Evidence map›Paper›PMID 39922789›Full record

ArticleBritish journal of anaesthesia2026

A comparison of large language model-generated and published perioperative neurocognitive disorder recommendations: a cross-sectional web-based analysis.

Sarah Saxena, Odmara L Barreto Chang, Melanie Suppan, Basak Ceyda Meco, Susana Vacas, Finn Radtke, Idit Matot, Arnout Devos, Mervyn Maze, Mia Gisselbaek and 1 more

Abstract readComparative Study
In one paragraph

Article in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 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, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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.

Sarah SaxenaDepartment of Surgery, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium; Department of Anesthesiology, Helora, Mons, Belgium.
Odmara L Barreto ChangDepartment of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA. Electronic address: https://twitter.com/@OdmaraBarreto.
Melanie SuppanDivision of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Basak Ceyda MecoDepartment of Anaesthesia and Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey; Ankara University Brain Research Center (BAUM), Ankara, Turkey.
Susana VacasDepartment of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Finn RadtkeDepartment of Anaesthesia and Intensive Care, Hospital of Nykøbing Falster, University of Southern Denmark, Odense, Denmark.
Idit MatotDivision of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
Arnout DevosETH AI Center, Swiss Federal Institute of Technology Zurich (ETH Zurich), Zurich, Switzerland.
Mervyn MazeDepartment of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
Mia GisselbaekDivision of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland; Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Joana Berger-EstilitaInstitute for Medical Education, University of Bern, Bern, Switzerland; CINTESIS@RISE, Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal. Electronic address: joanamberger@gmail.com.

Funding

Mechanisms Mediating Postoperative Neurocognitive DisordersK23GM132795 · NIGMS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI VACAS, SUSANA · 2019 to 2023
$1.0M
NIGMS NIH HHS K23 GM132795
6 · The paper itself

Abstract

backgroundPerioperative neurocognitive disorders (PNDs) are common complications after surgery and anaesthesia, particularly in older adults, leading to increased morbidity, mortality, and healthcare costs. Therefore, major medical societies have developed recommendations for the prevention and treatment of PNDs. Our study evaluated the reliability of large language models, specifically ChatGPT-4 and Gemini, in generating recommendations for PND management and comparing them with published guidelines.

methodsWe conducted an online cross-sectional web-based analysis over 48 h in June 2024. Artificial intelligence (AI)-generated recommendations were produced in six different locations across five countries (Switzerland, Belgium, Turkey, Canada, and the East and West Coasts of the USA). The English prompt 'a table of a bundle of care for perioperative neurocognitive disorders' was entered into ChatGPT-4 and Gemini, generating tables evaluated by independent reviewers. The primary outcomes were the Total Disagreement Score (TDS) and Quality Assessment of Medical Artificial Intelligence (QAMAI), which compared AI-generated recommendations with published guidelines.

resultsThe study generated 14 tables, with TDS and QAMAI scores showing similar results for ChatGPT-4 and Gemini (2 [1-3] vs 2 [2-3], P=0.636 and 4 [4-4] vs 4 [3-4], P=0.424, respectively). AI-generated recommendations aligned well with published guidelines, with the highest alignment observed in ChatGPT-4-generated recommendations. No complete agreement with guidelines was achieved, and lack of cited sources was a noted limitation.

conclusionsLarge language models can generate perioperative neurocognitive disorder recommendations that align closely with published guidelines. However, further validation and integration of clinician feedback are required before clinical application.

Indexed as

LanguageNeurocognitive DisordersPerioperative CarePractice Guidelines as TopicArtificial IntelligenceCross-Sectional StudiesHumansInternetLarge Language ModelsReproducibility of Resultsartificial intelligence (AI)ChatGPT-4clinical guidelinesGeminilarge language models (LLM)patient outcomesperioperative neurocognitive disorders (PND)

Identifiers

PMID39922789
PMCPMC13168983

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.