Evidence map›Paper›PMID 41772565›Full record

ArticleBMC medical informatics and decision making2026

Large language models for structuring knee ultrasound reports-A comparative evaluation of DeepSeek R1, gemini 2.5 flash, and GPT-4o.

Min Tang, Le Xu, Libiao Zhu, Abasi Maimaitiabula, Xianzuo Zhang, Chong Pei, Lei Hu

Abstract readComparative Study
In one paragraph

Article in BMC medical informatics and decision making, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

7 authors.

Min Tang *Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Le Xu *Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Libiao ZhuDepartment of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Abasi MaimaitiabulaDepartment of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Xianzuo Zhang *Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China. zhangxianzuo@ustc.edu.cn.
Chong Pei *Department of Respiratory and Critical Care Medicine, The First People's Hospital of Hefei City, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230001, China. pchl331@126.com.
Lei Hu *Department of Ultrasound, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China. hulei@ustc.edu.cn.ORCID 0000-0002-6871-3547

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate three LLMs (DeepSeek R1, Gemini 2.5 Flash, and GPT-4o) for generating structured, clinically interpretable outputs from free-text knee ultrasound reports. MATERIALS AND

methodsWe retrospectively analyzed 359 de-identified knee ultrasound reports using four prompt strategies targeting (Prompt 1) information extraction, (Prompt 2) structured report generation, (Prompt 3) impression generation, and (Prompt 4) clinical recommendation generation. Two experienced physicians rated outputs using prespecified 5-point Likert rubrics for extraction quality, structuring quality, diagnostic usefulness, recommendation quality, readability, and subjective repeatability. Objective evaluations included Prompt 2 structural completeness and stability under a fixed slot schema (schema compliance, missing-item rate, and slot-level exact match), Prompt 3 objective repeatability via mapped binary findings (percent agreement and Cohen's κ across repeated runs), and Prompt 3 diagnostic performance against an expert binary reference standard (sensitivity/specificity, F1 score, balanced accuracy, and MCC; 95% confidence intervals via bootstrapping). For Chinese recommendation metrics, BLEU/ROUGE-L were computed using character-level tokenization.

resultsAcross 359 knee ultrasound reports, GPT-4o demonstrated the strongest overall performance across extraction, diagnostic impression generation, and clinical recommendation tasks. It achieved the highest physician-rated scores for NER (4.0 ± 0.6) and diagnostic summarization (3.8 ± 0.7), along with the best diagnostic performance (F1-score = 0.79 vs 0.54 for DeepSeek R1 and 0.45 for Gemini 2.5 Flash, with the highest balanced accuracy and MCC). DeepSeek R1 showed competitive performance in structured reporting (4.0 ± 0.5) and repeatability (3.41 ± 0.06), with stable schema compliance and run-to-run consistency. Gemini 2.5 Flash consistently underperformed, particularly in NER accuracy (3.2 ± 0.7) and diagnostic recall (0.37). Objective analyses further confirmed superior structural completeness, repeatability, and semantic quality of recommendations for GPT-4o compared with the other models.

conclusionGPT-4o consistently outperformed DeepSeek R1 and Gemini 2.5 Flash, supporting its potential to improve knee ultrasound report consistency and clinical utility.

Indexed as

KneeKnee JointLarge Language ModelsHumansRetrospective StudiesUltrasonographyClinical decision supportKnee ultrasonographyLarge language modelsNatural language processingStructured reporting

Identifiers

PMID41772565
PMCPMC13063850

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.