{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:37:37Z","timestamp":1777448257070,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Large language models (LLMs) are advanced tools capable of understanding and generating human-like text. This study evaluated the accuracy of several commercial LLMs in addressing clinical questions related to diagnosis and management of acute cholecystitis, as outlined in the Tokyo Guidelines 2018 (TG18). We assessed their congruence with the expert panel discussions presented in the guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated ChatGPT4.0, Gemini Advanced, and GPTo1-preview on ten clinical questions. Eight derived from TG18, and two were formulated by the authors. Two authors independently rated the accuracy of each LLM\u2019s responses on a four-point scale: (1) accurate and comprehensive, (2) accurate but not comprehensive, (3) partially accurate, partially inaccurate, and (4) entirely inaccurate. A third author resolved any scoring discrepancies. Then, we comparatively analyzed the performance of ChatGPT4.0 against newer large language models (LLMs), specifically Gemini Advanced and GPTo1-preview, on the same set of questions to delineate their respective strengths and limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ChatGPT4.0 provided consistent responses for 90% of the questions. It delivered \u201caccurate and comprehensive\u201d answers for 4\/10 (40%) questions and \u201caccurate but not comprehensive\u201d answers for 5\/10 (50%). One response (10%) was rated as \u201cpartially accurate, partially inaccurate.\u201d Gemini Advanced demonstrated higher accuracy on some questions but yielded a similar percentage of \u201cpartially accurate, partially inaccurate\u201d responses. Notably, neither model produced \u201centirely inaccurate\u201d answers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>LLMs, such as ChatGPT and Gemini Advanced, demonstrate potential in accurately addressing clinical questions regarding acute cholecystitis. With awareness of their limitations, their careful implementation, and ongoing refinement, LLMs could serve as valuable resources for physician education and patient information, potentially improving clinical decision-making in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251323719","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T12:30:57Z","timestamp":1741782657000},"page":"967-977","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Using Large Language Models in the Diagnosis of Acute Cholecystitis: Assessing Accuracy and Guidelines Compliance"],"prefix":"10.1177","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3763-8847","authenticated-orcid":false,"given":"Marta","family":"Goglia","sequence":"first","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"},{"name":"PhD School in Translational Medicine and Oncology, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3910-8307","authenticated-orcid":false,"given":"Arianna","family":"Cicolani","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco Maria","family":"Carrano","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niccol\u00f2","family":"Petrucciani","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"D\u2019Angelo","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Pace","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucio","family":"Chiarini","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranco","family":"Silecchia","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, Department of Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Aurello","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sapienza University of Rome, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2196\/57594"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)44477-4"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.515"},{"key":"e_1_3_4_5_2","unstructured":"Gemini Team Google. Gemini: A Family of Highly Capable Multimodal Models. Google. 2024. https:\/\/doi.org\/10.48550\/arXiv.2312.11805"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-023-06603-5"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-081155"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001066"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.13534"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2023.06.009"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/00031348241256075"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2023.11.008"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.57795"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.48185\/JAAI.V5I1.1052"},{"key":"e_1_3_4_15_2","unstructured":"Saab K Tu T Weng WH et al. Capabilities of gemini models in medicine. arXiv preprint arXiv:240418416. 2024."}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251323719","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251323719","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251323719","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:37:27Z","timestamp":1777379847000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251323719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,12]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1177\/00031348251323719"],"URL":"https:\/\/doi.org\/10.1177\/00031348251323719","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,12]]}}}