Challenging ChatGPT 3.5 in Senology-An Assessment of Concordance with Breast Cancer Tumor Board Decision Making

With the recent diffusion of access to publicly available large language models (LLMs), common interest in generative artificial-intelligence-based applications for medical purposes has skyrocketed. The increased use of these models by tech-savvy patients for personal health issues calls for a scientific evaluation of whether LLMs provide a satisfactory level of accuracy for treatment decisions. This observational study compares the concordance of treatment recommendations from the popular LLM ChatGPT 3.5 with those of a multidisciplinary tumor board for breast cancer (MTB). The study design builds on previous findings by combining an extended input model with patient profiles reflecting patho- and immunomorphological diversity of primary breast cancer, including primary metastasis and precancerous tumor stages. Overall concordance between the LLM and MTB is reached for half of the patient profiles, including precancerous lesions. In the assessment of invasive breast cancer profiles, the concordance amounts to 58.8%. Nevertheless, as the LLM makes considerably fraudulent decisions at times, we do not identify the current development status of publicly available LLMs to be adequate as a support tool for tumor boards. Gynecological oncologists should familiarize themselves with the capabilities of LLMs in order to understand and utilize their potential while keeping in mind potential risks and limitations.

Automated summary

The recent availability of large language models (LLMs) has sparked interest in using artificial intelligence for medical purposes. This study compares the treatment recommendations of the LLM ChatGPT 3.5 with those of a tumor board for breast cancer. The results show that while there is some agreement between the LLM and the tumor board, there are also significant discrepancies, raising concerns about the reliability of publicly available LLMs for medical decision-making.