Artificial Versus Human Intelligence in the Diagnostic Approach of Ophthalmic Case Scenarios: A Qualitative Evaluation of Performance and Consistency

Abstract

Purpose: To evaluate the efficiency of three artificial intelligence (AI) chatbots (ChatGPT-3.5 (OpenAI, San Francisco, California, United States), Bing Copilot (Microsoft Corporation, Redmond, Washington, United States), Google Gemini (Google LLC, Mountain View, California, United States)) in assisting the ophthalmologist in the diagnostic approach and management of challenging ophthalmic cases and compare their performance with that of a practicing human ophthalmic specialist. The secondary aim was to assess the short- and medium-term consistency of ChatGPT’s responses. Methods: Eleven ophthalmic case scenarios of variable complexity were presented to the AI chatbots and to an ophthalmic specialist in a stepwise fashion. Advice regarding the initial differential diagnosis, the final diagnosis, further investigation, and management was asked for. One month later, the same process was repeated twice on the same day for ChatGPT only. Results: The individual diagnostic performance of all three AI chatbots was inferior to that of the ophthalmic specialist; however, they provided useful complementary input in the diagnostic algorithm. This was especially true for ChatGPT and Bing Copilot. ChatGPT exhibited reasonable short- and medium-term consistency, with the mean Jaccard similarity coefficient of responses varying between 0.58 and 0.76. Conclusion: AI chatbots may act as useful assisting tools in the diagnosis and management of challenging ophthalmic cases; however, their responses should be scrutinized for potential inaccuracies, and by no means can they replace consultation with an ophthalmic specialist.