Evidence map›Paper›PMID 40891225›Full record

ArticleLiver international : official journal of the International Association for the Study of the Liver2025

The Impact of Access to Clinical Guidelines on LLM-Based Treatment Recommendations for Chronic Hepatitis B.

Robert Siepmann, Carolin Victoria Schneider, Marc Sebastian von der Stueck, Iakovos Amygdalos, Karsten Große, Kai Markus Schneider, Maike Rebecca Pollmanns, Mohamad Murad, Joel Joy, Elena Kabak and 6 more

Abstract read
In one paragraph

Article in Liver international : official journal of the International Association for the Study of the Liver, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. The Impact of Access to Clinical Guidelines on LLM-Based Treatment Recommendations for Chronic Hepatitis B.Liver international : official journal of the International Association for the Study of the Liver · 2025
    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

16 authors.

Robert SiepmannDepartment of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.ORCID 0000-0002-4608-5180
Carolin Victoria SchneiderDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.ORCID 0000-0002-6728-9246
Marc Sebastian von der StueckDepartment of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.
Iakovos AmygdalosDepartment of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany.
Karsten GroßeDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Kai Markus SchneiderDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Maike Rebecca PollmannsDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Mohamad MuradDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Joel JoyDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Elena KabakDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Marcella Ricardis MayDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Jan ClusmannDepartment of Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Christiane KuhlDepartment of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.
Sven NebelungDepartment of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.ORCID 0000-0002-5267-9962
Jakob Nikolas KatherElse Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Daniel TruhnDepartment of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, Aachen, Germany.

Funding

Deutsche Forschungsgemeinschaft NE2136/3-1Deutsche Forschungsgemeinschaft NE2136/7-1Deutsche Forschungsgemeinschaft TR 1700/7-1European Union Research and Innovation Programme GA101057091German Federal Ministry of Research, Technology and Space 01KD2420BGerman Federal Ministry of Research, Technology and Space 031L0312C
6 · The paper itself

Abstract

BACKGROUND AND

aimsLarge language models (LLMs) can potentially support clinicians in their daily routine by providing easy access to information. Yet, they are plagued by stating incorrect facts and hallucinating when queried. Increasing the context by providing external databases while prompting LLMs may decrease the risk of misinformation. This study compares the influence of increased context on the coherence of LLM-based treatment recommendations with the recently updated WHO guidelines for the treatment of chronic hepatitis B (CHB).

methodsGPT-4 was queried with five clinical case vignettes in two configurations: with and without additional context. The clinical vignettes were explicitly constructed so that treatment recommendations differed between the formerly applicable 2015 WHO guidelines and the updated 2024 ones. GPT-4 with context was provided access to the updated guidelines, while GPT-4 without context had to rely on its internal knowledge. GPT-4 was accessed only a few days after the release of the new WHO guidelines. Treatment recommendations were compared regarding guideline coherence, information inclusion, textual errors, wording clarity and preciseness by seven physicians.

resultsUsing GPT-4 with context increased the coherence of the treatment recommendations with the new 2024 guidelines from 51% to 91% compared to GPT-4 without context. Similar trends were observed for all other categories, leading to an increase of 54% in preciseness and clarity, 24% in completeness of incorporating the case vignette information, and 12% in textual correctness.

conclusionsIf LLMs are consulted by clinicians for medical advice, they should be given access to external data sources to increase the chance of providing factually correct advice.

Indexed as

Access to InformationAntiviral AgentsHepatitis B, ChronicLanguagePractice Guidelines as TopicAdultFemaleHumansMaleMiddle AgedWorld Health OrganizationAntiviral Agentschronic hepatitis BGPTguideline coherenceLLM

Identifiers

PMID40891225
PMCPMC12402858

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.