{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T15:26:02Z","timestamp":1787153162535,"version":"build-2736575974"},"reference-count":21,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"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":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Little is known about large language model (LLM) performance on palliative care (PC)-related knowledge-based tasks. We evaluated two LLMs in answering PC-related test questions and explaining their answer choice rationale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      LLMs were prompted to answer 25 randomly selected questions from the\n                      <jats:italic toggle=\"yes\">Fast Facts Quiz<\/jats:italic>\n                      and provide their answer choice rationale. Three PC educators ranked and rated LLM-generated answer choice explanations versus the test\u2019s answer key explanations. Linear fixed-effect models evaluated reviewer ranking, and ordinal logistic regression evaluated reviewer ratings of quality, suitability, accuracy, relevance, and comprehensiveness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Both LLMs answered 96% of selected questions correctly. Reviewers rated LLM-generated explanations more highly than\n                      <jats:italic toggle=\"yes\">Fast Facts Quiz<\/jats:italic>\n                      explanations. Five themes emerged from reviewer comments: perceived inaccuracies, clarity of writing, educational value, linguistic style, and miscellaneous.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      LLMs demonstrated high answer choice accuracy and generated preferable answer explanations when compared to the\n                      <jats:italic toggle=\"yes\">Fast Facts Quiz<\/jats:italic>\n                      answer key.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261456817","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:23:12Z","timestamp":1780460592000},"page":"1282-1286","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Performance of Large Language Models on Palliative Care Test Questions: A Mixed Methods Study"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8404-8452","authenticated-orcid":false,"given":"Isaac S.","family":"Chua","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA."},{"name":"Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Ting","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California Irvine, Orange, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc D.","family":"Succi","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Zhang","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Yeh","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Medicine, Division of General Internal Medicine, Section of Palliative Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara M.","family":"Skarf","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Section of Palliative Care, VA Boston healthcare System, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Doyle","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Department of Medicine, Division of Palliative Care &amp; Geriatric Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Gundersen","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School, Rutgers Institute for Nicotine and Tobacco Studies, Newark, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Bates","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of General Internal Medicine and Primary Care, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA."},{"name":"Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Department of Healthcare Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1404684"},{"key":"e_1_3_2_3_1","unstructured":"2.World Health Organization. Palliative care. 2020. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/palliative-care [Last accessed: May2 2025]."},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-017624"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.00018"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/m23-2772"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.2789"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.01.008"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2024.0526"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.06.019"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.25259\/IJPC_155_2023"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-03425-5"},{"key":"e_1_3_2_13_1","unstructured":"12.Winsconsin PNo. Fast facts quiz. Available from: https:\/\/www.mypcnow.org\/fast-facts\/quiz\/ [Last accessed: July11 2025]."},{"key":"e_1_3_2_14_1","unstructured":"13.Palliative Care Network of Wisconsin. About fast facts & concepts. Available from: https:\/\/www.mypcnow.org\/fast-facts\/about\/ [Last accessed: November28 2025]."},{"key":"e_1_3_2_15_1","unstructured":"14.OpenAI. Hello GPT-4o. Available from: https:\/\/openai.com\/index\/hello-gpt-4o\/ [Last accessed: November28 2025]."},{"key":"e_1_3_2_16_1","unstructured":"15.Anthrop\\c. Claude 3.5 sonnet. Available from: https:\/\/www.anthropic.com\/news\/claude-3-5-sonnet [Last accessed: November28 2025]."},{"key":"e_1_3_2_17_1","unstructured":"16.Synscribe. GPT-4o Benchmark\u2014Detailed Comparison with Claude & Gemini. Available from: https:\/\/wielded.com\/blog\/gpt-4o-benchmark-detailed-comparison-with-claude-and-gemini"},{"key":"e_1_3_2_18_1","unstructured":"17.Qualtrics. 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