Is ChatGPT Better Than Epileptologists at Interpreting Seizure Semiology?

Abstract

AbstractBackgroundUtilizing large language models (LLMs), primarily ChatGPT, to interpret the seizure semiology with focal epilepsy could yield valuable data for presurgical assessment. Assessing the reliability and comparability of LLM-generated responses with those from well-trained neurologists, especially epileptologists, is crucial for ascertaining the value of LLMs in the presurgical evaluation.MethodsA total of 865 descriptions of seizure semiology and validated epileptogenic zone (EZ) pairs were derived from 189 public papers. These semiology records were utilized as input of ChatGPT to generate responses on the most likely locations of EZ. Additionally, a panel of 5 epileptologists was recruited to complete an online survey by providing responses on EZ locations based on 100 well-defined semiology records. All responses from ChatGPT and epileptologists were graded for their reliability score (RS) and regional accuracy rate (RAR).ResultsIn evaluating responses to semiology queries, the highest RARs in each general region from ChatGPT-4.0 were 89.28% for the frontal lobe and 71.39% for the temporal lobe. However, the RAR was lower for the occipital lobe at 46.24%, the parietal lobe at 31.01%, the insular cortex at 8.51%, and the cingulate cortex at 2.78%. Comparatively, the RAR achieved by epileptologists was 82.76% for the frontal lobe, 58.33% for the temporal lobe, 68.42% for the occipital lobe, 50% for the parietal lobe, 60% for the insular cortex, and 28.57% for the cingulate cortex.ConclusionsIn this study of seizure semiology interpretation, ChatGPT-4.0 outperformed epileptologists in interpreting seizure semiology originating in the frontal and temporal lobes, whereas epileptologists outperformed ChatGPT-4.0 in the occipital and parietal lobes, and significantly outperformed in the insular cortex and cingulate cortex. ChatGPT demonstrates the potential to assist in the preoperative assessment for epilepsy surgery. Presumably, with the continuous development of LLM, the reliability of ChatGPT will be strengthened in the foreseeable future.