Evidence map›Paper›PMID 38830730›Full record

ArticleBMJ open quality2024

Performance evaluation of ChatGPT in detecting diagnostic errors and their contributing factors: an analysis of 545 case reports of diagnostic errors.

Yukinori Harada, Tomoharu Suzuki, Taku Harada, Tetsu Sakamoto, Kosuke Ishizuka, Taiju Miyagami, Ren Kawamura, Kotaro Kunitomo, Hiroyuki Nagano, Taro Shimizu and 1 more

Abstract read
In one paragraph

Article in BMJ open quality, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yukinori HaradaDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan yuki.gym23@gmail.com.ORCID 0000-0001-6042-7397
Tomoharu SuzukiUrasoe General Hospital, Urasoe, Okinawa, Japan.
Taku HaradaDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.
Tetsu SakamotoDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.
Kosuke IshizukaYokohama City University School of Medicine Graduate School of Medicine, Yokohama, Kanagawa, Japan.
Taiju MiyagamiDepartment of General Medicine, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan.ORCID 0000-0002-4893-2224
Ren KawamuraDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.ORCID 0000-0002-5632-3218
Kotaro KunitomoNHO Kumamoto Medical Center, Kumamoto, Kumamoto, Japan.
Hiroyuki NaganoDepartment of General Internal Medicine, Tenri Hospital, Tenri, Nara, Japan.
Taro ShimizuDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan.ORCID 0000-0002-3788-487X
Takashi WatariIntegrated Clinical Education Center, Kyoto University Hospital, Kyoto, Kyoto, Japan.ORCID 0000-0002-9322-8455

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManual chart review using validated assessment tools is a standardised methodology for detecting diagnostic errors. However, this requires considerable human resources and time. ChatGPT, a recently developed artificial intelligence chatbot based on a large language model, can effectively classify text based on suitable prompts. Therefore, ChatGPT can assist manual chart reviews in detecting diagnostic errors.

objectiveThis study aimed to clarify whether ChatGPT could correctly detect diagnostic errors and possible factors contributing to them based on case presentations.

methodsWe analysed 545 published case reports that included diagnostic errors. We imputed the texts of case presentations and the final diagnoses with some original prompts into ChatGPT (GPT-4) to generate responses, including the judgement of diagnostic errors and contributing factors of diagnostic errors. Factors contributing to diagnostic errors were coded according to the following three taxonomies: Diagnosis Error Evaluation and Research (DEER), Reliable Diagnosis Challenges (RDC) and Generic Diagnostic Pitfalls (GDP). The responses on the contributing factors from ChatGPT were compared with those from physicians.

resultsChatGPT correctly detected diagnostic errors in 519/545 cases (95%) and coded statistically larger numbers of factors contributing to diagnostic errors per case than physicians: DEER (median 5 vs 1, p<0.001), RDC (median 4 vs 2, p<0.001) and GDP (median 4 vs 1, p<0.001). The most important contributing factors of diagnostic errors coded by ChatGPT were 'failure/delay in considering the diagnosis' (315, 57.8%) in DEER, 'atypical presentation' (365, 67.0%) in RDC, and 'atypical presentation' (264, 48.4%) in GDP.

conclusionChatGPT accurately detects diagnostic errors from case presentations. ChatGPT may be more sensitive than manual reviewing in detecting factors contributing to diagnostic errors, especially for 'atypical presentation'.

Indexed as

Diagnostic ErrorsArtificial IntelligenceHumansArtificial IntelligenceChart review methodologiesDiagnostic errors

Identifiers

PMID38830730
PMCPMC11149143

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Registered trials

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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.