ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2024
Diagnosis of malignancy in oropharyngeal confocal laser endomicroscopy using GPT 4.0 with vision.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Clinical decision support using large language models in otolaryngology: a systematic review.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Pooled it
- Unveiling the Potential of Large Language Models in Transforming Chronic Disease Management: Mixed Methods Systematic Review.Journal of medical Internet research · 2025Pooled it
- Artificial intelligence in otolaryngology: current applications, limitations, and future perspectives.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Review
- Clinical Applications of Multimodal Artificial Intelligence in Otolaryngology: A State-of-the-Art Review.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Review
- Fine-tuned multimodal GPT-4o for generating diagnostic impressions in breast magnetic resonance imaging: insights into non-mass enhancement lesions.Quantitative imaging in medicine and surgery · 2026Article
- Feasibility of confocal laser endomicroscopy as an optical biopsy method for SCC on the auricle : an exploratory study.Oral and maxillofacial surgery · 2026Article
- [Skull base surgery-where do we stand?]HNO · 2025Review
- Multimodal large language models in ultrasound diagnosis of breast masses: a multicenter comparative analysis based on GPT-4o, radiologists, and convolutional neural network (CNN).Quantitative imaging in medicine and surgery · 2025Article
- Applications of Natural Language Processing in Otolaryngology: A Scoping Review.The Laryngoscope · 2025Article
- Large language model integrations in cancer decision-making: a systematic review and meta-analysis.NPJ digital medicine · 2025Article
- Characterization of irradiated mucosa using confocal laser endomicroscopy in the upper aerodigestive tract.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Medical accuracy of artificial intelligence chatbots in oncology: a scoping review.The oncologist · 2025Article
- Assessing the feasibility of ChatGPT-4o and Claude 3-Opus in thyroid nodule classification based on ultrasound images.Endocrine · 2025Article
- Large language models in oncology: a review.BMJ oncology · 2025Review
- Artificial Intelligence-Based Applications for Bone Fracture Detection Using Medical Images: A Systematic Review.Diagnostics (Basel, Switzerland) · 2024Review
- Applications of Large Language Models in Pathology.Bioengineering (Basel, Switzerland) · 2024Review
- ChatGPT in veterinary medicine: a practical guidance of generative artificial intelligence in clinics, education, and research.Frontiers in veterinary science · 2024Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
purposeConfocal Laser Endomicroscopy (CLE) is an imaging tool, that has demonstrated potential for intraoperative, real-time, non-invasive, microscopical assessment of surgical margins of oropharyngeal squamous cell carcinoma (OPSCC). However, interpreting CLE images remains challenging. This study investigates the application of OpenAI's Generative Pretrained Transformer (GPT) 4.0 with Vision capabilities for automated classification of CLE images in OPSCC.
methodsCLE Images of histological confirmed SCC or healthy mucosa from a database of 12 809 CLE images from 5 patients with OPSCC were retrieved and anonymized. Using a training data set of 16 images, a validation set of 139 images, comprising SCC (83 images, 59.7%) and healthy normal mucosa (56 images, 40.3%) was classified using the application programming interface (API) of GPT4.0. The same set of images was also classified by CLE experts (two surgeons and one pathologist), who were blinded to the histology. Diagnostic metrics, the reliability of GPT and inter-rater reliability were assessed.
resultsOverall accuracy of the GPT model was 71.2%, the intra-rater agreement was κ = 0.837, indicating an almost perfect agreement across the three runs of GPT-generated results. Human experts achieved an accuracy of 88.5% with a substantial level of agreement (κ = 0.773).
conclusionsThough limited to a specific clinical framework, patient and image set, this study sheds light on some previously unexplored diagnostic capabilities of large language models using few-shot prompting. It suggests the model`s ability to extrapolate information and classify CLE images with minimal example data. Whether future versions of the model can achieve clinically relevant diagnostic accuracy, especially in uncurated data sets, remains to be investigated.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.