Evidence map›Paper›PMID 41398287›Full record

ArticleScientific reports2025

Benchmarking large language models against clinicians across hospital levels in cardiovascular decision-making: a cross-sectional vignette-based study.

Zixi Zhang, Yingxu Ma, Yichao Xiao, Yongguo Dai, Qiuzhen Lin, Chan Liu, Cancan Wang, Tao Tu, Qiming Liu

Abstract read
In one paragraph

Article in Scientific reports, 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

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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

3 citing papers in PubMed.

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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

9 authors.

Zixi ZhangDepartment of Cardiology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha City, Hunan Province, People's Republic of China.
Yingxu MaDepartment of Cardiology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha City, Hunan Province, People's Republic of China.
Yichao XiaoDepartment of Cardiology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha City, Hunan Province, People's Republic of China.
Yongguo DaiDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China.
Qiuzhen LinDepartment of Cardiology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha City, Hunan Province, People's Republic of China.
Chan LiuDepartment of International Medicine, The Second Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China.
Cancan WangThe First Detention Area, Central Hospital of Hunan Provincial Prison Administration, Changsha City, Hunan Province, People's Republic of China.
Tao TuDepartment of Cardiology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha City, Hunan Province, People's Republic of China. tutaotodd@csu.edu.cn.
Qiming LiuDepartment of Cardiology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Furong District, Changsha City, Hunan Province, People's Republic of China. qimingliu@csu.edu.cn.

Funding

Chinese Society of Cardiology's Foundation CSCF2024B02Clinical Medical Technology Innovation Guidance Project of Hunan Science and Technology Agency 2021SK53519Hunan Provincial Natural Science Foundation of China 2021JJ30033Hunan Provincial Natural Science Foundation of China 2023JJ30791Key Project of Hunan Provincial Science and Technology Innovation 2024JK2119National Natural Science Foundation of China 82070356National Natural Science Foundation of China 82200367National Natural Science Foundation of China 82300357National Natural Science Foundation of China 82470333
6 · The paper itself

Abstract

Large language models (LLMs) have showed strong performance on standardized medical examinations, yet their comparative clinical relevance against human clinicians remains limited. This study benchmarked the performance of DeepSeek-R1 and ChatGPT 4.0 against cardiovascular clinicians from different hospital levels in China. We conducted a cross-sectional, vignette-based assessment consisting of 100 standardized cardiovascular multiple-choice questions covering four competency domains: clinical reasoning (CR), frontier updates (FU), basic memory (BM), and emergency decision (ED). Thirty clinicians from six hospitals (three primary and three tertiary) were compared with two LLMs. Each question was executed five times per model, and run-to-run consistency was evaluated. Mean differences (LLM - clinician) with 95% confidence intervals (CIs) were estimated using nonparametric bootstrap resampling (10,000 iterations). Clinicians achieved a mean total score of 69.7 ± 7.9, whereas DeepSeek-R1 and ChatGPT-4.0 scored 97 and 95, respectively. The mean total score differences were + 27.3 points (95% CI 24.4-30.1) for DeepSeek-R1 and + 25.3 points (22.4-28.1) for ChatGPT 4.0. Both models outperformed clinicians in CR, FU, BM, and ED. Run-to-run agreement was high (DeepSeek-R1 κ = 0.73; ChatGPT 4.0 κ = 0.76). LLMs substantially outperformed clinicians in knowledge- and decision-based tasks while approaching clinician-level performance in CR. These findings suggest that LLMs may complement clinical expertise and enhance diagnostic consistency across hospital levels.

Indexed as

BenchmarkingCardiovascular DiseasesClinical Decision-MakingLanguageAdultChinaClinical CompetenceCross-Sectional StudiesFemaleHospitalsHumansLarge Language ModelsMaleMiddle AgedArtificial intelligenceChatGPT 4.0ChinaClinical decision-makingDeepSeek-R1

Identifiers

PMID41398287
PMCPMC12823645

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LicenceCC BY-NC-ND
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Registered trials

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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.