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Background The latest large language models (LLMs) solve unseen problems via user-defined text prompts without the need for retraining, offering potentially more efficient information extraction from free-text medical records than manual annotation. Purpose To compare the performance of the LLMs ChatGPT and GPT-4 in data mining and labeling oncologic phenotypes from free-text CT reports on lung cancer by using user-defined prompts. Materials and Methods This retrospective study included patients who underwent lung cancer follow-up CT between September 2021 and March 2023. A subset of 25 reports was reserved for prompt engineering to instruct the LLMs in extracting lesion diameters, labeling metastatic disease, and assessing oncologic progression. This output was fed into a rule-based natural language processing pipeline to match ground truth annotations from four radiologists and derive performance metrics. The oncologic reasoning of LLMs was rated on a five-point Likert scale for factual correctness and accuracy. The occurrence of confabulations was recorded. Statistical analyses included Wilcoxon signed rank and McNemar tests. Results On 424 CT reports from 424 patients (mean age, 65 years ± 11 SD; 265 male), GPT-4 outperformed ChatGPT in extracting lesion parameters (98.6% vs 84.0%, P P P P Supplemental material is available for this article. See also the editorial by Hafezi-Nejad and Trivedi in this issue.
Fink et al. (Fri,) studied this question.