Cited by 71Artificial Intelligence in Healthcare and EducationArtificial Intelligence in EducationInnovations in Medical Education

Performance of three artificial intelligence (AI)‐based large language models in standardized testing; implications for AI‐assisted dental education

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Sabri, Hamoun, Saleh, Muhammad H. A., Hazrati, Parham, Merchant, Keith, Misch, Jonathan, Kumar, Purnima S., Wang, Hom‐Lay, Barootchi, Shayan·2025·Journal of Periodontal Research

Abstract

Introduction: The emerging rise in novel computer technologies and automated data analytics has the potential to change the course of dental education. In line with our long‐term goal of harnessing the power of AI to augment didactic teaching, the objective of this study was to quantify and compare the accuracy of responses provided by ChatGPT (GPT‐4 and GPT‐3.5) and Google Gemini, the three primary large language models (LLMs), to human graduate students (control group) to the annual in‐service examination questions posed by the American Academy of Periodontology (AAP). Methods: Under a comparative cross‐sectional study design, a corpus of 1312 questions from the annual in‐service examination of AAP administered between 2020 and 2023 were presented to the LLMs. Their responses were analyzed using chi‐square tests, and the performance was juxtaposed to the scores of periodontal residents from corresponding years, as the human control group. Additionally, two sub‐analyses were performed: one on the performance of the LLMs on each section of the exam; and in answering the most difficult questions. Results: ChatGPT‐4 (total average: 79.57%) outperformed all human control groups as well as GPT‐3.5 and Google Gemini in all exam years ( p < .001). This chatbot showed an accuracy range between 78.80% and 80.98% across the various exam years. Gemini consistently recorded superior performance with scores of 70.65% ( p = .01), 73.29% ( p = .02), 75.73% ( p < .01), and 72.18% ( p = .0008) for the exams from 2020 to 2023 compared to ChatGPT‐3.5, which achieved 62.5%, 68.24%, 69.83%, and 59.27% respectively. Google Gemini (72.86%) surpassed the average scores achieved by first‐ (63.48% ± 31.67) and second‐year residents (66.25% ± 31.61) when all exam years combined. However, it could not surpass that of third‐year residents (69.06% ± 30.45). Conclusions: Within the confines of this analysis, ChatGPT‐4 exhibited a robust capability in answering AAP in‐service exam questions in terms of accuracy and reliability while Gemini and ChatGPT‐3.5 showed a weaker performance. These findings underscore the potential of deploying LLMs as an educational tool in periodontics and oral implantology domains. However, the current limitations of these models such as inability to effectively process image‐based inquiries, the propensity for generating inconsistent responses to the same prompts, and achieving high (80% by GPT‐4) but not absolute accuracy rates should be considered. An objective comparison of their capability versus their capacity is required to further develop this field of study.

