{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T11:41:20Z","timestamp":1792755680734,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"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":["World j. otorhinolaryngol.-head neck surg."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the ability of large language models (LLMs) and otolaryngologists to identify prognostic signals from brief clinical vignettes in CRSwNP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this blinded study, 68 adults initiating biologic therapy for CRSwNP (\u2265\u200936 months follow\u2010up) were represented by standardized vignettes derived from documentation immediately before biologic initiation. Vignettes summarized symptoms, prior surgery, comorbidities, and medications. Biomarkers, imaging scores, smell testing, and follow\u2010up data were excluded to isolate text\u2010based prognostic reasoning under identical constraints. Five attending otolaryngologists, one rhinology fellow, and two residents independently predicted four 5\u2010year outcomes: subsequent endoscopic sinus surgery, recurrent systemic steroid bursts, biologic switch, and a composite endpoint. Multiple LLMs were queried in identical zero\u2010shot format across three sessions to assess stability. Predictions were compared with verified outcomes using accuracy, sensitivity, specificity, F1 score, Cohen's \u03ba, and Matthews correlation coefficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five\u2010year outcome prevalences were 38.2% (26 of 68) for subsequent sinus surgery, 26.5% (18 of 68) for steroid bursts, 14.7% (10 of 68) for biologic switch, and 58.8% (40 of 68) for composite failure. Macro\u2010averaged LLM accuracies ranged from 65.0% to 76.1%, compared with 65.7%\u2009\u00b1\u20097.4% for human raters. The best\u2010performing LLM achieved accuracy comparable to the top attending. Both groups showed higher negative than positive predictive values, indicating better discrimination for patients without adverse events. Agreement between LLMs and clinicians was moderate and within the range of inter\u2010clinician variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>When restricted to short pretreatment text, LLMs produced prognostic judgments within the range of clinician variability for severe, biologic\u2010treated CRSwNP outcomes. These findings suggest that in information\u2010limited settings, LLMs may provide an auxiliary reasoning signal rather than a standalone decision tool.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjo2.70164","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:52:38Z","timestamp":1787817158000},"page":"645-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Generative AI and Clinicians Show Comparable Prognostic Reasoning From Clinical Narratives in Biologic\u2010Treated CRSwNP"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0651-6994","authenticated-orcid":false,"given":"Sholem","family":"Hack","sequence":"first","affiliation":[{"name":"City St. George's University of London, School of Medicine Program delivered by University of Nicosia at the Chaim Sheba Medical Center Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase","family":"Kahn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Integrated Surgical Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6813-7850","authenticated-orcid":false,"given":"Ainhoa","family":"Garcia\u2010Lliberos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Valencia University General Hospital Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6153-9455","authenticated-orcid":false,"given":"Cristina","family":"Rodriguez\u2010Prado","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Valencia University General Hospital Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3768-6216","authenticated-orcid":false,"given":"Ameen","family":"Biadsee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Meir Medical Center Kfar Saba Israel"},{"name":"Faculty of Medicine Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8317-2286","authenticated-orcid":false,"given":"Maxime","family":"Fieux","sequence":"additional","affiliation":[{"name":"Hospices civils de Lyon, H\u00f4pital Lyon Sud, Service d'ORL, d'otoneurochirurgie et de chirurgie cervico\u2010faciale Pierre B\u00e9nite France"},{"name":"Universit\u00e9 de Lyon, Universit\u00e9 Lyon 1 Lyon France"},{"name":"UMR 5305, Laboratoire de Biologie Tissulaire et d'Ing\u00e9nierie Th\u00e9rapeutique, Institut de Biologie et Chimie des Prot\u00e9ines, CNRS\/Universit\u00e9 Claude Bernard Lyon 1 Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Integrated Surgical Institute Cleveland Clinic Foundation Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-9811","authenticated-orcid":false,"given":"Eran","family":"Glikson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Sheba Medical Center Ramat Gan Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9790-3529","authenticated-orcid":false,"given":"Masayoshi","family":"Takashima","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Houston Methodist Hospital Houston Texas 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