Diane Ghanem, Alexander R Zhu, Whitney Kagabo, Greg Osgood, Babar Shafiq
{"title":"ChatGPT-4 Knows Its A B C D E but Cannot Cite Its Source.","authors":"Diane Ghanem, Alexander R Zhu, Whitney Kagabo, Greg Osgood, Babar Shafiq","doi":"10.2106/JBJS.OA.24.00099","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The artificial intelligence language model Chat Generative Pretrained Transformer (ChatGPT) has shown potential as a reliable and accessible educational resource in orthopaedic surgery. Yet, the accuracy of the references behind the provided information remains elusive, which poses a concern for maintaining the integrity of medical content. This study aims to examine the accuracy of the references provided by ChatGPT-4 concerning the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach in trauma surgery.</p><p><strong>Methods: </strong>Two independent reviewers critically assessed 30 ChatGPT-4-generated references supporting the well-established ABCDE approach to trauma protocol, grading them as 0 (nonexistent), 1 (inaccurate), or 2 (accurate). All discrepancies between the ChatGPT-4 and PubMed references were carefully reviewed and bolded. Cohen's Kappa coefficient was used to examine the agreement of the accuracy scores of the ChatGPT-4-generated references between reviewers. Descriptive statistics were used to summarize the mean reference accuracy scores. To compare the variance of the means across the 5 categories, one-way analysis of variance was used.</p><p><strong>Results: </strong>ChatGPT-4 had an average reference accuracy score of 66.7%. Of the 30 references, only 43.3% were accurate and deemed \"true\" while 56.7% were categorized as \"false\" (43.3% inaccurate and 13.3% nonexistent). The accuracy was consistent across the 5 trauma protocol categories, with no significant statistical difference (p = 0.437).</p><p><strong>Discussion: </strong>With 57% of references being inaccurate or nonexistent, ChatGPT-4 has fallen short in providing reliable and reproducible references-a concerning finding for the safety of using ChatGPT-4 for professional medical decision making without thorough verification. Only if used cautiously, with cross-referencing, can this language model act as an adjunct learning tool that can enhance comprehensiveness as well as knowledge rehearsal and manipulation.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 3","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368215/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JBJS Open Access","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2106/JBJS.OA.24.00099","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The artificial intelligence language model Chat Generative Pretrained Transformer (ChatGPT) has shown potential as a reliable and accessible educational resource in orthopaedic surgery. Yet, the accuracy of the references behind the provided information remains elusive, which poses a concern for maintaining the integrity of medical content. This study aims to examine the accuracy of the references provided by ChatGPT-4 concerning the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach in trauma surgery.
Methods: Two independent reviewers critically assessed 30 ChatGPT-4-generated references supporting the well-established ABCDE approach to trauma protocol, grading them as 0 (nonexistent), 1 (inaccurate), or 2 (accurate). All discrepancies between the ChatGPT-4 and PubMed references were carefully reviewed and bolded. Cohen's Kappa coefficient was used to examine the agreement of the accuracy scores of the ChatGPT-4-generated references between reviewers. Descriptive statistics were used to summarize the mean reference accuracy scores. To compare the variance of the means across the 5 categories, one-way analysis of variance was used.
Results: ChatGPT-4 had an average reference accuracy score of 66.7%. Of the 30 references, only 43.3% were accurate and deemed "true" while 56.7% were categorized as "false" (43.3% inaccurate and 13.3% nonexistent). The accuracy was consistent across the 5 trauma protocol categories, with no significant statistical difference (p = 0.437).
Discussion: With 57% of references being inaccurate or nonexistent, ChatGPT-4 has fallen short in providing reliable and reproducible references-a concerning finding for the safety of using ChatGPT-4 for professional medical decision making without thorough verification. Only if used cautiously, with cross-referencing, can this language model act as an adjunct learning tool that can enhance comprehensiveness as well as knowledge rehearsal and manipulation.