Performance of an Artificial Intelligence Chatbot in Ophthalmic Knowledge Assessment

Abstract

ImportanceChatGPT is an artificial intelligence (AI) chatbot that has significant societal implications. Training curricula using AI are being developed in medicine, and the performance of chatbots in ophthalmology has not been characterized.ObjectiveTo assess the performance of ChatGPT in answering practice questions for board certification in ophthalmology.Design, Setting, and ParticipantsThis cross-sectional study used a consecutive sample of text-based multiple-choice questions provided by the OphthoQuestions practice question bank for board certification examination preparation. Of 166 available multiple-choice questions, 125 (75%) were text-based.ExposuresChatGPT answered questions from January 9 to 16, 2023, and on February 17, 2023.Main Outcomes and MeasuresOur primary outcome was the number of board certification examination practice questions that ChatGPT answered correctly. Our secondary outcomes were the proportion of questions for which ChatGPT provided additional explanations, the mean length of questions and responses provided by ChatGPT, the performance of ChatGPT in answering questions without multiple-choice options, and changes in performance over time.ResultsIn January 2023, ChatGPT correctly answered 58 of 125 questions (46%). ChatGPT’s performance was the best in the category general medicine (11/14; 79%) and poorest in retina and vitreous (0%). The proportion of questions for which ChatGPT provided additional explanations was similar between questions answered correctly and incorrectly (difference, 5.82%; 95% CI, −11.0% to 22.0%; χ21 = 0.45; P = .51). The mean length of questions was similar between questions answered correctly and incorrectly (difference, 21.4 characters; SE, 36.8; 95% CI, −51.4 to 94.3; t = 0.58; df = 123; P = .22). The mean length of responses was similar between questions answered correctly and incorrectly (difference, −80.0 characters; SE, 65.4; 95% CI, −209.5 to 49.5; t = −1.22; df = 123; P = .22). ChatGPT selected the same multiple-choice response as the most common answer provided by ophthalmology trainees on OphthoQuestions 44% of the time. In February 2023, ChatGPT provided a correct response to 73 of 125 multiple-choice questions (58%) and 42 of 78 stand-alone questions (54%) without multiple-choice options.Conclusions and RelevanceChatGPT answered approximately half of questions correctly in the OphthoQuestions free trial for ophthalmic board certification preparation. Medical professionals and trainees should appreciate the advances of AI in medicine while acknowledging that ChatGPT as used in this investigation did not answer sufficient multiple-choice questions correctly for it to provide substantial assistance in preparing for board certification at this time.

Performance of an Upgraded Artificial Intelligence Chatbot for Ophthalmic Knowledge Assessment

“…In this study, we found that the newer version of the chatbot, ChatGPT-4, responded correctly to 84% of multiple-choice practice questions on OphthoQuestions, which is commonly used in preparing for the board certification examination. This study expanded on recent work, which found that the previous version of this chatbot correctly answered 46% of the same multiple-choice questions in January 2023 and 58% in February 2023 . Performance of the updated version of this chatbot across all question categories on OphthoQuestions appeared to improve compared with the performance of the previous version .…”

“…We asked ChatGPT-4 (March 2023 release; OpenAI) the same practice questions for the Ophthalmic Knowledge Assessment Program (OKAP) and Written Qualifying Exam (WQE) tests from the free OphthoQuestions trial, per the methods outlined in our previous study . In accordance with the Common Rule (6 CFR Part 46), this cross-sectional study was exempt from ethics review and informed consent because it was not considered human participant research.…”

“…Artificial intelligence (AI) chatbots have been shown to produce humanlike responses to virtually any prompt . A recent study found that the older version of a popular chatbot correctly answered approximately half of the multiple-choice questions in the free OphthoQuestions trial used to prepare for the American Board of Ophthalmology board certification examination . In this study, we updated our previous investigation by assessing the accuracy of an updated version of this chatbot in responding to practice questions for the ophthalmology board certification examination.…”

Exploring the Test-Taking Capabilities of Chatbots—From Surgeon to Sommelier

“…In March 2023, OpenAI unveiled the latest iteration of the chatbot, which is built on the generative pretrained transformer (GPT)–4 architecture. In JAMA Ophthalmology , Mihalache et al examine the performance of the updated version of this chatbot on a question bank designed to help candidates prepare for ophthalmology board examinations, building on previous work evaluating the older GPT-3.5 architecture …”

“…In JAMA Ophthalmology, Mihalache et al 2 examine the performance of the updated version of this chatbot on a question bank designed to help candidates prepare for ophthalmology board examinations, building on previous work evaluating the older GPT-3.5 architecture. 3 The use of professional examinations for benchmarking AI chatbot performance is well established. Both ChatGPT and Google's Med-PaLM made headlines when they successfully passed the written components of the United States Medical Licensing Examination.…”