ChatGPT-4 Consistency in Interpreting Laryngeal Clinical Images of Common Lesions and Disorders

ObjectiveTo investigate the consistency of Chatbot Generative Pretrained Transformer (ChatGPT)-4 in the analysis of clinical pictures of common laryngological conditions.Study DesignProspective uncontrolled study.SettingMulticenter study.MethodsPatient history and clinical videolaryngostroboscopic images were presented to ChatGPT-4 for differential diagnoses, management, and treatment(s). ChatGPT-4 responses were assessed by 3 blinded laryngologists with the artificial intelligence performance instrument (AIPI). The complexity of cases and the consistency between practitioners and ChatGPT-4 for interpreting clinical images were evaluated with a 5-point Likert Scale. The intraclass correlation coefficient (ICC) was used to measure the strength of interrater agreement.ResultsForty patients with a mean complexity score of 2.60 +/- 1.15. were included. The mean consistency score for ChatGPT-4 image interpretation was 2.46 +/- 1.42. ChatGPT-4 perfectly analyzed the clinical images in 6 cases (15%; 5/5), while the consistency between GPT-4 and judges was high in 5 cases (12.5%; 4/5). Judges reported an ICC of 0.965 for the consistency score (P = .001). ChatGPT-4 erroneously documented vocal fold irregularity (mass or lesion), glottic insufficiency, and vocal cord paralysis in 21 (52.5%), 2 (0.05%), and 5 (12.5%) cases, respectively. ChatGPT-4 and practitioners indicated 153 and 63 additional examinations, respectively (P = .001). The ChatGPT-4 primary diagnosis was correct in 20.0% to 25.0% of cases. The clinical image consistency score was significantly associated with the AIPI score (rs = 0.830; P = .001).ConclusionThe ChatGPT-4 is more efficient in primary diagnosis, rather than in the image analysis, selecting the most adequate additional examinations and treatments.