Comparing Performance of Large Language Model-Based Tools on Patient-Driven Glaucoma Inquiries.

Purpose: Large language models (LLMs) can assist patients who seek medical knowledge online to guide their own glaucoma care. Understanding the differences in LLM performance on glaucoma-related questions can inform patients about the best resources to obtain relevant information.

Methods: This cross-sectional study evaluated the accuracy, comprehensiveness, quality, and readability of LLM-generated responses to glaucoma inquiries. Seven questions posted by patients on the American Academy of Ophthalmology's Eye Care Forum were randomly selected and prompted into GPT-4o, GPT-4o Mini, Gemini Pro, and Gemini Flash in September 2024. Four physicians practicing ophthalmology assessed responses using a Likert scale based on accuracy, comprehensiveness, and quality. The Flesch-Kincaid Grade level measured readability while Bidirectional Encoder Representations from Transformers (BERT) Scores measured semantic similarity between LLM responses. Statistical analysis involved either the Kruskal-Wallis test with Dunn's post-hoc test or ANOVA analysis with Tukey's Honestly Significant Difference (HSD) test.

Results: GPT-4o rated higher in accuracy (P=0.016), comprehensiveness (P=0.007), and quality (P=0.002) compared to Gemini Pro. GPT-4o Mini rated higher in comprehensiveness (P=0.011) and quality (P=0.007). Gemini Flash and Gemini Pro were similar across all criteria. There were no differences in readability, and LLMs mostly produced semantically similar responses.

Conclusions: GPT models surpass Gemini Pro in addressing commonly asked questions about glaucoma, providing valuable insights into the application of LLMs for providing health information.