{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:25:45Z","timestamp":1786951545256,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early decision\u2010making in acute pancreatitis (AP) involves diagnostic confirmation, early severity triage, escalation thresholds, and initiation of guideline\u2010concordant management under time pressure and incomplete information. Large language models (LLMs) may support structured bedside reasoning, but their clinical usefulness cannot be inferred from guideline knowledge alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional, scenario\u2010based comparative evaluation was conducted in January 2026 using 20 AP scenarios: 15 refined hypothetical vignettes and 5 de\u2010identified, privacy\u2010modified real\u2010life case patterns. GPT\u20104, GPT\u20105, and Gemini received identical single\u2010turn prompts. Model access was through OpenAI API gpt\u20104\u20100613, OpenAI API gpt\u20105, and Google Vertex AI Gemini 1.0 Pro; temperature was set to 0.0, and each prompt was repeated three times per model. Outputs were scored by two independent clinician\u2010raters using a prespecified 1\u20135 ordinal rubric across guideline concordance, safety, actionability, and data\u2010synthesis quality. Two senior board\u2010certified surgeons independently generated expert reference pathways for comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>GPT\u20105 achieved the highest guideline concordance (4.28\u00a0\u00b1\u00a00.38) and safety (4.20\u00a0\u00b1\u00a00.45) profiles. GPT\u20104 provided the clearest stepwise actionability (4.15\u00a0\u00b1\u00a00.48), whereas Gemini showed the strongest data\u2010synthesis quality (4.22\u00a0\u00b1\u00a00.52). With deterministic settings, internal consistency across three repeated runs was 100%. All models demonstrated clinically relevant failure modes, particularly unwarranted certainty under missing data; this occurred in 12\/20 GPT\u20104, 7\/20 GPT\u20105, and 15\/20 Gemini outputs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No model should be used as a stand\u2010alone bedside decision\u2010maker for AP. In this scenario\u2010based early evaluation, GPT\u20105 was the most safety\u2010aligned model, GPT\u20104 was the most operationally actionable, and Gemini was strongest for synthesis, but all require clinician oversight, prospective validation, and governance before clinical deployment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70492","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:53:59Z","timestamp":1783594439000},"page":"2321-2328","source":"Crossref","is-referenced-by-count":0,"title":["Bedside Triage by Large Language Models in Acute Pancreatitis: A Scenario\u2010Based Comparative Evaluation of GPT\u20104, GPT\u20105, and Gemini"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1999-1601","authenticated-orcid":false,"given":"Yahya Kemal","family":"\u00c7al\u0131\u015fkan","sequence":"first","affiliation":[{"name":"Department of General Surgery University of Health Sciences Kanuni Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1854-7437","authenticated-orcid":false,"given":"Fatih","family":"Ba\u015fak","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of Health Sciences Umraniye Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1433-3431","authenticated-orcid":false,"given":"Olgun","family":"Erdem","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of Health Sciences Umraniye Training and Research Hospital  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102012\u2010302779"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002645"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.01.032"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2013.07.063"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2008.152702"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2202884"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2005.40587.x"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2012.12.011"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0908821"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(17)32404\u20102"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u20108\u2010200710160\u201000010"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102023\u2010078378"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102022\u2010070904"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010025\u201004274\u2010w"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010023\u201006291\u20102"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/M23\u20102772"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70492","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70492","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70492","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:59:21Z","timestamp":1786949961000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,9]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/wjs.70492"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70492","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,9]]}}}