{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:46:35Z","timestamp":1788389195559,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"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 Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>ChatGPT has emerged as a medical resource through advanced language processing. Patients with thyroid nodules classified under The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) may use it to complement discussions with physicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to determine whether ChatGPT's recommendations on managing thyroid nodules classified by TBSRTC align with those of experienced thyroid specialists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants<\/jats:title>\n                    <jats:p>A multidisciplinary panel of 5 thyroid cancer specialists, including otolaryngologists and endocrinologists, from 3 university-affiliated teaching hospitals in Montreal, Canada, evaluated the responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention\/Exposure<\/jats:title>\n                    <jats:p>ChatGPT-3.5 was prompted with 4 questions for each of the 6 Bethesda categories regarding the meaning and management of thyroid nodules, generating 24 responses for evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome\/Measures<\/jats:title>\n                    <jats:p>We assessed ChatGPT\u2019s accuracy against the latest American Thyroid Association (ATA) guidelines using a 4-point Likert scale (&lt;50%, 50-74%, 75-89%, &gt;90%). Additionally, specialists rated their comfort or reluctance in recommending ChatGPT as a complementary tool for patient discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 24 ChatGPT-generated responses, 19 (79.2%) demonstrated moderate to good consistency with the ATA guidelines. The mean consistency score was 3.38\/4 and median was 3.5. Consensus (IQR \u2264 1) was achieved in 23 out of 24 responses (95.8%), reflecting strong inter-rater reliability. Consistency scores were highest in Bethesda I\u2013III and declined progressively in higher-risk categories, with the lowest mean score observed in Bethesda VI. Similarly, an upward trend in clinician reluctance was observed from Bethesda I through VI, indicating greater caution in recommending ChatGPT responses for patients suspicious for or diagnosed with malignancy (Bethesda V\u2013VI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>While ChatGPT\u2019s responses generally align with specialist recommendations, they are not fully reliable. ChatGPT lacks the ability to serve as an independent or accurate source of medical advice for thyroid nodule management. It remains a useful complement for patient discussions, especially in low-risk scenarios, but further improvements are necessary to make it a safe, reliable component of patient care in complex cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251387617","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T08:21:56Z","timestamp":1764577316000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Thyroid Nodule Experts Evaluating ChatGPT\u2019s Assessment of Thyroid Nodules Classified by the Bethesda System for Reporting Thyroid Cytopathology"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9438-1788","authenticated-orcid":false,"given":"Alexander","family":"Moise","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2581-3209","authenticated-orcid":false,"given":"Luiza","family":"Tatar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noa","family":"Sela","sequence":"additional","affiliation":[{"name":"Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Daniela da Silva","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Kouz","sequence":"additional","affiliation":[{"name":"D\u00e9partement d\u2019Endocrinologie, H\u00f4pital du Sacr\u00e9-C\u0153ur de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tamilia","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Jewish General Hospital, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael P.","family":"Hier","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique-Isabelle","family":"Forest","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Payne","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Jewish General Hospital, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0141"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-2566942\/v1"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000198"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-023-08326-w"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.48296"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/frai.2023.1169595"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab224"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0033354919874074"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-6507.23.03952-0"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.47576"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0491"},{"key":"e_1_3_2_14_2","unstructured":"OpenAI. 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