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  1. [1]Kopytko V, Shevchuk L, Yankovska L, Semchuk Z, Strilchuk R. Smart home and artificial intelligence as environment for the implementation of new technologies. Traekt Nauki=Path Sci. 2018; 4: 2007‐ 2012.
  2. [2]Xu L, Sanders L, Li K, Chow JC. Chatbot for health care and oncology applications using artificial intelligence and machine learning: systematic review. JMIR Cancer. 2021; 7: e27850. 34847056 PMC8669585
  3. [3]Teng M, Ren Y. Application and development prospect of artificial intelligence in the daily life of the elderly and disabled. In: 2021 3rd International Conference on Machine Learning, Big Data and Business Intelligence (MLBDBI). IEEE; 2021: 767‐ 770.
  4. [4]Holmes J, Liu Z, Zhang L, et al. Evaluating large language models on a highly‐specialized topic, radiation oncology physics. Front Oncol. 2023; 13: 1219326. 37529688 PMC10388568
  5. [5]Thirunavukarasu AJ, Ting DSJ, Elangovan K, Gutierrez L, Tan TF, Ting DSW. Large language models in medicine. Nat Med. 2023; 29: 1930‐ 1940. 37460753
  6. [7]Cocci A, Pezzoli M, Lo Re M, et al. Quality of information and appropriateness of ChatGPT outputs for urology patients. Prostate Cancer Prostatic Dis. 2023; 27(1): 103‐ 108. doi: 10.1038/s41391-023-00705-y. 37516804 · DOI
  7. [9]Shah NH, Entwistle D, Pfeffer MA. Creation and adoption of large language models in medicine. JAMA. 2023; 330: 866‐ 869. 37548965
  8. [10]Harris E. Large language models answer medical questions accurately, but can't match clinicians' knowledge. JAMA. 2023; 330: 792. 37548971
  9. [14]Huang RS, Lu KJQ, Meaney C, Kemppainen J, Punnett A, Leung FH. Assessment of resident and AI Chatbot performance on the University of Toronto Family Medicine Residency Progress Test: comparative study. JMIR Med Educ. 2023; 9: e50514. 37725411 PMC10548315
  10. [16]Najafali D, Reiche E, Araya S, et al. Bard versus the 2022 American Society of Plastic Surgeons in‐service examination: performance on the examination in its intern year. Aesthetic Surg J Open Forum. 2023; 6: ojad066. PMC10776237 38196964
  11. [17]Vaishya R, Iyengar KP, Patralekh MK, et al. Effectiveness of AI‐powered Chatbots in responding to orthopaedic postgraduate exam questions—an observational study. Int Orthop. 2024. Epub ahead of print. doi: 10.1007/s00264-024-06182-9 38619565 · DOI
  12. [18]Dwivedi YK, Kshetri N, Hughes L, et al. Opinion Paper: “so what if ChatGPT wrote it?” Multidisciplinary perspectives on opportunities, challenges and implications of generative conversational AI for research, practice and policy. Int J Inf Manage. 2023; 71: 102642.
  13. [19]Thapa S, Adhikari S. ChatGPT, Bard, and large language models for biomedical research: opportunities and pitfalls. Ann Biomed Eng. 2023; 51: 2647‐ 2651. 37328703
  14. [20]Ali R, Tang OY, Connolly ID, et al. Performance of ChatGPT, GPT‐4, and Google Bard on a neurosurgery oral boards preparation question Bank. Neurosurgery. 2023; 93(5): 1090‐ 1098. 37306460
  15. [21]Rahsepar AA, Tavakoli N, Kim GHJ, Hassani C, Abtin F, Bedayat A. How AI responds to common lung cancer questions: ChatGPT vs Google Bard. Radiology. 2023; 307: e230922. 37310252
  16. [22]Haver HL, Lin CT, Sirajuddin A, Yi PH, Jeudy J. Use of ChatGPT, GPT‐4, and Bard to improve readability of ChatGPT's answers to common questions on lung cancer and lung cancer screening. AJR Am J Roentgenol. 2023; 221: 701‐ 704. 37341179
  17. [23]Achiam J, Adler S, Agarwal S, et al. GPT‐4 technical report. arXiv preprint arXiv:230308774 2023.
  18. [24]Takagi S, Watari T, Erabi A, Sakaguchi K. Performance of GPT‐3.5 and GPT‐4 on the Japanese medical licensing examination: comparison study. JMIR Med Educ. 2023; 9: e48002. 37384388 PMC10365615
  19. [25]Kung TH, Cheatham M, Medenilla A, et al. Performance of ChatGPT on USMLE: potential for AI‐assisted medical education using large language models. PLOS Digit Health. 2023; 2: e0000198. 36812645 PMC9931230
  20. [26]Massey PA, Montgomery C, Zhang AS. Comparison of ChatGPT‐3.5, ChatGPT‐4, and Orthopaedic resident performance on orthopaedic assessment examinations. J Am Acad Orthop Surg. 2023; 31: 1173‐ 1179. 37671415 PMC10627532
  21. [27]Farajollahi M, Modaberi A. Can ChatGPT pass the “Iranian Endodontics Specialist Board” exam? Iran Endod J. 2023; 18: 192. 37431530 PMC10329760
  22. [28]Danesh A, Pazouki H, Danesh K, Danesh F, Danesh A. The performance of artificial intelligence language models in board‐style dental knowledge assessment: a preliminary study on ChatGPT. J Am Dent Assoc. 2023; 154: 970‐ 974. 37676187
  23. [29]Danesh A, Pazouki H, Danesh F, Danesh A, Vardar‐Sengul S. Artificial intelligence in dental education: ChatGPT's performance on the periodontic in‐service examination. J Periodontol. 2024. Epub ahead of print. doi: 10.1002/JPER.23-0514. 38197146 · DOI
  24. [30]Freire Y, Santamaría Laorden A, Orejas Pérez J, Gómez Sánchez M, Díaz‐Flores García V, Suárez A. ChatGPT performance in prosthodontics: assessment of accuracy and repeatability in answer generation. J Prosthet Dent. 2024; 131: 659.e1‐ 659.e6. 38310063
  25. [31]Brown T, Mann B, Ryder N, et al. Language models are few‐shot learners. Adv Neural Inf Process Syst. 2020; 33: 1877‐ 1901.

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Authors
Sabri, H., Saleh, M. H. A., Hazrati, P., Merchant, K., Misch, J., Kumar, P. S., Wang, H., & Barootchi, S.
Affiliations
  • University of Michigan (US)
  • Naval Post‐Graduate Dental School Bethesda Maryland USA
  • Harvard University (US)
Corresponding author
  • Sabri, Hamoun
  • Barootchi, Shayan
Venue
Journal of Periodontal Research
Publisher
Wiley
Published
2024-07-18
Volume
60
Issue
2
Pages
121-133
ISSN
  • 0022-3484 (ISSN-L)
  • 1600-0765
OpenAlex
W4400838583
Cited by
71
References
6
Citations by year
2026: 34 · 2025: 30 · 2024: 7
FWCI
6.64
Type
journal article
Language
en
Open access
Locations
  • Journal of Periodontal Research (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
  • Physical Sciences › Computer Science › Information Systems › Artificial Intelligence in Education
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Keywords
large language models, ChatGPT, Google Gemini, GPT-3.5, periodontal education, standardized testing, in-service examination, American Academy of Periodontology, ChatGPT-4, ChatGPT-3.5
MeSH terms
Large Language Models, Artificial Intelligence, Cross-Sectional Studies, Education, Dental, Educational Measurement, Humans, Language, Periodontics

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