Evidence map›Paper›PMID 41941722›Full record

Observational studyJMIR formative research2026

Evaluation of GPT-5 in Periodontitis Staging and Grading: Retrospective Observational Study.

Ihunna Amugo, Katie Lee Frederickson, Harshana Rajakaruna, Hua Xie, Pandu Gangula, Anil Shanker, Qingguo Wang

Abstract readObservational Study
In one paragraph

Observational study in JMIR formative research, 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

5 · Who and what money

Authors and funding

7 authors.

Ihunna Amugo *Department of Oral Diagnostic Sciences (ODS) & Research, School of Dentistry, Meharry Medical College, Nashville, TN, 37208, United States, 1 615-327-6786.ORCID 0009-0006-4087-7415
Katie Lee Frederickson *Department of Biochemistry, Cancer Biology, Neurosciences and Pharmacology, School of Medicine, Meharry Medical College, 1023 21st Ave N, Nashville, TN, 37208, United States.ORCID 0009-0007-9318-6535
Harshana RajakarunaThe Office for Research and Innovation, Meharry Medical College, Nashville, TN, United States.ORCID 0009-0001-5264-2780
Hua XieDepartment of Oral Diagnostic Sciences (ODS) & Research, School of Dentistry, Meharry Medical College, Nashville, TN, 37208, United States, 1 615-327-6786.ORCID 0000-0002-1712-3256
Pandu GangulaDepartment of Oral Diagnostic Sciences (ODS) & Research, School of Dentistry, Meharry Medical College, Nashville, TN, 37208, United States, 1 615-327-6786.ORCID 0000-0001-7259-570X
Anil ShankerDepartment of Biochemistry, Cancer Biology, Neurosciences and Pharmacology, School of Medicine, Meharry Medical College, 1023 21st Ave N, Nashville, TN, 37208, United States.ORCID 0000-0001-6372-3669
Qingguo WangDepartment of Biochemistry, Cancer Biology, Neurosciences and Pharmacology, School of Medicine, Meharry Medical College, 1023 21st Ave N, Nashville, TN, 37208, United States.ORCID 0000-0002-5125-3724

Funding

AIM-AHEAD Coordinating Center - All Four CoresOT2OD032581 · OD · UNIVERSITY OF NORTH TEXAS HLTH SCI CTR · PI Paul Avillach, Bettina M. Beech · 2021 to 2026
$168.7M
The RCMI Program in Health Disparities Research at Meharry Medical College - SupplementU54MD007586 · NIMHD · MEHARRY MEDICAL COLLEGE · PI Samuel Evans Adunyah · 2017 to 2026
$48.2M
Multidisciplinary Practice-Based Research Training in Meharry Medical College, School of DentistryU01DE033241 · NIDCR · MEHARRY MEDICAL COLLEGE · PI PANDU R GANGULA · 2023 to 2026
$2.3M
Diversity Center for Genome Research at MeharryUG3HG013248 · NHGRI · MEHARRY MEDICAL COLLEGE · PI SHANKER, ANIL · 2023 to 2023
$866k
Development and characterization of anti-P. gingivalis peptidesR16GM149359 · NIGMS · MEHARRY MEDICAL COLLEGE · PI Qingguo Wang · 2023 to 2026
$582k
NHGRI NIH HHS UG3 HG013248NIDCR NIH HHS U01 DE033241NIGMS NIH HHS R16 GM149359NIH HHS OT2 OD032581NIMHD NIH HHS U54 MD007586
6 · The paper itself

Abstract

Background: Periodontitis is a chronic gum disease affecting approximately 42% of adults aged 30 years and older in the United States. Training dental students to accurately diagnose and manage periodontitis is a critical component of dental education and clinical care. Recent advances in large language models offer new opportunities to support both domains, yet their performance in periodontal diagnosis remains largely unexplored, particularly for newer models such as GPT-5. Objective: This study conducted an exploratory evaluation of GPT-5's ability to stage and grade periodontitis. Methods: A total of 25 publicly available clinical cases explicitly reporting periodontitis stage and grade were identified through Google and PubMed searches. Each case description was entered into GPT-5 using a zero-shot prompting approach to assess guideline-based reasoning without exemplar conditioning. The model's predictions were compared with the published reference diagnoses. Performance was measured using accuracy, 95% CI, unweighted Cohen κ, and weighted Cohen κ. Results: Across these cases, GPT-5 showed marked class-dependent performance and a tendency to overestimate disease severity. Grading performance was notably imbalanced, with high recall for grade C but substantially lower discrimination for grade B. GPT-5 achieved a staging accuracy of 68% (95% CI 48.4%-82.8%) and a grading accuracy of 77.3% (95% CI 56.6%-89.9%), with corresponding Cohen κ values of 0.454 (95% CI 11.0%-75.6%) and 0.179 (95% CI -15.8% to 63.8%), respectively. While staging performance showed fair agreement beyond chance, the low κ for grading indicates poor agreement and limited reliability in distinguishing periodontal disease severity. Conclusions: These findings suggest that although GPT-5 demonstrates potential for guideline-based periodontitis staging and grading, its current diagnostic performance, particularly for periodontitis grading, limits its use in clinical assessment and educational training. Meaningful application in periodontal diagnosis and training will require substantial improvements in reliability and rigorous validation in larger, more diverse, and prospectively collected datasets.

Indexed as

PeriodontitisAdultHumansLarge Language ModelsRetrospective StudiesSeverity of Illness IndexChatGPTdental caredental educationGPT-5large language modelperiodontitisperiodontitis staging and grading

Identifiers

PMID41941722
PMCPMC13052999

What OpenQuestion holds

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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.