A cross-sectional comparative study: ChatGPT 3.5 versus diverse levels of medical experts in the diagnosis of ENT diseases.

PURPOSE: With recent advances in artificial intelligence (AI), it has become crucial to thoroughly evaluate its applicability in healthcare. This study aimed to assess the accuracy of ChatGPT in diagnosing ear, nose, and throat (ENT) pathology, and comparing its performance to that of medical experts. METHODS: We conducted a cross-sectional comparative study where 32 ENT cases were presented to ChatGPT 3.5, ENT physicians, ENT residents, family medicine (FM) specialists, second-year medical students (Med2), and third-year medical students (Med3). Each participant provided three differential diagnoses. The study analyzed diagnostic accuracy rates and inter-rater agreement within and between participant groups and ChatGPT. RESULTS: The accuracy rate of ChatGPT was 70.8%, being not significantly different from ENT physicians or ENT residents. However, a significant difference in correctness rate existed between ChatGPT and FM specialists (49.8%, p < 0.001), and between ChatGPT and medical students (Med2 47.5%, p < 0.001; Med3 47%, p < 0.001). Inter-rater agreement for the differential diagnosis between ChatGPT and each participant group was either poor or fair. In 68.75% of cases, ChatGPT failed to mention the most critical diagnosis. CONCLUSIONS: ChatGPT demonstrated accuracy comparable to that of ENT physicians and ENT residents in diagnosing ENT pathology, outperforming FM specialists, Med2 and Med3. However, it showed limitations in identifying the most critical diagnosis.

CT Scan in Children Suspected of Foreign Body Aspiration: A Systematic Review and Meta-analysis.

OBJECTIVE: The goal of this study is to evaluate the sensitivity and specificity of computed tomography (CT) scans in the diagnosis of foreign body aspiration (FBA) in children, and to determine whether chest CT scans would reduce the need for diagnostic rigid bronchoscopies. DATA SOURCES: MEDLINE, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for relevant articles and conference proceedings that were published in English through November 1, 2022. REVIEW METHODS: We included prospective and retrospective studies comparing chest CT scans and rigid bronchoscopy for the diagnosis of FBA in pediatric patients (<16 years old). The pooled estimates of the sensitivity and specificity of the chest CT scan in the diagnosis of FBA were calculated using a fixed- or common-effects analysis and a random-effects analysis that accounts for heterogeneity if present. Forest plots were constructed to combine the evidence identified during the systematic review. RESULTS: Eighteen articles (4178 patients) were included. The average age of the children was 2.26 (±0.75) years, and 65% (±5.64%) of them were boys. Cough was the most prevalent symptom upon presentation. The pooled analysis showed that the sensitivity of chest CT scan in detecting a foreign body in children was 99% (95% confidence interval, CI [97, 100]; I2 = 72%, τ2 = 0.0065, p < .01). The false negative rate was 1.8% (95% CI [0.3, 2.7]; I2 = 72%, p < .01). The specificity of chest CT scan was 92% (95% CI [83, 98]; I2 = 83%, τ2 = 0.0437, p < .01). CONCLUSIONS: Chest CT scan is a sensitive and specific test for the diagnosis of FBA in the pediatric population. Its use can help to reduce unnecessary rigid bronchoscopies, especially in patients with a low clinical suspicion of aspiration. It should not be a replacement for the gold standard bronchoscopy, particularly in cases where there is a clear history and symptoms suggestive of aspiration.