Cited by 24Artificial Intelligence in Healthcare and EducationArtificial Intelligence in EducationInnovations in Medical Education

Performance of ChatGPT incorporated chain-of-thought method in bilingual nuclear medicine physician board examinations

Open access
Ting, Yu-Ting, Hsieh, Te-Chun, Wang, Yuh-Feng, Kuo, Yu-Chieh, Chen, Yi-Jin, Chan, Pak-Ki, Kao, Chia-Hung·2024·DIGITAL HEALTH

Abstract

Objective: This research explores the performance of ChatGPT, compared to human doctors, in bilingual, Mandarin Chinese and English, medical specialty exam in Nuclear Medicine in Taiwan. Methods: The study employed generative pre-trained transformer (GPT-4) and integrated chain-of-thoughts (COT) method to enhance performance by triggering and explaining the thinking process to answer the question in a coherent and logical manner. Questions from the Taiwanese Nuclear Medicine Specialty Exam served as the basis for testing. The research analyzed the correctness of AI responses in different sections of the exam and explored the influence of question length and language proportion on accuracy. Results: AI, especially ChatGPT with COT, exhibited exceptional capabilities in theoretical knowledge, clinical medicine, and handling integrated questions, often surpassing, or matching human doctor performance. However, AI struggled with questions related to medical regulations. The analysis of question length showed that questions within the 109–163 words range yielded the highest accuracy. Moreover, an increase in the proportion of English words in questions improved both AI and human accuracy. Conclusions: This research highlights the potential and challenges of AI in the medical field. ChatGPT demonstrates significant competence in various aspects of medical knowledge. However, areas like medical regulations require improvement. The study also suggests that AI may help in evaluating exam question difficulty and maintaining fairness in examinations. These findings shed light on AI role in the medical field, with potential applications in healthcare education, exam preparation, and multilingual environments. Ongoing AI advancements are expected to further enhance AI utility in the medical domain.

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  • LLMs have demonstrated strong performance across a wide range of biomedical knowledge and reasoning tasks.

    “LLMs have demonstrated strong performance across a wide range of biomedical knowledge and reasoning tasks, accelerating their adoption in health care workflows [1-6].”

    From Retrieve-Then-Verify for Evaluating Evidence Support and Hallucination in Large Language Model–Generated Medical Information: Empirical Study (2026) · cites this paper as [3]

    The Discussion reports strong performance on theoretical, clinical, and integrated questions in a bilingual nuclear medicine exam, but the Conclusion also reports 0% accuracy on medical legal regulation questions. This supports performance on several biomedical knowledge and reasoning tasks, not a wide range of tasks generally; the cited passages also do not establish accelerated adoption in health care workflows. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 9

  1. [1]Huh S. Are ChatGPT’s knowledge and interpretation ability comparable to those of medical students in Korea for taking a parasitology examination?: a descriptive study. J Educ Eval Health Prof 2023; 20: 1. 36627845 PMC9905868
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Authors
Ting, Y.-T., Hsieh, T.-C., Wang, Y.-F., Kuo, Y.-C., Chen, Y.-J., Chan, P.-K., & Kao, C.-H.
Affiliations
  • China Medical University (TW)
  • National Yang Ming Chiao Tung University (TW)
  • Asia University (TW)
Corresponding author
Kao, Chia-Hung
Venue
DIGITAL HEALTH
Published
2024-01
Volume
10
Pages
20552076231224074-20552076231224074
ISSN
2055-2076 (ISSN-L)
OpenAlex
W4390613062
Cited by
24
References
3
Citations by year
2026: 7 · 2025: 10 · 2024: 7
FWCI
2.24
Type
journal article
Language
en
Open access
Locations
  • Digital Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
China Medical University Hospital
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
ChatGPT, chain-of-thought prompting, GPT-4, question length, medical regulation, exam question difficulty, medical education

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