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ChatGPT Performs Worse on USMLE-Style Ethics Questions Compared to Medical Knowledge Questions.

Tessa Danehy1, Jessica Hecht1, Sabrina Kentis1

  • 1Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, United States.

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Large Language Models like ChatGPT struggle with medical ethics questions compared to medical knowledge questions. GPT-4 shows higher accuracy and less response variability than GPT-3.5 for USMLE-style questions.

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Area of Science:

  • Artificial Intelligence in Medical Education
  • Natural Language Processing in Healthcare
  • Large Language Models (LLMs)

Background:

  • The integration of AI tools like ChatGPT into medical education is rapidly increasing.
  • Evaluating the performance of LLMs on specialized medical examinations is crucial for understanding their utility and limitations.
  • Previous studies have explored LLM capabilities in medical knowledge recall, but less is known about their performance on ethics-based questions.

Purpose of the Study:

  • To assess the accuracy of ChatGPT (GPT-3.5 and GPT-4) in answering United States Medical Licensing Examination (USMLE) style medical ethics questions versus medical knowledge questions.
  • To compare the performance difference between GPT-3.5 and GPT-4 on these question types.
  • To evaluate the response variability of each ChatGPT version.

Main Methods:

  • Utilized AMBOSS, a USMLE preparation service, to select 27 medical ethics and 27 matched medical knowledge questions.
  • Conducted 30 trials for each question type on both GPT-3.5 and GPT-4.
  • Employed regression analysis for accuracy assessment and Shannon entropy for response variation analysis.

Main Results:

  • Both GPT-3.5 and GPT-4 performed worse on medical ethics questions than medical knowledge questions.
  • GPT-4 demonstrated significantly better accuracy (18% points worse on ethics vs. knowledge, p<0.05) and lower response variability (Shannon entropy 0.21) compared to GPT-3.5 (7% points worse on ethics vs. knowledge, p=0.41; Shannon entropy 0.59).
  • GPT-4 outperformed GPT-3.5 by 22% points on ethics and 33% points on knowledge questions (p<0.001 for both).

Conclusions:

  • ChatGPT versions exhibit diminished performance on medical ethics questions compared to medical knowledge questions.
  • GPT-4 significantly surpasses GPT-3.5 in both accuracy and response consistency for USMLE-style medical questions.
  • Continuous evaluation of evolving ChatGPT models is essential for their responsible application in medical education.