{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:54:43Z","timestamp":1782219283685,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82201195"],"award-info":[{"award-number":["82201195"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To compare the performance of GPT\u20104o, used here as a representative multimodal large language model (MLLM), against human fitters in orthokeratology (OK) lens fitting, with a focus on retrospective parameter\u2010matching accuracy, efficiency and cost\u2010effectiveness in initial lens parameter selection.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A total of 70 OK lens fittings were analysed. GPT\u20104o and human fitters provided recommendations for trial lens parameters based on patient data. The recommendations were compared with the final fitting parameters to assess accuracy. Additionally, the fitting time and costs for each fitter were recorded. Statistical methods were applied to compare GPT\u20104o's performance with human fitters.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n GPT\u20104o achieved 78% accuracy (196\/250), comparable to human fitters (experienced ophthalmologist: 83%, optometrists: 85%, general ophthalmologists: 76%). It showed similar precision in key parameters like base curve (BC), reduction, diameter and cylinder power (CP). Interrater reliability between GPT\u20104o and human fitters ranged from slight to moderate (\u03ba\u2009=\u20090.18\u20130.60). GPT\u20104o was more efficient, taking only 11.60\u2009s per case compared to an average of 85.35\u2009s for humans, and reduced costs to $0.03 per case versus $0.33 for Chinese human fitters (\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In this single\u2010model retrospective study, GPT\u20104o, evaluated as a representative MLLM, achieved parameter\u2010matching accuracy broadly comparable to that of human fitters while substantially reducing processing time and costs. However, given the slight\u2010to\u2010moderate interrater reliability, retrospective design and absence of external validation, these findings should be interpreted as supporting a preliminary decision\u2010support role rather than autonomous clinical implementation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aos.70185","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:29:28Z","timestamp":1782217768000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of\n GPT<\/scp>\n \u20104o as a representative multimodal large language model and human fitters in orthokeratology lens fitting: Assessing accuracy, efficiency and cost\u2010effectiveness in initial lens parameter selection"],"prefix":"10.1111","author":[{"given":"Daohuan","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Children and Adolescents' Health and Diseases Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Children and Adolescents' Health and Diseases Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6742-484X","authenticated-orcid":false,"given":"Jia","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Children and Adolescents' Health and Diseases Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3724-2391","authenticated-orcid":false,"given":"Andrzej","family":"Grzybowski","sequence":"additional","affiliation":[{"name":"Institute for Research in Ophthalmology Foundation for Ophthalmology Development Poznan Poland"},{"name":"Department of Ophthalmology University of Warmia and Mazury Olsztyn Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4369-2417","authenticated-orcid":false,"given":"Kai","family":"Jin","sequence":"additional","affiliation":[{"name":"Eye Center of Second Affiliated Hospital, School of Medicine Zhejiang University Hangzhou Zhejiang China"},{"name":"Zhejiang Provincial Key Laboratory of Ophthalmology Zhejiang Provincial Clinical Research Center for Eye Diseases. Zhejiang Provincial Engineering Institute on Eye Diseases Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Children's Hospital, Zhejiang University School of Medicine National Clinical Research Center for Children and Adolescents' Health and Diseases Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2024.105969","article-title":"8. Agreement of large language models with humans in extracting data from unstructured records of multiple sclerosis patients","volume":"92","author":"Alnhwi Z.A.","year":"2024","journal-title":"Multiple Sclerosis and Related Disorders"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1038\/s41572-020-00231-4","article-title":"Myopia","volume":"6","author":"Baird P.N.","year":"2020","journal-title":"Nature Reviews Disease Primers"},{"key":"e_1_2_10_4_1","unstructured":"Bo\u017ei\u0107 V.(2023)Using artifical intelligence in triage process: benefits challenges and considerations."