ArticleFrontiers in medicine2026
Evaluating the potential of ChatGPT as an educational decision-support tool for hemodialysis decision-making in nephrology training.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: This study aimed to evaluate the performance of ChatGPT in identifying hemodialysis (HD) indications from authentic nephrology consultation notes and to compare its recommendations with both real-world clinical decisions and expert nephrologist consensus. Methods: This exploratory observational study included 22 anonymized nephrology consultation notes from routine inpatient care at a tertiary care university hospital. Each note was independently evaluated by ChatGPT 5.4 using a standardized zero-shot prompt. The same notes were independently reviewed by three blinded senior academic nephrologists. The majority-vote consensus among these nephrologists was defined as the primary reference standard. Real-world decisions documented by nephrology fellows were evaluated as a secondary comparator. Agreement was assessed using Cohen's kappa coefficient, and inter-rater reliability among nephrologists was evaluated using Fleiss' kappa. Results: Expert consensus classified eight of 22 cases (40.9%) as requiring hemodialysis and 13 (59.1%) as not requiring HD. Inter-rater agreement among the nephrologists was excellent (Fleiss' Conclusion: These exploratory findings suggest that ChatGPT may align more closely with nephrology fellows' decision-making than with senior nephrologists' judgments. The observed discrepancies may reflect differences in how clinical findings were interpreted and incorporated into the overall clinical context. Although ChatGPT cannot replace expert clinical judgment, it may have potential as an educational tool for trainees, encouraging systematic evaluation of HD indications and structured clinical reasoning. Larger, prospective, multicenter studies are needed to confirm these findings and evaluate ChatGPT's educational impact in nephrology training.
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