Evidence map›Paper›PMID 40033723›Full record

ArticleAsian spine journal2025

Can generative artificial intelligence provide accurate medical advice?: a case of ChatGPT versus Congress of Neurological Surgeons management of acute cervical spine and spinal cord injuries clinical guidelines.

Michael Saturno, Mateo Restrepo Mejia, Wasil Ahmed, Alexander Yu, Akiro Duey, Bashar Zaidat, Fady Hijji, Jonathan Markowitz, Jun Kim, Samuel Cho

Abstract read
In one paragraph

Article in Asian spine journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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. Large language models in the vertical integration of spine surgery workflow: a scoping review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Review
  2. Article
  3. AI for clinical neurology: Comparing five large language models in neurological diagnosis and lesion localization.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  4. Review
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

10 authors.

Michael SaturnoIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Mateo Restrepo MejiaIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Wasil AhmedIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Alexander YuIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Akiro DueyIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Bashar ZaidatIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Fady HijjiIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Jonathan MarkowitzIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Jun KimIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Samuel ChoIcahn School of Medicine at Mount Sinai, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designAn experimental study. PURPOSE: To explore the concordance of ChatGPT responses with established national guidelines for the management of cervical spine and spinal cord injuries. OVERVIEW OF LITERATURE: ChatGPT-4.0 is an artificial intelligence model that can synthesize large volumes of data and may provide surgeons with recommendations for the management of spinal cord injuries. However, no available literature has quantified ChatGPT's capacity to provide accurate recommendations for the management of cervical spine and spinal cord injuries.

methodsReferencing the "Management of acute cervical spine and spinal cord injuries" guidelines published by the Congress of Neurological Surgeons (CNS), a total of 36 questions were formulated. Questions were stratified into therapeutic, diagnostic, or clinical assessment categories as seen in the guidelines. Questions were secondarily grouped according to whether the corresponding recommendation contained level I evidence (highest quality) versus only level II/III evidence (moderate and low quality). ChatGPT-4.0 was prompted with each question, and its responses were assessed by two independent reviewers as "concordant" or "nonconcordant" with the CNS clinical guidelines. "Nonconcordant" responses were rationalized into "insufficient" and "contradictory" categories.

resultsIn this study, 22/36 (61.1%) of ChatGPT's responses were concordant with the CNS guidelines. ChatGPT's responses aligned with 17/24 (70.8%) therapeutic questions and 4/7 (57.1%) diagnostic questions. ChatGPT's response aligned with only one of the five clinical assessment questions. Notably, the recommendations supported by level I evidence were the least likely to be replicated by ChatGPT. ChatGPT's responses agreed with 80.8% of the recommendations supported exclusively by level II/III evidence.

conclusionsChatGPT-4 was moderately accurate when generating recommendations that aligned with the clinical guidelines. The model frequently aligned with low evidence and therapeutic recommendations but exhibited inferior performance on topics that contained high-quality evidence or pertained to diagnostic and clinical assessment strategies. Medical practitioners should monitor its usage until further models can be rigorously trained on medical data.

Indexed as

Artificial intelligenceCervical vertebraeDecision making, computer-assistedGenerative artificial intelligenceSpinal cord injuries

Identifiers

PMID40033723
PMCPMC12242251

What OpenQuestion holds

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LicenceCC BY-NC
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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.