Exploring ChatGPT’s potential in diagnosing oral and maxillofacial pathologies: a study of 123 challenging cases

Abstract

This study aimed to evaluate the diagnostic performance of ChatGPT-4o, a large language model developed by OpenAI, in challenging cases of oral and maxillofacial diseases presented in the Clinicopathologic Conference section of the journal Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology. A total of 123 diagnostically challenging oral and maxillofacial cases published in the aforementioned journal were retrospectively collected. The case presentations, which included detailed clinical, radiographic, and sometimes histopathologic descriptions, were input into ChatGPT-4o. The model was prompted to provide a single most likely diagnosis for each case. These outputs were then compared to the final diagnoses established by expert consensus in each original case report. The accuracy of ChatGPT-4o was calculated based on exact diagnostic matches. ChatGPT-4o correctly diagnosed 96 out of 123 cases, achieving an overall diagnostic accuracy of 78%. Nevertheless, even in cases where the exact diagnosis was not provided, the model often suggested one of the clinically reasonable differential diagnoses. ChatGPT-4o demonstrates a promising ability to assist in the diagnostic process of complex maxillofacial conditions, with a relatively high accuracy rate in challenging cases. While it is not a replacement for expert clinical judgment, large language models may offer valuable decision support in oral and maxillofacial radiology, particularly in educational or consultative contexts. Not applicable.

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