From Bytes to Best Practices: Tracing ChatGPT-3.5’s Evolution and Alignment With the National Comprehensive Cancer Network® Guidelines in Pancreatic Adenocarcinoma Management

Introduction Artificial intelligence continues to play an increasingly important role in modern health care. ChatGPT-3.5 (OpenAI, San Francisco, CA) has gained attention for its potential impact in this domain. Objective To explore the role of ChatGPT-3.5 in guiding clinical decision-making specifically in the context of pancreatic adenocarcinoma and to assess its growth over a period of time. Participants We reviewed the National Comprehensive Cancer Network® (NCCN) Clinical Practice Guidelines for the Management of Pancreatic Adenocarcinoma and formulated a complex clinical question for each decision-making page. ChatGPT-3.5 was queried in a reproducible fashion. We scored answers on the following Likert scale: 5) Correct; 4) Correct, with missing information requiring clarification; 3) Correct, but unable to complete answer; 2) Partially incorrect; 1) Absolutely incorrect. We repeated this protocol at 3-months. Score frequencies were compared, and subgroup analysis was conducted on Correctness (defined as scores 1-2 vs 3-5) and Accuracy (scores 1-3 vs 4-5). Results In total, 50-pages of the NCCN Guidelines® were analyzed, generating 50 complex clinical questions. On subgroup analysis, the percentage of Acceptable answers improved from 60% to 76%. The score improvement was statistically significant (Mann-Whitney U-test; Mean Rank = 44.52 vs 56.48, P = .027). Conclusion ChatGPT-3.5 represents an interesting but limited tool for assistance in clinical decision-making. We demonstrate that the platform evolved, and its responses to our standardized questions improved over a relatively short period (3-months). Future research is needed to determine the validity of this tool for this clinical application.