The Diagnostic and Triage Accuracy of the GPT-3 Artificial Intelligence Model

ImportanceArtificial intelligence (AI) applications in health care have been effective in many areas of medicine, but they are often trained for a single task using labeled data, making deployment and generalizability challenging. Whether a general-purpose AI language model can perform diagnosis and triage is unknown. ObjectiveCompare the general-purpose Generative Pre-trained Transformer 3 (GPT-3) AI models diagnostic and triage performance to attending physicians and lay adults who use the Internet. DesignWe compared the accuracy of GPT-3s diagnostic and triage ability for 48 validated case vignettes of both common (e.g., viral illness) and severe (e.g., heart attack) conditions to lay people and practicing physicians. Finally, we examined how well calibrated GPT-3s confidence was for diagnosis and triage. Setting and ParticipantsThe GPT-3 model, a nationally representative sample of lay people, and practicing physicians. ExposureValidated case vignettes (<60 words; <6th grade reading level). Main Outcomes and MeasuresCorrect diagnosis, correct triage. ResultsAmong all cases, GPT-3 replied with the correct diagnosis in its top 3 for 88% (95% CI, 75% to 94%) of cases, compared to 54% (95% CI, 53% to 55%) for lay individuals (p<0.001) and 96% (95% CI, 94% to 97%) for physicians (p=0.0354). GPT-3 triaged (71% correct; 95% CI, 57% to 82%) similarly to lay individuals (74%; 95% CI, 73% to 75%; p=0.73); both were significantly worse than physicians (91%; 95% CI, 89% to 93%; p<0.001). As measured by the Brier score, GPT-3 confidence in its top prediction was reasonably well-calibrated for diagnosis (Brier score = 0.18) and triage (Brier score = 0.22). Conclusions and RelevanceA general-purpose AI language model without any content-specific training could perform diagnosis at levels close to, but below physicians and better than lay individuals. The model was performed less well on triage, where its performance was closer to that of lay individuals.