Related Experiment Video
Updated: Feb 10, 2026
08:04
Proximal Cadaveric Femur Preparation for Fracture Strength Testing and Quantitative CT-based Finite Element Analysis
Published on: March 11, 2017
9.8K
Bot vs. doc-who is better at reading proximal humerus fracture x-rays?
Kyle K Obana1, Mark Ren1, Andrew J Luzzi1
1Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.
JSES International
|February 9, 2026
Summary
ChatGPT-5 shows low accuracy in identifying proximal humerus fractures (PHFx) on shoulder x-rays. Over-reliance on AI for clinical decisions may pose risks to patient safety.
Area of Science:
- Orthopedic Surgery
- Radiology
- Artificial Intelligence in Medicine
Background:
- Artificial intelligence (AI) tools like ChatGPT are increasingly used for information retrieval.
- The potential of AI, specifically ChatGPT-5, as an aid in clinical decision-making requires evaluation.
- This study investigates AI's diagnostic capabilities in orthopedic imaging.
Purpose of the Study:
- To assess the accuracy of ChatGPT-5 in diagnosing proximal humerus fractures (PHFx) on shoulder x-rays.
- To evaluate the interrater reliability between ChatGPT-5 and orthopedic surgeons with varying experience levels.
- To determine the AI's performance in differentiating normal shoulder x-rays from those with PHFx.
Main Methods:
- A dataset of 70 shoulder x-rays (35 PHFx, 35 normal) was analyzed.
- X-rays were independently reviewed by orthopedic residents, a fellow, and an attending physician.
- ChatGPT-5 was queried using a response-based algorithm for each x-ray.
Main Results:
- ChatGPT-5 achieved 67.1% overall accuracy for PHFx detection, with 61.8% sensitivity and 74.3% specificity.
- The AI misdiagnosed 25.7% of normal x-rays and incorrectly interpreted 23.5% of PHFx cases.
- Interrater reliability between ChatGPT-5 and surgeons was poor to slight for various fracture and joint assessments.
Conclusions:
- ChatGPT-5 demonstrates significant inaccuracies in identifying and characterizing proximal humerus fractures on shoulder x-rays.
- The current generative AI tool is not reliable for interpreting shoulder radiographs.
- Clinicians should exercise caution and limit reliance on AI for critical diagnostic decisions to prevent patient harm.
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