ArticleNPJ digital medicine2025
Multiple large language models versus experienced physicians in diagnosing challenging cases with gastrointestinal symptoms.
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Article in NPJ digital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed.
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- When silence is safer: a review and decision-theoretic framework for LLM abstention in healthcare.NPJ digital medicine · 2026Article
- Potential of large language models for rapid clinical information support: evidence from acute kidney injury knowledge testing.Scientific reports · 2026Article
- Optimizing prompting strategies improves large language model classification of pain- and fatigue-related functional impact in childhood cancer survivors.Communications medicine · 2026Article
- Benchmarking Large Language Models for Drug Combination Alerts: Achieving Expert-Level Reliability via Knowledge Grounding and Contextual Reasoning.Journal of medicinal chemistry · 2026Article
- Independent and collaborative performance of large language models and healthcare professionals in diagnosis and triage.NPJ digital medicine · 2026Article
- Large language models in Chinese anesthesiology residency examinations: a comparative analysis of performance, reliability and clinical reasoning.BMC medical education · 2026Article
- Artificial Authority: The Promise and Perils of LLM Judges in Healthcare.Bioengineering (Basel, Switzerland) · 2026Review
- Evaluating large language models' performance in answering common questions on drug-induced liver injury.JHEP reports : innovation in hepatology · 2025Article
- Evaluating the diagnostic accuracy of vision language models for neuroradiological image interpretation.NPJ digital medicine · 2025Article
- Grounded large language models for diagnostic prediction in real-world emergency department settings.JAMIA open · 2025Article
- Beyond the Growth: A Registry-Based Analysis of Global Imbalances in Artificial Intelligence Clinical Trials.Healthcare (Basel, Switzerland) · 2025Article
- Article
- Punching Above Its Weight: A Head-to-Head Comparison of Deepseek-R1 and OpenAI-o1 on Pancreatic Adenocarcinoma-Related Questions.International journal of medical sciences · 2025Article
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Authors and funding
34 authors.
Xintian Yang *State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.ORCID http://orcid.org/0000-0002-0466-8767
Tongxin Li *State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Han Wang *Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Rongchun ZhangDepartment of Gastroenterology, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, China.ORCID http://orcid.org/0000-0003-0711-1582
Zhi NiDepartment of Gastroenterology, Xiamen Humanity Hospital, Fujian Medical University, Xiamen, China.ORCID http://orcid.org/0000-0001-7933-2937
Na LiuDepartment of Gastroenterology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.
Huihong ZhaiDepartment of Gastroenterology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Jianghai ZhaoDepartment of Gastroenterology, Huaihe Hospital of Henan University, Kaifeng, China.
Fandong MengDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing Digestive Disease Center, Beijing Key Laboratory for Precancerous Lesion of Digestive Disease, Beijing, China.
Zhongyin ZhouDepartment of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.
Shanhong TangDepartment of Gastroenterology, The General Hospital of Western Theater Command, Chengdu, China.
Limei WangDepartment of Gastroenterology, Shaanxi Second Provincial People's Hospital, Xi'an, China.
Xiangping WangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Hui LuoState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Gui RenState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Linhui ZhangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Xiaoyu KangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Jun WangDepartment of Gastroenterology, The 986th Hospital of Xijing Hospital, Air Force Military Medical University, Xi'an, China.
Ning BoDepartment of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Xiaoning YangDepartment of Gastroenterology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
Weijie XueDepartment of Transplantation and Pediatric Surgery, Kumamoto University Hospital, Kumamoto, Japan.
Xiaoyin ZhangDepartment of Gastroenterology, National Clinical Research Center of Infectious Disease, The Third People's Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China.
Ning ChenDepartment of Gastroenterology, Peking University People's Hospital, Peking University, Beijing, China.
Rui GuoDepartment of Gastroenterology, Beijing Shijingshan Hospital, Capital Medical University, Beijing, China.
Baiwen LiDepartment of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Yajun LiDepartment of Gastroenterology, General Hospital of Ningxia Medical University, Yinchuan, China.
Yaling LiuState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Tiantian ZhangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Shuhui LiangState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Yong LvState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Yongzhan NieState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Daiming FanState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.
Lina ZhaoDepartment of Radiotherapy, Xijing Hospital, Fourth Military Medical University, Xi'an, China. zhaolina@fmmu.edu.cn.
Yanglin PanState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China. yanglinpan@hotmail.com.ORCID http://orcid.org/0000-0002-4596-4642
Funding
National Natural Science Foundation of China (National Science Foundation of China) 82000506National Natural Science Foundation of China (National Science Foundation of China) 82003152
Abstract
Faced with challenging cases, doctors are increasingly seeking diagnostic advice from large language models (LLMs). This study aims to compare the ability of LLMs and human physicians to diagnose challenging cases. An offline dataset of 67 challenging cases with primary gastrointestinal symptoms was used to solicit possible diagnoses from seven LLMs and 22 gastroenterologists. The diagnoses by Claude 3.5 Sonnet covered the highest proportion (95% confidence interval [CI]) of instructive diagnoses (76.1%, [70.6%-80.9%]), significantly surpassing all the gastroenterologists (p < 0.05 for all). Claude 3.5 Sonnet achieved a significantly higher coverage rate (95% CI) than that of the gastroenterologists using search engines or other traditional resource (76.1% [70.6%-80.9%] vs. 45.5% [40.7%-50.4%], p < 0.001). The study highlights that advanced LLMs may assist gastroenterologists with instructive, time-saving, and cost-effective diagnostic scopes in challenging cases.
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