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Large language models (LLMs) show potential in clinical decision-making, with ChatGPT and Bard demonstrating comparable accuracy. Prompt engineering offered minor improvements for open-ended questions but not select-all-that-apply formats.

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Area of Science:

  • Artificial Intelligence in Medicine
  • Clinical Decision Support Systems
  • Radiology Informatics

Background:

  • Large language models (LLMs) like ChatGPT and Bard are increasingly used in medical tasks, including radiology report translation and research drafting.
  • Despite their potential, the accuracy of LLM responses in clinical settings is inconsistent, necessitating careful evaluation.

Purpose of the Study:

  • To assess the accuracy of ChatGPT and Bard in clinical decision-making using the American College of Radiology Appropriateness Criteria for cancer-related scenarios.
  • To evaluate the impact of prompt engineering (PE) techniques on LLM response accuracy for different question formats.

Main Methods:

  • ChatGPT and Bard were tested with open-ended (OE) and select-all-that-apply (SATA) prompts based on established clinical guidelines.
  • Prompt engineering techniques were applied to investigate their effect on the accuracy of LLM outputs.
  • Performance was compared between the two LLMs and across different prompt types.

Main Results:

  • ChatGPT and Bard performed similarly on OE prompts.
  • ChatGPT showed a slight accuracy advantage over Bard in SATA prompts.
  • Prompt engineering marginally improved OE prompt responses but did not significantly enhance SATA prompt accuracy.

Conclusions:

  • LLMs show promise as tools to assist clinical decision-making in radiology, particularly when prompts are carefully engineered.
  • Further research across diverse clinical contexts is essential to fully understand the role and limitations of LLMs in radiology practice.