Assessing adult sinusitis guidelines: A comparative analysis of AAO-HNS and AI Chatbots

Objective: To compare the guidelines offered by the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNS) on adult sinusitis to chatbots. Methods: ChatGPT-3.5, ChatGPT-4.0, Bard, and Llama 2 represent openly accessible large language model-based chatbots. Accuracy, over-conclusiveness, supplemental, and incompleteness of chatbot responses were compared to the AAO-HNS Adult sinusitis clinical guidelines. Results: 12 guidelines consisting of 30 questions from the AAO-HNS were compared to 4 different chatbots. Adherence to AAO-HNS guidelines varied, with Llama 2 providing 80 % accurate responses, BARD 83.3 %, ChatGPT-4.0 80 %, and ChatGPT-3.5 73.3 %. Over-conclusive responses were minimal, with only one instance each from Llama 2 and ChatGPT-4.0. However, rates of incomplete responses varied, with Llama 2 exhibiting the highest at 40 %, followed by ChatGPT-4.0 at 33.3 %, BARD at 23.3 %, and ChatGPT-3.5 at 36.7 %. Fisher's Exact Test analysis revealed significant deviations from the guideline standard, with less accuracy (p = 0.012 for Llama 2, p = 0.026 for BARD, p = 0.012 for ChatGPT-4.0, p = 0.002 for ChatGPT-3.5), inclusion of supplemental data (p < 0.001 for all), and less completeness (p < 0.01 for all) across all chatbots, indicating potential areas for enhancement in their performance. Conclusion: Although AI chatbots like Llama 2, Bard, and ChatGPT exhibit potential in sharing health-related information, their present performance in responding to clinical concerns concerning adult rhinosinusitis is not up to par with recognized clinical criteria. Future revisions should focus on addressing these shortcomings and placing an emphasis on accuracy, completeness, and conformity with evidence-based practices.