Evaluation of ChatGPT as a diagnostic tool for medical learners and clinicians

ChatGPT is a large language model (LLM) trained on over 400 billion words from books, articles, and websites. Its extensive training draws from a large database of information, making it valuable as a diagnostic aid. Moreover, its capacity to comprehend and generate human language allows medical trainees to interact with it, enhancing its appeal as an educational resource. This study aims to investigate ChatGPT's diagnostic accuracy and utility in medical education.

150 Medscape case challenges (September 2021 to January 2023) were inputted into ChatGPT. The primary outcome was the number (%) of cases for which the answer given was correct. Secondary outcomes included diagnostic accuracy, cognitive load, and quality of medical information. A qualitative content analysis was also conducted to assess its responses.

ChatGPT answered 49% (74/150) cases correctly. It had an overall accuracy of 74%, a precision of 48.67%, sensitivity of 48.67%, specificity of 82.89%, and an AUC of 0.66. Most answers were considered low cognitive load 51% (77/150) and most answers were complete and relevant 52% (78/150).

ChatGPT in its current form is not accurate as a diagnostic tool. ChatGPT does not necessarily give factual correctness, despite the vast amount of information it was trained on. Based on our qualitative analysis, ChatGPT struggles with the interpretation of laboratory values, imaging results, and may overlook key information relevant to the diagnosis. However, it still offers utility as an educational tool. ChatGPT was generally correct in ruling out a specific differential diagnosis and providing reasonable next diagnostic steps. Additionally, answers were easy to understand, showcasing a potential benefit in simplifying complex concepts for medical learners. Our results should guide future research into harnessing ChatGPT's potential educational benefits, such as simplifying medical concepts and offering guidance on differential diagnoses and next steps.