Evaluating the performance of large language models versus human researchers on real world complex medical queries.

Whether large language models (LLMs) can resolve real-world dilemmas faced by clinicians remains unclear and physician quality assessment is often used as a measure of LLM output quality. We compared reports - defined as answers to clinical queries generated by LLMs or written by human researchers - generated by GPT-4o, Gemini 2.0, and Claude Sonnet 3.5 in response to such dilemmas (n = 20) to reports written by trained human researchers and studied whether physician satisfaction correlates with objective report quality. Twenty human reports and fifty-six LLM-reports were analyzed. Human reports met physicians' expectations more frequently (p = 0.044), were considered more reliable (p = 0.032), professionally written (p = 0.003), and time-saving (p = 0.003). Human reports cited more sources (p < 0.001) and while these were from lower ranking journals (median IF: 7 [3, 11] vs 14 [10, 27], p = 0.003), they were considered more relevant (p < 0.001). Unlike LLMs, human reports contained no hallucinated (p < 0.001) or unfaithful (p < 0.001) citations. However, no meaningful correlation was identified between physician satisfaction and objective measures of report quality. A meaningful gap remains between LLM and human capacity to respond reliably and in a relevant manner to real-life clinical dilemmas. Of greater concern is that physician satisfaction with generated content is not a good measure of quality.