A Comparative Analysis of the Performance of Large Language Models and Human Respondents in Dermatology.

Background: With the growing interest in generative artificial intelligence (AI), the scientific community is witnessing the vast utility of large language models (LLMs) with chat interfaces such as ChatGPT and Microsoft Bing Chat in the medical field and research. This study aimed to investigate the accuracy of ChatGPT and Microsoft Bing Chat to answer questions on Dermatology, Venereology, and Leprosy, the frequency of artificial hallucinations, and to compare their performance with human respondents.

Aim and objectives: The primary objective of the study was to compare the knowledge and interpretation abilities of LLMs (ChatGPT v3.5 and Microsoft Bing Chat) with human respondents (12 final-year postgraduates) and the secondary objective was to assess the incidence of artificial hallucinations with 60 questions prepared by the authors, including multiple choice questions (MCQs), fill-in-the-blanks and scenario-based questions.

Materials and methods: The authors accessed two commercially available large language models (LLMs) with chat interfaces namely ChatGPT version 3.5 (OpenAI; San Francisco, CA) and Microsoft Bing Chat from August 10^th to August 23^rd, 2023.

Results: In our testing set of 60 questions, Bing Chat outperformed ChatGPT and human respondents with a mean correct response score of 46.9 ± 0.7. The mean correct responses by ChatGPT and human respondents were 35.9 ± 0.5 and 25.8 ± 11.0, respectively. The overall accuracy of human respondents, ChatGPT and Bing Chat was observed to be 43%, 59.8%, and 78.2%, respectively. Of the MCQs, fill-in-the-blanks, and scenario-based questions, Bing Chat had the highest accuracy in all types of questions with statistical significance (P < 0.001 by ANOVA test). Topic-wise assessment of the performance of LLMs showed that Bing Chat performed better in all topics except vascular disorders, inflammatory disorders, and leprosy. Bing Chat performed better in answering easy and medium-difficulty questions with accuracies of 85.7% and 78%, respectively. In comparison, ChatGPT performed well on hard questions with an accuracy of 55% with statistical significance (P < 0.001 by ANOVA test). The mean number of questions answered by the human respondents among the 10 questions with multiple correct responses was 3 ± 1.4. The accuracy of LLMs in answering questions with multiple correct responses was assessed by employing two prompts. ChatGPT and Bing Chat could answer 3.1 ± 0.3 and 4 ± 0 questions respectively without prompting. On evaluating the ability of logical reasoning by the LLMs, it was found that ChatGPT gave logical reasoning in 47 ± 0.4 questions and Bing Chat in 53.9 ± 0.5 questions, irrespective of the correctness of the responses. ChatGPT exhibited artificial hallucination in 4 questions, even with 12 repeated inputs, which was not observed in Bing chat.

Limitations: Variability in respondent accuracy, a small question set, and exclusion of newer AI models and image-based assessments.

Conclusion: This study showed an overall better performance of LLMs compared to human respondents. However, the LLMs were less accurate than respondents in topics like inflammatory disorders and leprosy. Proper regulations concerning the use of LLMs are the need of the hour to avoid potential misuse.