Table 3.
ChatGPT‐Provided Treatment and Physician Agreement
| Prompt | Treatment | Median (IQR) | Range |
|---|---|---|---|
| 1 |
Based on the given scenario, the most likely diagnosis is an orbital blowout fracture. Here's a suggested treatment plan: Consults—ophthalmology, OMFS Radiographic studies—CT scan of orbits and facial bones Medical treatment—pain control, tetanus prophylaxis if immunization is not up to date, antibiotics may be prescribed Surgical treatment—depending on the extent of the fracture, muscle entrapment, and any functional or cosmetic concerns, surgical repair may be necessary within 1‐2 weeks of injury. Surgery typically involves reconstruction of the orbital floor or wall with implants or grafts, as well as the release of any entrapped muscles Follow‐up—regular follow‐up appointments with ophthalmology and maxillofacial surgery |
4.00 (2.00) | 1.00‐5.00 |
| 2 |
The most likely diagnosis, in this case, is acute bacterial sinusitis. Here's a suggested treatment plan: Consults—ENT if symptoms persist despite medical therapy Radiographic studies—CT sinus if there is no significant improvement within 48‐72 hours of starting antibiotics Medical treatment—antibiotics (amoxicillin‐clavulanate for 5‐10 days in adults; doxycycline or a respiratory fluoroquinolone if the patient has a penicillin allergy) Symptomatic relief—pain relief, oral or topical nasal decongestant no longer than 3 days to avoid rebound congestion, nasal saline irrigation Follow up—educate the patient on the importance of completing the full course of antibiotics, follow up in 10‐14 days |
5.00 (1.00) | 4.00‐5.00 |
| 3 |
Given the patient's history and presentation, the most likely diagnosis is squamous cell carcinoma (SCC) of the tongue. Here's a suggested treatment plan: Consults—ENT and OMFS Radiographic studies—contrast‐enhanced CT or MRI of the head and neck, CXR, or CT chest may be considered to rule out distant metastasis Other studies—biopsy of the lesion should be performed, along with imaging can be used to stage the tumor for treatment Treatment—may include a combination of surgery, radiation therapy, and chemotherapy |
5.00 (1.00) | 4.00‐5.00 |
| |||
| 4 |
The most likely diagnosis, in this case, is a spontaneous cerebrospinal fluid leak. Here's a suggested treatment plan: Consults—ENT and/or NSGY if CSF leak does not resolve with conservative measures Radiographic studies—high‐resolution CT of sinuses, MRI with intrathecal gadolinium Other studies—LP to measure opening pressure and obtain CSF for analysis Medical treatment—bed rest with head elevation, analgesics, and prophylactic antibiotics to minimize the risk of meningitis if necessary Surgical treatment—endoscopic surgical repair if the leak does not resolve with conservative measures, lumbar drain or shunt if the leak is not identifiable or if multiple leaks are present Follow up—weight loss/obesity management, monitor recurrence of symptoms which if persist or worsen then consider repeat imaging and re‐evaluating treatment plan |
5.00 (2.00) | 2.00‐5.00 |
| 5 |
The most likely diagnosis, in this case, is granulomatosis with polyangiitis. Here's a suggested treatment plan: Consults—rheumatology, ENT Radiographic studies— CXR, CT Chest Labs—CBC, CMP, ESR, CRP, ANCA, UA Biopsy—nasal or sinus biopsy Medical treatment—induction high‐dose corticosteroids with a DMARD; maintenance with less toxic DMARD Follow up—rheumatology, monitor laboratory markers, assess for end organ complications |
4.00 (4.00) | 1.00‐5.00 |
| 6 |
Based on the patient's history and presentation, the most likely diagnosis is a vestibular schwannoma (acoustic neuroma). Here's a suggested treatment plan: Consults—neuro‐otologist, NSGY, audiologist Radiographic studies—MRI head w/contrast Treatment options—observation (small tumors with mild symptoms), stereotactic radiosurgery (serviceable hearing and tumor < 3 cm), surgical resection (large tumors with significant symptoms or when hearing preservation is not possible) Follow‐up—facial nerve rehabilitation, neuro‐otology, NSGY |
5.00 (0) | 1.00‐5.00 |
| 7 |
The most likely diagnosis is Chronic Otitis Media with Cholesteatoma. Here is a treatment plan for this condition: Consults—ENT, audiologist Radiographic studies—high‐resolution CT of the temporal bones Medical treatment—treat concurrent infections with antibiotics and/or corticosteroid ear drops Surgical treatment—excision which may include canal‐wall‐up or canal‐wall‐down mastoidectomy with tympanoplasty Follow up—monitor for postoperative complications, regular follow up with otoscopic exams and audiograms, manage eustachian tube dysfunction and allergic rhinitis |
