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Artificial Intelligence Driven Diagnosis and Prognosis Comparison of ChatGPT-4o and DeepSeek-R1 in HIV Negative
Haiyang He1, Liuyang Cai1, Yi Liu1
1Shanghai Key Laboratory of Medical Mycology, Department of Dermatology, The Center for Fungal Infectious Diseases Basic Research and Innovation of Medicine and Pharmacy, Ministry of Education, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, 200003, China.
Abstract:
This study evaluates and compares the diagnostic and prognostic capabilities of ChatGPT-4o and DeepSeek-R1 in 56 HIV-negative talaromycosis cases. Clinical case fragments were de-identified and submitted to both models, with diagnostic accuracy and prognostic prediction rates statistically analyzed using chi-square tests, Fisher's exact tests, and logistic regression. Results showed DeepSeek-R1 achieved significantly higher diagnostic accuracy (66.1%) than ChatGPT-4o (3.6%) (χ2 = 48.2, p < 0.001), attributable to its regional data training focusing on Southeast Asia and southern China. Conversely, ChatGPT-4o demonstrated superior prognostic prediction accuracy (78.6% vs. 50.0%, p < 0.001), with 90.2% specificity for improved (survival) outcomes, while DeepSeek-R1 showed 86.7% sensitivity for mortality. Key diagnostic predictors included hilar lymphadenectasis (odds ratio [OR] = 6.8, 95% confidence interval [CI]: 2.1-22.3, P = 0.002) and chest pain (OR = 5.9, 95% CI: 1.4-25.6, P = 0.016). The findings highlight DeepSeek-R1's regional diagnostic advantage and ChatGPT-4o's prognostic utility, advocating for their collaborative use to enhance early detection and management of this neglected fungal infection in immunocompromised, non-HIV populations.

