Cited by 640Artificial Intelligence in Healthcare and EducationExplainable Artificial Intelligence (XAI)Radiology practices and education

The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index; none of the 30 sources its claims cite is checked for support yet.

ChatGPT makes medicine easy to swallow: an exploratory case study on simplified radiology reports

Open access

Abstract

Objectives: To assess the quality of simplified radiology reports generated with the large language model (LLM) ChatGPT and to discuss challenges and chances of ChatGPT-like LLMs for medical text simplification. Methods: In this exploratory case study, a radiologist created three fictitious radiology reports which we simplified by prompting ChatGPT with “Explain this medical report to a child using simple language.” In a questionnaire, we tasked 15 radiologists to rate the quality of the simplified radiology reports with respect to their factual correctness, completeness, and potential harm for patients. We used Likert scale analysis and inductive free-text categorization to assess the quality of the simplified reports. Results: Most radiologists agreed that the simplified reports were factually correct, complete, and not potentially harmful to the patient. Nevertheless, instances of incorrect statements, missed relevant medical information, and potentially harmful passages were reported. Conclusion: While we see a need for further adaption to the medical field, the initial insights of this study indicate a tremendous potential in using LLMs like ChatGPT to improve patient-centered care in radiology and other medical domains. Clinical relevance statement: Patients have started to use ChatGPT to simplify and explain their medical reports, which is expected to affect patient-doctor interaction. This phenomenon raises several opportunities and challenges for clinical routine. Key Points: • Patients have started to use ChatGPT to simplify their medical reports, but their quality was unknown. • In a questionnaire, most participating radiologists overall asserted good quality to radiology reports simplified with ChatGPT. However, they also highlighted a notable presence of errors, potentially leading patients to draw harmful conclusions. • Large language models such as ChatGPT have vast potential to enhance patient-centered care in radiology and other medical domains. To realize this potential while minimizing harm, they need supervision by medical experts and adaption to the medical field. Graphical Abstract:

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

In this exploratory case study, ChatGPT was prompted to simplify three fictitious radiology reports, and 15 radiologists generally rated the outputs as factually correct, complete, and not potentially harmful. However, they also identified incorrect statements, missing relevant information, and potentially harmful passages in a considerable number of simplified reports.

Key findings

  • Across all 45 simplified reports, median ratings were 2 (“Agree”) for factual correctness and completeness, and 4 (“Disagree”) for potential harm; no radiologist selected “Strongly disagree” for correctness/completeness, and none selected “Strongly agree” for potential harm.
  • Free-text review found incorrect text passages in 23/45 simplified reports (51%), missing relevant medical information in 10/45 (22%), and potentially harmful conclusions in 16/45 (36%).
  • Error categories included misinterpretation of medical terms (e.g., “DD”/differential diagnosis mistaken as final diagnosis; “thyroid struma” described as “infection in their thyroid gland” or “extra thyroid gland”), hallucinations (e.g., “no signs of cancer in the thyroid gland”; “brain does not seem to be damaged”), imprecise language, odd language, unmentioned findings, and unspecific location information.
  • The Oncol. CT report had the highest mean factual-correctness rating (2.5, SD 1.1) and potential-harm mean 3.3 (SD 1.1); Head MRI had a slightly lower potential-harm median (3) than Knee MRI and Oncol. CT (both median 4).

Methods

  • Prospective exploratory case study using three fictitious radiology reports (Knee MRI, Head MRI, Oncol. CT) written by a radiologist with 10 years of experience and intended to be of intermediate complexity.
  • The ChatGPT online interface (version December 15th, 2022) was prompted with “Explain this medical report to a child using simple language:” followed by the original report; the model was restarted and prompted 15 times per report, generating 45 simplified reports.
  • Fifteen radiologists with median experience of 5 years (IQR [1–10]) rated one randomly selected simplified version per original report on 5-point Likert scales for factual correctness, completeness, and potential harm, with free-text follow-up; analysis used descriptive statistics and inductive categorization.

Limitations

  • Stated: small number of original reports (n = 3) and experts (n = 15); fictitious reports were written to represent intermediate medical complexity and translated to English by a non-native-speaking radiologist; only one prompt phrasing was used after heuristic selection; the study did not measure the quality of simplification.
  • Evident: the radiologist sample came from a single clinic (“from our clinic”), and ChatGPT outputs were non-deterministic, while each questionnaire included only one randomly selected simplified version per original report.
  • Evident: the study used fictitious reports and no patient information, so it does not validate performance on real clinical reports or patient outcomes.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s00330-023-10213-1

