GPT-4 was released in March 2023 in limited form to paid users, specifically claiming to have improved advanced reasoning capabilities over GPT-3.5.
In a follow-up study, GPT-4 answered 81% (121 of 150) of the same questions correctly, outperforming GPT-3.5 and exceeding the passing threshold of 70%. GPT-4 performed much better than GPT-3.5 on higher-order thinking questions (81%), more specifically those involving description of imaging findings (85%) and application of concepts (90%).
The findings suggest that GPT-4’s claimed improved advanced reasoning capabilities translate to enhanced performance in a radiology context. They also suggest improved contextual understanding of radiology-specific terminology, including imaging descriptions, which is critical to enable future downstream applications.
“Our study demonstrates an impressive improvement in performance of ChatGPT in radiology over a short time period, highlighting the growing potential of large language models in this context,” Dr. Bhayana said.
GPT-4 showed no improvement on lower-order thinking questions (80% vs 84%) and answered 12 questions incorrectly that GPT-3.5 answered correctly, raising questions related to its reliability for information gathering.
“We were initially surprised by ChatGPT’s accurate and confident answers to some challenging radiology questions, but then equally surprised by some very illogical and inaccurate assertions,” Dr. Bhayana said. “Of course, given how these models work, the inaccurate responses should not be particularly surprising.”
ChatGPT’s dangerous tendency to produce inaccurate responses, termed hallucinations, is less frequent in GPT-4 but still limits usability in medical education and practice at present.
Both studies showed that ChatGPT used confident language consistently, even when incorrect. This is particularly dangerous if solely relied on for information, Dr. Bhayana notes, especially for novices who may not recognize confident incorrect responses as inaccurate.
“To me, this is its biggest limitation. At present, ChatGPT is best used to spark ideas, help start the medical writing process and in data summarization. If used for quick information recall, it always needs to be fact-checked,” Dr. Bhayana said.
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