Performance of Novel GPT-4 in Otolaryngology Knowledge Assessment

Purpose GPT-4, recently released by OpenAI, improves upon GPT-3.5 with increased reliability and expanded capabilities, including user-specified, customizable GPT-4 models. This study aims to investigate updates in GPT-4 performance vs. GPT-3.5 on Otolaryngology board-style questions. Methods 150 Otolaryngology board-style questions were obtained from the BoardVitals question bank. These questions, which were previously assessed with GPT-3.5, were inputted into standard GPT-4 and a custom GPT-4 model designed to specialize in Otolaryngology board-style questions, emphasize precision, and provide evidence-based explanations. Results Standard GPT-4 correctly answered 72.0% and custom GPT-4 correctly answered 81.3% of the questions, vs. GPT-3.5 which answered 51.3% of the same questions correctly. On multivariable analysis, custom GPT-4 had higher odds of correctly answering questions than standard GPT-4 (adjusted odds ratio 2.19, P = 0.015). Both GPT-4 and custom GPT-4 demonstrated a decrease in performance between questions rated as easy and hard ( P < 0.001). Conclusions Our study suggests that GPT-4 has higher accuracy than GPT-3.5 in answering Otolaryngology board-style questions. Our custom GPT-4 model demonstrated higher accuracy than standard GPT-4, potentially as a result of its instructions to specialize in Otolaryngology board-style questions, select exactly one answer, and emphasize precision. This demonstrates custom models may further enhance utilization of ChatGPT in medical education.