Jan 1;112(1):35-36
pubmed: 34919878
Int J Radiat Oncol Biol Phys. 2022 Jul 1;113(3):489
pubmed: 35777388
Bioinformatics. 2020 Feb 15;36(4):1234-1240
pubmed: 31501885
Cureus. 2023 Jun 24;15(6):e40895
pubmed: 37492832
Crit Care. 2023 Mar 21;27(1):120
pubmed: 36945051
PLOS Digit Health. 2023 Feb 9;2(2):e0000198
pubmed: 36812645
J Am Med Inform Assoc. 2023 Jun 20;30(7):1237-1245
pubmed: 37087108
Int J Radiat Oncol Biol Phys. 2022 Jun 1;113(2):252-253
pubmed: 35569470

Auteurs

Yixing Huang (Y)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Ahmed Gomaa (A)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Sabine Semrau (S)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Marlen Haderlein (M)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Sebastian Lettmaier (S)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Thomas Weissmann (T)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Johanna Grigo (J)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Hassen Ben Tkhayat (HB)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Benjamin Frey (B)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Udo Gaipl (U)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Luitpold Distel (L)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Andreas Maier (A)

Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

Rainer Fietkau (R)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Christoph Bert (C)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Florian Putz (F)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany.

Classifications MeSH