},{"key":"e_1_2_10_5_1","first-page":"322","article-title":"Can ChatGPT 4.0 diagnose epilepsy? A study on artificial intelligence's diagnostic capabilities","volume":"14","author":"Brigo F.","year":"2025","journal-title":"Journal of Clinical Microbiology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"e970","DOI":"10.1111\/aos.16685","article-title":"Vision\u2010related quality of life in children: cross\u2010cultural adaptation and test\u2013retest reliability of the Danish version of the paediatric refractive error profile 2","volume":"102","author":"Cerullo C.","year":"2024","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.2147\/OPTO.S104507","article-title":"Orthokeratology: clinical utility and patient perspectives","volume":"9","author":"Charm Chi Foon J.","year":"2017","journal-title":"OPTO"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.clae.2013.02.012","article-title":"High myopia\u2010partial reduction orthokeratology (HM\u2010PRO): study design","volume":"36","author":"Charm J.","year":"2013","journal-title":"Contact Lens & Anterior Eye"},{"key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"24893","DOI":"10.1007\/s00521-024-10613-4","article-title":"Can large language models beat wall street? Evaluating GPT\u20104's impact on financial decision\u2010making with MarketSenseAI","volume":"37","author":"Fatouros G.","year":"2024","journal-title":"Neural Computing & Applications"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1038\/s41433-019-0566-0","article-title":"Artificial intelligence for diabetic retinopathy screening: a review","volume":"34","author":"Grzybowski A.","year":"2020","journal-title":"Eye"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.clindermatol.2023.12.013","article-title":"Challenges of artificial intelligence in medicine and dermatology","volume":"42","author":"Grzybowski A.","year":"2024","journal-title":"Clinics in Dermatology"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","unstructured":"Grzybowski A. Zhao K.&Jin K.(2026)Agentic artificial intelligence in ophthalmology: toward autonomous adaptive and ethical eye care. Acta Ophthalmologica.","DOI":"10.1111\/aos.70099"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden B.A.","year":"2016","journal-title":"Ophthalmology"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.4103\/jcor.jcor_86_24","article-title":"Beyond human perception: revolutionizing ophthalmology with artificial intelligence and deep learning","volume":"12","author":"Jabeen A.","year":"2024","journal-title":"Journal of Clinical Ophthalmology and Research"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/aos.16775","article-title":"Myopia control with orthokeratology lenses. A 3\u2010year follow\u2010up study including a cross\u2010over design: clinical study of near\u2010sightedness; TReatment with orthokeratology lenses 2 (CONTROL2 study)","volume":"103","author":"Jakobsen T.M.","year":"2025","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/4275269","article-title":"Comparison of Toric and spherical orthokeratology lenses in patients with astigmatism","volume":"2019","author":"Jiang J.","year":"2019","journal-title":"Journal of Ophthalmology"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.aopr.2024.03.003","article-title":"Integration of smartphone technology and artificial intelligence for advanced ophthalmic care: a systematic review","volume":"4","author":"Jin K.","year":"2024","journal-title":"Advances in Ophthalmology Practice and Research"},{"key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1038\/s41746-025-02300-y","article-title":"Grounded report generation for enhancing ophthalmic ultrasound interpretation using vision\u2010language segmentation models","volume":"9","author":"Jin K.","year":"2026","journal-title":"npj Digital Medicine"},{"key":"e_1_2_10_19_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2023.1291404","article-title":"Exploring large language model for next generation of artificial intelligence in ophthalmology","volume":"10","author":"Jin K.","year":"2023","journal-title":"Frontiers in Medicine"},{"key":"e_1_2_10_20_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoint.2025.100205","article-title":"Multimodal large language models for IOL power calculation in cataract surgery: a feasibility study","volume":"2","author":"Jun H.W.","year":"2025","journal-title":"AJO International"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"1841","DOI":"10.1007\/s40123-024-00958-3","article-title":"A Beginner's guide to artificial intelligence for ophthalmologists","volume":"13","author":"Kang D.","year":"2024","journal-title":"Ophthalmology and therapy"},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1167\/tvst.13.2.17","article-title":"Development of a machine\u2010learning\u2013based tool for overnight orthokeratology lens fitting","volume":"13","author":"Koo S.","year":"2024","journal-title":"Translational Vision Science & Technology"},{"key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis J.R.","year":"1977","journal-title":"Biometrics"},{"key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.eclinm.2019.03.001","article-title":"Diagnostic