{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:50:15Z","timestamp":1791355815307,"version":"4.3.1"},"reference-count":10,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Fetal echocardiography requires systematic anatomical assessment, segmental interpretation, and high\u2010level clinical reasoning. This study aimed to compare the performance of contemporary artificial intelligence (AI) systems and clinicians with different levels of expertise in a standardized fetal echocardiography knowledge\u2010based assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross\u2010sectional comparative assessment study used a 60\u2010item, single\u2010best\u2010answer multiple\u2010choice examination covering eight fetal echocardiography subdomains: general principles of fetal echocardiography, general fetal cardiac anatomy, left\u2010sided cardiac pathologies, conotruncal anomalies, isomerism and heterotaxy syndromes, fetal arrhythmias, anomalies of venous return, and pulmonary malformations\/right\u2010sided cardiac pathologies. The same examination was administered to seven publicly accessible AI systems and three clinicians: one senior perinatologist, one junior perinatologist, and one junior obstetrician. All AI systems were accessed during the same predefined evaluation period in January 2026. The primary outcome was response correctness. Secondary analyses included total accuracy, domain\u2010specific performance, and AI\u2013clinician group comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 600 group\u2013question response entries were analyzed, comprising 420 AI\u2010generated responses and 180 clinician responses. The senior perinatologist achieved the highest total score among all participants, with 53 correct responses out of 60, followed by GPT\u20105 with 52 correct responses. Overall accuracy was 78.8% for AI systems and 73.3% for clinicians. The mean domain\u2010level score was 5.91 for AI systems and 5.50 for clinicians, without a statistically significant difference using either unequal\u2010variance\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test or Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      \u2010test. AI systems showed higher mean performance in general fetal echocardiography principles and general fetal cardiac anatomy, whereas the senior perinatologist performed best in complex integrative domains, particularly conotruncal anomalies and isomerism\/heterotaxy syndromes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a structured text\u2010based fetal echocardiography knowledge assessment, AI systems achieved overall performance comparable to clinicians, particularly in standardized knowledge domains. However, the senior perinatologist retained the strongest performance in complex fetal cardiac categories requiring integrative clinical reasoning. These findings support the potential role of AI as an adjunctive educational and structured decision\u2010support tool in fetal echocardiography, while emphasizing that performance in a multiple\u2010choice format should not be interpreted as equivalent to autonomous real\u2010world fetal cardiac diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70430","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:58:33Z","timestamp":1791352713000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Artificial Intelligence Systems vs. Clinicians in Fetal Echocardiography: A Structured Knowledge\u2010Based Comparative Assessment"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8912-0812","authenticated-orcid":false,"given":"U\u011furcan","family":"Zorlu","sequence":"first","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9616-8139","authenticated-orcid":false,"given":"Hasan","family":"Alt\u0131nsoy","sequence":"additional","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5741-3875","authenticated-orcid":false,"given":"Mehmet Utku","family":"Ba\u015far\u0131r","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6007-965X","authenticated-orcid":false,"given":"\u015e\u00fckr\u00fc","family":"Bak\u0131rc\u0131","sequence":"additional","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4901-0544","authenticated-orcid":false,"given":"Eda \u00d6zden","family":"Tokal\u0131o\u011flu","sequence":"additional","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4204-0014","authenticated-orcid":false,"given":"\u00d6zg\u00fcr","family":"Kara","sequence":"additional","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4727-7982","authenticated-orcid":false,"given":"Fatma Do\u011fa","family":"\u00d6cal","sequence":"additional","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8567-9048","authenticated-orcid":false,"given":"Dilek","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Perinatalogy Ankara Bilkent City Hospital  Ankara Turkey"},{"name":"Department of Perinatalogy University of Health Sciences  Ankara 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