5.00 (0) | 1.00‐5.00 |
| 8 |
The most likely diagnosis, in this case, is pheochromocytoma with a cervical paraganglioma. Here's a treatment plan for this patient: Consults—endocrinology, ENT Radiographic studies—CT or MRI of the neck with contrast, abdominal CT or MRI Labs—plasma or 24‐hour urine metanephrines and catecholamines, CBC, renal function tests, and electrolytes Medical treatment—alpha‐blockers and subsequently beta‐blockers Surgical treatment—laparoscopic or open adrenalectomy and neck dissection Follow‐up—monitor patient's blood pressure and catecholeamine levels, adjust antihypertensive medications, imaging and laboratory testing for recurrence |
4.00 (1.00) | 2.00‐5.00 |
| 9 |
For the most likely diagnosis of auricular hematoma, the treatment plan would include the following steps: Consults—ENT Treatment—cold compress, aspiration or incision and drainage, pressure dressing or bolster after drainage, antibiotic prophylaxis, pain management Follow‐up—ENT within 1 week to monitor healing and removal of pressure dressing, avoid contact sports or other potentially traumatic activities until healing, and protective headgear in the future for prevention |
5.00 (0) | 4.00‐5.00 |
| 10 |
The most likely diagnosis, in this case, is sudden sensorineural hearing loss. Here's a treatment plan for this patient: Consults—ENT Radiographic studies—MRI brain and IAC with contrast Labs—CBC, renal function tests, electrolytes, autoimmune labs, and infectious etiologies (eg, Lyme disease, syphilitic) if indicated Treatment—oral corticosteroids preferably within 72 hours of onset with a 10‐14 day taper, intratympanic corticosteroid injections if oral treatment is contraindicated or ineffective, supportive care including hearing aids or assistive listening devices as necessary Follow up—follow up audiograms and adjust treatments as necessary |
4.00 (1.00) | 3.00‐5.00 |
| 11 |
The most likely diagnosis in this case is subglottic stenosis. The treatment plan for subglottic stenosis includes the following: Consults—ENT, pulmonology Radiographic studies—CT neck and chest Other studies—flexible laryngoscopy, pulmonary function tests Medical treatment—inhaled corticosteroids and bronchodilators Surgical options—endoscopic dilation, endoscopic lysis of adhesions, laser surgery, open surgical repair Follow‐up—speech therapy, pulmonary rehabilitation, regular follow‐up with ENT and pulmonology to monitor for recurrence |
5.00 (1.00) | 3.00‐5.00 |
| 12 |
The most likely diagnosis, in this case, is Sjögren's syndrome. Here's a treatment plan for this patient: Consults—rheumatology, ophthalmology Radiographic studies—CXR or CT test, parotid gland ultrasound Labs—CBC, renal function tests, electrolytes, liver function tests, ANA, anti‐Ro/SSA, anti‐La/SSB, ESR, CRP, immunoglobulins Other studies—Schirmer's test, minor salivary gland biopsy if clinically indicated Treatment—artificial tears and lubricating eye ointments, saliva substitutes, sugar‐free gum or lozenges, hydroxychloroquine, NSAIDs, pilocarpine, or cevimeline Follow‐up—close monitoring for potential complications, regular dental care, and good oral hygiene |
4.00 (3.00) | 1.00‐5.00 |
| 13 |
The most likely diagnosis, in this case, is a goiter associated with Hashimoto's thyroiditis. The treatment plan for goiter in the context of Hashimoto's thyroiditis includes the following: Consults—endocrinology Radiographic studies—thyroid ultrasound Labs—thyroid function tests Other studies—fine‐needle aspiration biopsy Medical treatment—levothyroxine for hypothyroidism and optionally for goiter size reduction Surgical treatment—thyroidectomy (partial or total) if there are compressive symptoms, malignancy is confirmed or strongly suspected, goiter is cosmetically bothersome Follow‐up—endocrinology, periodic thyroid ultrasound, and thyroid function tests |
5.00 (1.00) | 2.00‐5.00 |
| 14 |
The most likely diagnosis, in this case, is orbital cellulitis. Here's a treatment plan for this patient: Consults—ENT, ophthalmology Radiographic studies—CT or orbit and sinuses with contrast Labs—CBC, blood cultures, culture from sinus or conjunctival swab if possible Medical treatment—hospital admission, broad‐spectrum intravenous antibiotics to cover staphylococcus aureus and streptococcus species, adjust antibiotics when culture results are available, analgesics and antipyretics, nasal decongestants Surgical treatment—consider drainage of abscess or endoscopic sinus surgery in cases of severe infection, abscess, or lack of clinical improvement with conservative management Follow‐up—monitor for complications including vision loss, cavernous sinus thrombosis, and intracranial spread of infection |
