Key result
ChatGPT-3.5 correctly identified the true ocular pathology as its first differential diagnosis in 51% of cases, with diagnostic accuracy significantly improving in neuro-ophthalmology when additional risk factors were provided.
Why the study?
ChatGPT-3.5 has the potential to assist ophthalmologists by generating a differential diagnosis based on patient presentation.
Does ChatGPT-3.5 accurately generate differential diagnoses for ocular pathologies based on clinical vignettes?
Does ChatGPT-3.5 accurately generate differential diagnoses for ocular pathologies based on clinical vignettes?
ChatGPT-3.5 can assist in generating differential diagnoses for ocular pathologies, and its accuracy improves with the addition of patient-specific risk factors, though it cannot replace clinical decision-making.
Purpose: ChatGPT-3.5 has the potential to assist ophthalmologists by generating a differential diagnosis based on patient presentation. Methods: One hundred ocular pathologies were tested. Each pathology had two signs and two symptoms prompted into ChatGPT-3.5 through a clinical vignette template to generate a list of four preferentially ordered differential diagnoses, denoted as Method A. Thirty of the original 100 pathologies were further subcategorized into three groups of 10: cornea, retina, and neuroophthalmology. To assess whether additional clinical information affected the accuracy of results, these subcategories were again prompted into ChatGPT-3.5 with the same previous two signs and symptoms, along with additional risk factors of age, sex, and past medical history, denoted as Method B. A one-tailed Wilcoxon signed-rank test was performed to compare the accuracy between Methods A and B across each subcategory (significance indicated by P < 0.05). Results: ChatGPT-3.5 correctly diagnosed 51 out of 100 cases (51.00%) as its first differential diagnosis and 18 out of 100 cases (18.00%) as a differential other than its first diagnosis. However, 31 out of 100 cases (31.00%) were not included in the differential diagnosis list. Only the subcategory of neuro-ophthalmology showed a significant increase in accuracy (P = 0.01) when prompted with the additional risk factors (Method B) compared to only two signs and two symptoms (Method A). Conclusion: These results demonstrate that ChatGPT-3.5 may help assist clinicians in suggesting possible diagnoses based on varying complex clinical information. However, its accuracy is limited, and it cannot be utilized as a replacement for clinical decision-making.
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Cayenne et al. (2025) studied Ocular pathologies (n=100). ChatGPT-3.5 was evaluated on Correct diagnosis as the first differential diagnosis. ChatGPT-3.5 correctly identified the true ocular pathology as its first differential diagnosis in 51% of cases, with diagnostic accuracy significantly improving in neuro-ophthalmology when additional risk factors were provided.
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