Evidence map›Paper›PMID 41014370›Full record

ArticleRheumatology international2025

Referential hallucination and clinical reliability in large language models: a comparative analysis using regenerative medicine guidelines for chronic pain.

Ozlem Kuculmez, Ahmet Usen, Emine Dündar Ahi

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Rheumatology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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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

2 citing papers in PubMed.

  1. Review
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4 · The record

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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

3 authors.

Ozlem KuculmezDepartment of Physical Medicine and Rehabilitation, Baskent University Alanya Hospital, Oba neighbourhood, Cevreyolu Street. No:79, Alanya, Antalya, 07400, Turkey.ORCID 0000-0002-8900-0060
Ahmet UsenFaculty of Medicine, Department of Physical Medicine and Rehabilitation, Medipol University, Göztepe neighbourhood, Atatürk Street. No:1, Beykoz, Istanbul, 34815, Turkey. ahmetusen1@hotmail.com.ORCID 0000-0002-2754-1232
Emine Dündar AhiDepartment of Physical Medicine and Rehabilitation, Kocaeli Health and Technology University, Fatih Neighborhood, Kadıoğlu Street, Alizepark Complex, Block D1, No:1, Başiskele, Kocaeli, Turkey.ORCID 0000-0001-6417-5406

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study compared language models' responses to open-ended questions on regenerative therapy guidelines for chronic pain, assessing their accuracy, reliability, usefulness, readability, semantic similarity, and hallucination rates. This cross-sectional study used 16 open-ended questions based on the American Society of Pain and Neuroscience's regenerative therapy guidelines for chronic pain. Questions were answered by ChatGPT-4o, Gemini 2.5 Flash, and Claude 4 Opus. Responses were rated on a 7-point Likert scale for usability and reliability, and a 5-point scale for accuracy. Hallucinogenicity, readability (FKRE, FKGL), and similarity (USE, ROUGE-L) were also assessed. Statistical comparisons were made, with significance set at p < 0.05. Claude Opus 4 showed the highest reliability (5.19 ± 1.11), usefulness (5.06 ± 1.0), and clinical accuracy (4.06 ± 0.68), outperforming ChatGPT-4o (4.13 ± 0.96; 3.94 ± 0.85; 3.38 ± 0.72) and Gemini 2.5 (4.19 ± 0.98; 4.06 ± 0.93; 3.38 ± 0.62). Claude had the lowest reference hallucinations (RHS 4.44 ± 3.18) vs. ChatGPT-4o (8.38 ± 1.86) and Gemini 2.5 (8.75 ± 1.73). In semantic similarity, Claude (0.68 ± 0.08) and Gemini (0.65 ± 0.07) surpassed ChatGPT-4o (0.60 ± 0.09). Gemini led in ROUGE-L F1 (0.12 ± 0.03) vs. Claude (0.10 ± 0.02) and ChatGPT-4o (0.07 ± 0.03). Readability was similar, though Gemini had a higher FKGL (11.3 ± 1.06) than Claude (10.3 ± 2.09). Claude Opus 4 showed superior accuracy, reliability, and usefulness, with significantly fewer hallucinations. Readability scores were similar across models. Further research is recommended.

Indexed as

Chronic PainHallucinationsLanguagePain ManagementPractice Guidelines as TopicComprehensionCross-Sectional StudiesHumansLarge Language ModelsMaleReproducibility of ResultsSurveys and QuestionnairesArtificial intelligenceGuidelinePainRegenerationStem cell

Identifiers

What OpenQuestion holds

Textmetadata
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.