Cites

24 of 24 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Fig. 1 Prompting ChatGPT to simplify a radiology report of an oncological CT results in different responses each time. Even when responses sound plausible, the content does not need to be true. The response on the top correctly simplifies the term “thyroid struma,” while the response on the bottom fails to give a correct simplification
Fig. 1 Prompting ChatGPT to simplify a radiology report of an oncological CT results in different responses each time. Even when responses sound plausible, the content does not need to be true. The response on the top correctly simplifies the term “thyroid struma,” while the response on the bottom fails to give a correct simplificationCC BY · PubMed Central
Fig. 2 Summary of our workflow: After the creation of three fictitious radiology reports, ChatGPT is prompted to generate multiple simplified reports. Radiologists are then tasked to assess their quality in a questionnaire. Lastly, the obtained data is analyzed and evaluated
Fig. 2 Summary of our workflow: After the creation of three fictitious radiology reports, ChatGPT is prompted to generate multiple simplified reports. Radiologists are then tasked to assess their quality in a questionnaire. Lastly, the obtained data is analyzed and evaluatedCC BY · PubMed Central
Fig. 3 Frequency of the radiologists’ ratings for all 45 simplified reports grouped by rating category. a Absolute frequency of ratings for all reports combined. b Absolute frequency of ratings additionally grouped by original report
Fig. 3 Frequency of the radiologists’ ratings for all 45 simplified reports grouped by rating category. a Absolute frequency of ratings for all reports combined. b Absolute frequency of ratings additionally grouped by original reportCC BY · PubMed Central

Verification

Claims the paper makes

25 Own result · 10 Not checked yet · 7 Own interpretation · 6 Own method · 1 No basis given

Verify all 30 references — free account

Show all 21 claims

  • Probably not a substantial claim. 17
  • It may state two separate claims as one. 15
28 of 28
  • The paper relies on this without support.

    Patients have started to use ChatGPT to simplify and explain their medical reports.

    “Patients have started to use ChatGPT to simplify and explain their medical reports, which is expected to affect patient-doctor interaction.”
  • The paper relies on this without support.

    ChatGPT was not explicitly trained for medical text simplification and is not intended to be used for this critical task.

    “At the same time, ChatGPT was not explicitly trained for medical text simplification and is not intended to be used for this critical task.”
  • The paper relies on this without support.

    The training data of ChatGPT is static, i.e., new research findings are not considered in ChatGPT’s output.

    “The training data is static, i.e., new research findings are not considered in ChatGPT’s output.”
  • The paper relies on this without support.

    The resulting models lack the accessibility and quality of ChatGPT.

    “However, the resulting models lack the accessibility and quality of ChatGPT.”
  • The paper relies on this without support.

    Uploading protected health information to a proprietary service such as ChatGPT might compromise patients’ privacy.

    “Finally, uploading protected health information to a proprietary service, such as ChatGPT, might compromise patients’ privacy.”
5 of 5

Claims other papers make about this one

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Citations

Cites

Show all 22 references

Research works printed but not linked: 8

  1. Brown T, Mann B, Ryder N, Subbiah M, Kaplan JD, Dhariwal P et al (2020) Language models are few-shot learners. Adv Neural Inf Process Syst 33:1877–1901
  2. Agarwal A (2022) Explain to me like I am five–sentence simplification using transformers. ArXiv Prepr ArXiv221204595
  3. Taylor R, Kardas M, Cucurull G et al (2022) Galactica: a large language model for science. ArXiv Prepr ArXiv221109085.
  4. Singhal K, Azizi S, Tu T et al (2022) Large language models encode clinical knowledge [Internet]. arXiv; [cited 2023 Jan 13].
  5. Shardlow M (2014) A survey of automated text simplification. Int J Adv Comput Sci Appl 4(1):58–70
  6. Al-Thanyyan SS, Azmi AM (2021) Automated text simplification: a survey. ACM Comput Surv CSUR 54(2):1–36
  7. Kvist M, Velupillai S (2013) Professional language in Swedish radiology reports–characterization for patient-adapted text simplification. In: Scandinavian Conference on Health Informatics. Linköping University Electronic Press, p 55–59
  8. Bommasani R, Hudson DA, Adeli E et al (2021) On the opportunities and risks of foundation models. ArXiv Prepr ArXiv210807258.

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Metadata

Authors
Jeblick, K., Schachtner, B., Dexl, J., Mittermeier, A., Stüber, A. T., Topalis, J., Weber, T., Wesp, P., Sabel, B. O., Ricke, J., & Ingrisch, M.
Affiliations
LMU Klinikum (DE)
Corresponding author
Jeblick, Katharina
Venue
European Radiology
Published
2023-10-05
Volume
34
Issue
5
Pages
2817-2825
ISSN
  • 0938-7994 (ISSN-L)
  • 1432-1084
OpenAlex
W4387356888
Cited by
549
References
22
Citations by year
2026: 105 · 2025: 152 · 2024: 157 · 2023: 133
FWCI
21.84
Type
journal article
Language
en
Open access
Locations
  • European Radiology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Open access LMU (Ludwid Maxmilian's Universitat Munchen) (submittedVersion, cc-by)
  • PUBLISSO (German National Library of Medicine) (submittedVersion, cc-by)
Funders
  • Deutsche Forschungsgemeinschaft (460037581)
  • Universitätsklinik München
Topics
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Artificial Intelligence › Explainable Artificial Intelligence (XAI)
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
Keywords
ChatGPT, large language models, radiology reports, medical text simplification, patient-centered care, factual accuracy, patient harm, radiologist evaluation, patient-doctor interaction, artificial intelligence in radiology
MeSH terms
Radiologists, Humans, Physician-Patient Relations, Surveys and Questionnaires, Radiology, Radiology Information Systems, Patient-Centered Care

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