Comparative analysis of ChatGPT-4o mini, ChatGPT-4o and Gemini Advanced in the treatment of postmenopausal osteoporosis

BACKGROUND: Osteoporosis is a sex-specific disease. Postmenopausal osteoporosis (PMOP) has been the focus of public health research worldwide. The purpose of this study is to evaluate the quality and readability of artificial intelligence large-scale language models (AI-LLMs): ChatGPT-4o mini, ChatGPT-4o and Gemini Advanced for responses generated in response to questions related to PMOP. METHODS: We collected 48 PMOP frequently asked questions (FAQs) through offline counseling and online medical community forums. We also prepared 24 specific questions about PMOP based on the Management of Postmenopausal Osteoporosis: 2022 ACOG Clinical Practice Guideline No. 2 (2022 ACOG-PMOP Guideline). In this project, the FAQs were imported into the AI-LLMs (ChatGPT-4o mini, ChatGPT-4o, Gemini Advanced) and randomly assigned to four professional orthopedic surgeons, who independently rated the satisfaction of each response via a 5-point Likert scale. Furthermore, a Flesch Reading Ease (FRE) score was calculated for each of the LLMs' responses to assess the readability of the text generated by each LLM. RESULTS: When it comes to addressing questions related to PMOP and the 2022 ACOG-PMOP guidelines, ChatGPT-4o and Gemini Advanced provide more concise answers than ChatGPT-4o mini. In terms of the overall FAQs of PMOP, ChatGPT-4o has a significantly higher accuracy rate than ChatGPT-4o mini and Gemini Advanced. When answering questions related to the 2022 ACOG-PMOP guidelines, ChatGPT-4o mini vs. ChatGPT-4o have significantly higher response accuracy than Gemini Advanced. ChatGPT-4o mini, ChatGPT-4o, and Gemini Advanced all have good levels of self-correction. CONCLUSIONS: Our research shows that Gemini Advanced and ChatGPT-4o provide more concise and intuitive answers. ChatGPT-4o responds better in answering frequently asked questions related to PMOP. When answering questions related to the 2022 ACOG-PMOP guidelines, ChatGPT-4o mini and ChatGPT-4o responded significantly better than Gemini Advanced. ChatGPT-4o mini, ChatGPT-4o, and Gemini Advanced have demonstrated a strong ability to self-correct. CLINICAL TRIAL NUMBER: Not applicable.