Assessment of the Large Language Models in Creating Dental Board-Style Questions: A Prospective Cross-Sectional Study

Although some studies have investigated the application of large language models (LLMs) in generating dental-related multiple-choice questions (MCQs), they have primarily focused on ChatGPT and Gemini. This study aims to evaluate and compare the performance of five of the LLMs in generating dental board-style questions.

This prospective cross-sectional study evaluated five of the advanced LLMs as of August 2024, including ChatGPT-4o (OpenAI), Claude 3.5 Sonnet (Anthropic), Copilot Pro (Microsoft), Gemini 1.5 Pro (Google) and Mistral Large 2 (Mistral AI). The five most recent clinical guidelines published by The Journal of the American Dental Association were used to generate a total of 350 questions (70 questions per LLM). Each question was independently evaluated by two investigators based on five criteria: clarity, relevance, suitability, distractor and rationale, using a 10-point Likert scale.

Inter-rater reliability was substantial (kappa score: 0.7-0.8). Median scores for clarity, relevance and rationale were above 9 across all five LLMs. Suitability and distractor had median scores ranging from 8 to 9. Within each LLM, clarity and relevance scored higher than other criteria (p < 0.05). No significant difference was observed between models regarding clarity, relevance and suitability (p > 0.05). Claude 3.5 Sonnet outperformed other models in providing rationales for answers (p < 0.01).

LLMs demonstrate strong capabilities in generating high-quality, clinically relevant dental board-style questions. Among them, Claude 3.5 Sonnet exhibited the best performance in providing rationales for answers.