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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Artificial Intelligence vs Human Clinicians in Esophagogastroduodenoscopy Appropriateness: A Comparative Study Using
Angelica Toppeta1, Mattia Corradi1,2, Beatrice Mantia1,2
1Department of Gastroenterology and Endoscopy, ASST Fatebenefratelli Sacco, Milan, Italy.
Introduction:
Large language models are increasingly used in clinical decision-making, but their role in appropriateness-based indications is uncertain.
Methods:
We conducted a vignette-based Italian survey comparing esophagogastroduodenoscopy appropriateness by 5 artificial intelligence (AI) (ChatGPT-4.0, ChatGPT-4.5, Gemini, Claude AI, OpenEvidence) at 2 times (April and September 2025) with gastroenterologists, residents, and general practitioners, using American Society for Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy guidelines.
Results:
A total of 135 physicians participated. AI performance varied over time: accuracies ranged from 50%-90% in April to 63%-80% in September, with ChatGPT-4.5 and ChatGPT-4.0 outperforming physicians in September.
Discussion:
Temporal and prompt variability highlight the need for multirun, longitudinal evaluation before clinical adoption.
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