• AI at the Forefront: Navigating Oncologic Care for Six Gastrointestinal Cancers According to the NCCN Guidelines Utilizing Gemini-1.0 Ultra and ChatGPT-4

    Tamir E Bresler, Tyler Wilson, Tadevos Makaryan, Shivam Pandya, Kevin Palmer, Ryan Meyer, Zin M Htway, Manabu Fujita

    J Surg Oncol. 2025 Jun 19. doi: 10.1002/jso.70005. Online ahead of print.

    Abstract

    Background and objectives: We explored the ability of large language models (LLMs) ChatGPT-4 and Gemini 1.0 Ultra in guiding clinical decision-making for six gastrointestinal cancers using the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines.

    Methods: We reviewed the NCCN Guidelines for anal squamous cell carcinoma, small bowel, ampullary, and pancreatic adenocarcinoma, and biliary tract and gastric cancers. Clinical questions were designed and categorized by type, queried up to three times, and rated on a Likert scale: (5) Correct; (4) Correct following clarification; (3) Correct but incomplete; (2) Partially incorrect; (1) Absolutely incorrect. Subgroup analysis was conducted on Correctness (scores 3-5) and Accuracy (scores 4-5).

    Results: A total of 270 questions were generated (range-per-cancer 32-68). ChatGPT-4 versus Gemini 1.0 Ultra score differences were not statistically-significant (Mean Rank 278.30 vs. 262.70, p = 0.222). Correctness was seen in 77.78% versus 75.93% of responses, and Accuracy in 64.81% versus 57.41%. There were no statistically-significant differences in Correctness or Accuracy between LLMs in terms of question or cancer type.

    Conclusions: Both LLMs demonstrated a limited capacity to assist with complex clinical decision-making. Their current Accuracy level falls below the acceptable threshold for clinical use. Future studies exploring LLMs in the healthcare domain are warranted.