Comparison of ChatGPT-3.5 and GPT-4 as potential tools in artificial intelligence-assisted clinical practice in renal and liver transplantation  

作　　者：Chrysanthos D Christou Olga Sitsiani Panagiotis Boutos Georgios Katsanos Georgios Papadakis Anastasios Tefas Vassilios Papalois Georgios Tsoulfas 

机构地区：[1]Center for Research and Innovation in Solid Organ Transplantation,School of Medicine,Aristotle University of Thessaloniki,Thessaloniki 54622,Greece [2]School of Medicine,Aristotle University of Thessaloniki,Thessaloniki 54622,Greece [3]Department of Nephrology and Transplantation,Guy’s Hospital,Guy’s and St Thomas’NHS Foundation Trust,London SE11UL,United Kingdom [4]Computational Intelligence and Deep Learning Group,Department of Informatics,Aristotle University of Thessaloniki,Thessaloniki 54636,Greece [5]Renal and Transplant Unit,Hammersmith Hospital,Imperial College Healthcare NHS Trust,London W120HS,United Kingdom

出　　处：《World Journal of Transplantation》2025年第3期194-211,共18页世界移植杂志(英文)

摘　　要：BACKGROUND Kidney and liver transplantation are two sub-specialized medical disciplines,with transplant professionals spending decades in training.While artificial intelligencebased(AI-based)tools could potentially assist in everyday clinical practice,comparative assessment of their effectiveness in clinical decision-making remains limited.AIM To compare the use of ChatGPT and GPT-4 as potential tools in AI-assisted clinical practice in these challenging disciplines.METHODS In total,400 different questions tested ChatGPT’s/GPT-4 knowledge and decision-making capacity in various renal and liver transplantation concepts.Specifically,294 multiple-choice questions were derived from open-access sources,63 questions were derived from published open-access case reports,and 43 from unpublished cases of patients treated at our department.The evaluation covered a plethora of topics,including clinical predictors,treatment options,and diagnostic criteria,among others.RESULTS ChatGPT correctly answered 50.3%of the 294 multiple-choice questions,while GPT-4 demonstrated a higher performance,answering 70.7%of questions(P<0.001).Regarding the 63 questions from published cases,ChatGPT achieved an agreement rate of 50.79%and partial agreement of 17.46%,while GPT-4 demonstrated an agreement rate of 80.95%and partial agreement of 9.52%(P=0.01).Regarding the 43 questions from unpublished cases,ChatGPT demonstrated an agreement rate of 53.49%and partial agreement of 23.26%,while GPT-4 demonstrated an agreement rate of 72.09%and partial agreement of 6.98%(P=0.004).When factoring by the nature of the task for all cases,notably,GPT-4 demonstrated outstanding performance,providing a differential diagnosis that included the final diagnosis in 90%of the cases(P=0.008),and successfully predicting the prognosis of the patient in 100%of related questions(P<0.001).CONCLUSION GPT-4 consistently provided more accurate and reliable clinical recommendations with higher percentages of full agreements both in renal and liver transplantation compared

关 键 词：Artificial intelligence ChatGPT GPT-4 TRANSPLANTATION KIDNEY LIVER Clinical decision support Generative artificial intelligence 

分 类 号：R617[医药卫生—外科学]