Evidence map›Paper›PMID 42164630›Full record

ArticleJournal of pathology informatics2026

How does AI perform compared to human expert panels in medical Delphi studies? A pilot study through the lens of pathology.

Joshua Pantanowitz, Christopher D Manko, John Majewski, M Alvaro Berbís, Alton B Farris, Aly Karsan, Andrey Bychkov, Antonio Luna, Bethany Williams, Brett Delahunt and 21 more

Erratum issuedAbstract read
In one paragraph

Article in Journal of pathology informatics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

31 authors.

Joshua PantanowitzUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Christopher D MankoGeisinger Commonwealth School of Medicine, Scranton, PA, USA.
John MajewskiDepartment of Internal Medicine, Wexner Medical Center, The Ohio State University College of Medicine, Columbus, OH, USA.
M Alvaro BerbísDepartment of R&D, HT Médica, San Juan de Dios Hospital, Córdoba, Spain.
Alton B FarrisDepartment of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
Aly KarsanDepartment of Pathology & Laboratory Medicine, University of British Columbia, BC Cancer Research Institute, Vancouver, Canada.
Andrey BychkovDepartment of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan.
Antonio LunaDepartment of Integrated Diagnostics, HT Médica, Clínica Las Nieves, Jaén, Spain.
Bethany WilliamsDepartment of Histopathology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Brett DelahuntMalaghan Institute of Medical Research, Wellington, New Zealand.
Catarina EloyPathology Laboratory, Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.
David S McClintockDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Eva HollemansDepartment of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands.
J Mark TuthillPathology Informatics, Department of Pathology, Henry Ford Hospital, Detroit, MI, USA.
Jeroen Van der LaakDepartment of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands.
Jerome Y ChengDepartment of Pathology, University of Michigan, Ann Arbor, MI, USA.
Jochen K LennerzBostonGene, Waltham, MA, USA.
John H SinardDepartment of Pathology, Yale University School of Medicine, New Haven, CT, USA.
Jose Aneiros-FernandezDepartment of R&D, HT Médica, San Juan de Dios Hospital, Córdoba, Spain.
Julien CalderaroDepartment of Pathology, Henri Mondor-Albert Chenevier University Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France.
Kenneth A IczkowskiDepartment of Pathology and Laboratory Medicine, University of California Davis Health, Sacramento, CA, USA.
Lars EgevadDepartment of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
Mark KriegsmannCenter for Histology, Cytology and Molecular Pathology Wiesbaden, Wiesbaden, Germany.
Markus D HerrmannF. Hoffmann-La Roche Ltd, Basel, Switzerland.
Mohamed E SalamaDepartment of Pathology, Sonic Healthcare, Austin, TX, USA.
Raimundo Garcia Del MoralDepartment of Pathological Anatomy and History of Science, University of Granada, and Institute of Biosanitary Research of Granada (ibs.GRANADA), Granada, Spain.
S Joseph SirintrapunDepartment of Pathology, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
Colleen VrbinAnalytical Insights LLC, Allison Park, PA, USA.
Liron PantanowitzComputational Pathology and AI Center of Excellence, Department of Pathology, University of Pittsburgh Medical Center and School of Medicine, Pittsburgh, PA, USA.
Jeanne ShenDepartment of Pathology and Center for Artificial Intelligence in Medicine & Imaging, Stanford University School of Medicine, Stanford, CA, USA.
Hooman RashidiComputational Pathology and AI Center of Excellence, Department of Pathology, University of Pittsburgh Medical Center and School of Medicine, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Since their inception, Delphi studies have been a key part of medical literature. They consist of an expert panel tasked with coming to consensus on answers to various questions where obtaining objective results is difficult or impossible, with ranked responses based on a Likert scale. The ability of artificial intelligence (AI), particularly large language models (LLMs), to perform this role traditionally assigned to a panel of experts has been scarcely explored in medicine. This study accordingly aimed to explore the feasibility of an "AI-run" Delphi study applied to the practice of pathology. Methods: A prior human-based Delphi study (PMID: 36603288) employed to forecast the future role of AI in pathology was repeated, but this time with LLMs (Llama 3, ChatGPT-4, and ChatGPT-3.5 based on availability at the time of the study). This was done at various temperature settings (0, 0.7, and 1.0), a measurement of how much an LLM prioritizes determinism versus creativity. Low temperature caused the models to be more deterministic and focused, whereas high temperature increased creativity. "Delphi-GPT" was created to automate prompts that entailed 5 trials for 180 questions, leading to data that were compared to the original human expert panel. Findings: All LLM and temperature combinations were able to reach consensus for a greater percentage of the 180 questions posed than human experts. Newer ChatGPT-4 and Llama 3 models performed better than ChatGPT-3.5. Whereas AI models and human experts did not always agree, the amount of agreement increased when the temperature setting was increased across all LLMs. Interpretation: LLMs are shown here to successfully be able to simulate a Delphi study in medicine. The data show that generative AI models were consistently able to reach greater degrees of consensus than human experts in their responses to 180 prompts related to the future practice of pathology. This serves as a proof-of-concept that one day, pending further robust methodological validation, AI could even serve as a surrogate for de novo Delphi studies that ordinarily would have relied on feedback from a panel of experts. The reliability of consensus/concordance achieved will depend upon the combination of LLM and temperature setting selected.

Indexed as

Artificial intelligenceDelphi studyLarge language modelMedicinePathologyTemperature setting

Identifiers

PMID42164630
PMCPMC13185839

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.