5.00 (1.00) | 1.00‐5.00 |
| 15 |
The most likely diagnosis, in this case, is a peritonsillar abscess. Here is a suggested treatment plan: Consults—ENT Radiographic studies—CT neck with contrast Labs—CBC, blood cultures Medical treatment—intravenous hydration, intravenous broad‐spectrum antibiotics to cover group A Streptococcus and anaerobes, analgesics and antipyretics, adjust antibiotics based on culture and clinical response Surgical treatment—needle aspiration, incision, and drainage, or tonsillectomy Follow‐up—monitor patient's clinical response to treatment, follow up with ENT for recovery, and discuss elective tonsillectomy if recurrent tonsillitis is an issue |
5.00 (1.00) | 2.00‐5.00 |
| 16 |
The most likely diagnosis, in this case, is vocal fold nodules. Here's a treatment plan for this patient: Consults—ENT, speech‐language pathologist Other studies—laryngoscopy, videostroboscopy Medical treatment—voice therapy, vocal hygiene, voice rest, vocal warm‐ups and cool‐downs Surgical treatment—microlaryngoscopy with excision or laser ablation if conservative management fails to yield improvement or in severe cases Follow‐up—monitor for improvement with voice therapy and consider re‐evaluating diagnosis and exploring alternative treatments if there is no significant improvement in a few months |
4.00 (1.00) | 1.00‐5.00 |
| 17 |
Based on the most likely diagnosis of recurrent laryngeal nerve injury or palsy following coronary artery bypass graft surgery, I can suggest a general approach for management: Consults—ENT Radiographic studies—CT or MRI of neck and chest Other studies—laryngoscopy Medical treatment—voice and swallow therapy Surgical treatment—injection laryngoplasty, medialization thyroplasty, or arytenoid adduction Follow‐up—aspiration precautions, pneumonia prevention, follow‐up with ENT and speech‐language pathology |
5.00 (1.00) | 4.00‐5.00 |
| 18 |
The most likely diagnosis, in this case, is congenital muscular torticollis. Here's a treatment plan for this patient: Consults—pediatrician, physical therapist Radiographic studies—neck ultrasound Medical treatment—physical therapy, parent education for strengthening and stretching exercises, head positioning techniques Surgical treatment—surgical release of the sternocleidomastoid muscle in severe cases or cases where physical therapy fails to yield improvement Follow‐up—pediatrician, physical therapist |
5.00 (1.00) | 2.00‐5.00 |
| 19 |
Based on the most likely diagnosis of acute suppurative thyroiditis, I can suggest a general approach for management: Consults—endocrinology, ENT Radiographic studies—neck ultrasound, CT neck with contrast Labs—CBC, thyroid function tests Other studies—fine‐needle aspiration Medical treatment—intravenous broad‐spectrum antibiotics until culture results are available after which adjust the antibiotics for a 2‐3 week course, pain and fever management Surgical treatment—drainage of abscess or in rare cases thyroidectomy (partial or total) Follow‐up—endocrinology, ENT |
3.00 (3.00) | 1.00‐5.00 |
| 20 |
The most likely diagnosis, in this case, is acute otitis media with complications. Here's a treatment plan for this patient: Consults—ENT, audiology Imaging studies—CT of the temporal bone Other studies—CBC, CRP, ESR Medical treatment—broad‐spectrum antibiotics, analgesics, antipyretics Surgical treatment—myringotomy with or without tympanostomy tube placement or a mastoidectomy if complications such as mastoiditis or cholesteatoma are identified Follow‐up—close monitoring for improvement, complications, and need for surgery |
4.00 (2.00) | 2.00‐5.00 |
| Overall | 5.00 (1.00) | 1.00‐5.00 |
Abbreviations: ANA, antinuclear antibody; ANCA, antineutrophil cytoplasmic antibody; CBC, complete blood count; ChatGPT, chat generative pretrained transformer; CMP, comprehensive metabolic panel; CRP, C‐reactive protein; CSF, cerebrospinal fluid; CT, computed tomography; CXR, chest X‐ray; DMARD, disease‐modifying antirheumatic drug; ENT, otolaryngology; ESR, erythrocyte sedimentation rate; IAC, internal auditory canal; IQR, interquartile range; LP, lumbar puncture; MRI, magnetic resonance imaging; NSAIDs, nonsteroidal anti‐inflammatory drugs; NSGY, neurosurgery; OMFS, oral maxillofacial surgery; SCC, squamous cell carcinoma; UA, urinanalysis.