efficacy and therapeutic decision\u2010making capacity of an artificial intelligence platform for childhood cataracts in eye clinics: a multicentre randomized controlled trial","volume":"9","author":"Lin H.","year":"2019","journal-title":"EClinicalMedicine"},{"key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1167\/tvst.14.1.6","article-title":"Conjunctival bulbar redness extraction pipeline for high\u2010resolution ocular surface photography","volume":"14","author":"Ostheimer P.","year":"2025","journal-title":"Translational Vision Science & Technology"},{"key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.47709\/ijmdsa.v2i1.2513","article-title":"Transforming healthcare: harnessing the power of AI in the modern era","volume":"2","author":"Patil S.","year":"2023","journal-title":"Ijmdsa"},{"key":"e_1_2_10_27_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10020336","article-title":"The role of Back optic zone diameter in myopia control with orthokeratology lenses","volume":"10","author":"Paun\u00e9 J.","year":"2021","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.clae.2020.03.016","article-title":"Orthokeratology in adults and factors affecting success: study design and preliminary results","volume":"43","author":"Ren Q.","year":"2020","journal-title":"Contact Lens & Anterior Eye"},{"key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"e229","DOI":"10.1111\/aos.15746","article-title":"A systematic review and meta\u2010analysis of the efficacy of different optical interventions on the control of myopia in children","volume":"102","author":"Sarkar S.","year":"2024","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_10_30_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/aos.17496","article-title":"Efficacy of interventions for myopia control in children: a systematic review with network meta\u2010analyses","volume":"103","author":"Schmidt D.C.","year":"2025","journal-title":"Acta Ophthalmologica"},{"key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ajo.2026.02.017","article-title":"Prediction of 9 artificial intelligence\u2010based intraocular lens power calculation formulas in long Caucasian eyes","volume":"286","author":"Stopyra W.","year":"2026","journal-title":"American Journal of Ophthalmology"},{"key":"e_1_2_10_32_1","unstructured":"Tan T.F. Elangovan K. Jin L. Jie Y. Yong L. Lim J.et\u00a0al. (2024)Fine\u2010tuning large language model (LLM) artificial intelligence chatbots in ophthalmology and LLM\u2010based evaluation using GPT\u20104.arXiv."},{"key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.clae.2021.02.003","article-title":"BCLA CLEAR \u2013 orthokeratology","volume":"44","author":"Vincent S.J.","year":"2021","journal-title":"Contact Lens & Anterior Eye"},{"key":"e_1_2_10_34_1","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1038\/s41433-023-02765-9","article-title":"Clinical evaluation of deep learning systems for assisting in the diagnosis of the epiretinal membrane grade in general ophthalmologists","volume":"38","author":"Yan Y.","year":"2024","journal-title":"Eye"},{"key":"e_1_2_10_35_1","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1111\/opo.13360","article-title":"Development and evaluation of a deep neural network model for orthokeratology lens fitting","volume":"44","author":"Yang H.W.","year":"2024","journal-title":"Ophthalmic and Physiological Optics"},{"key":"e_1_2_10_36_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.apjo.2024.100085","article-title":"Understanding natural language: potential application of large language models to ophthalmology","volume":"13","author":"Yang Z.","year":"2024","journal-title":"Asia\u2010Pacific Journal of Ophthalmology"},{"key":"e_1_2_10_37_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.clae.2024.102350","article-title":"Artificial intelligence\u2010assisted fitting method using corneal topography outcomes enhances success rate in orthokeratology lens fitting","volume":"48","author":"Zhou X.","year":"2024","journal-title":"Contact Lens & Anterior Eye"}],"container-title":["Acta Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.70185","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aos.70185","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aos.70185","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T12:29:40Z","timestamp":1782217780000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aos.70185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,23]]},"references-count":36,"alternative-id":["10.1111\/aos.70185"],"URL":"https:\/\/doi.org\/10.1111\/aos.70185","archive":["Portico"],"relation":{},"ISSN":["1755-375X","1755-3768"],"issn-type":[{"value":"1755-375X","type":"print"},{"value":"1755-3768","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,23]]},"assertion":[{"value":"2025-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aos.70185"}}