Limitations of GPT-4 as a geriatrician in geri-oncology case conference - A case series

Sep 29, 2026

Uploaded by Levi

Generative pre-trained transformer 4 (GPT-4) is an AI system with a chat interface. The study tested whether GPT-4 could suggest management strategies for elderly oncology patients similarly to geriatricians. Four oncology patient cases were presented in geri-oncology case conferences, comparing GPT-4 responses with geriatrician responses. GPT-4 provided a multidisciplinary approach and identified medication-related side effects in the first prompt, but could not suggest initial medication dosages or non-pharmacological anorexia approaches.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages3

Reading Time8 min

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Abstract

1. Introduction

2. Methods

J Chin MedAssoc Brief CommuniCation Limitations of GPT-4 as a geriatrician in gerioncology case conference: A case series Ling-Yuk Kuka,* , Dora Lai-Wan Kwongb, Wing-Lok Wendy Chanb, Yat-Fung Sheaa aGeriatrics Division, Department of Medicine, Queen Mary Hospital, Hong Kong, China; bDepartment of Clinical Oncology, Center of Cancer Medicine, Queen Mary Hospital University of Hong Kong, Hong Kong, China Abstract Generative pre-trained transformer 4 (GPT-4) is an artificial intelligence (AI) system with a chat interface. The number of studies testing GPT-4 in clinical applications has been increasing. We hypothesized that GPT-4 would be able to suggest management strategies for medical issues in elderly oncology patients, similar to those provided by geriatricians. We compared the responses of GPT-4 to those of a geriatrician for four oncological patients. After these case conferences, none of the patients required admission for medical consultation. In three out of four scenarios, GPT-4 was able to offer a multidisciplinary approach in the first prompt. In all three scenarios, GPT-4 identified medication-related side effects and suggested appropriate medications in the first prompt. However, GPT-4 was unable to suggest initial dosages of medications to be used in the first prompt and was unable to suggest amore humanistic and non-pharmacological approach to anorexia, even with a follow-up prompt. In conclusion, GPT-4 may be used as a screening tool to provide potential rudimentary directions for management, which can then be reviewed by medical professionals before considering a formal consultation for more tailored and refined opinions from specialists. Keywords: Case conference; Geriatrics; GPT-4; Oncology 1. INTRODUCTION Artificial intelligence (AI) has been increasingly studied and utilized in medical consultations, such as those involving drug interactions or medical image analyses.1 Generative pre-trained transformer 4 (GPT-4), developed by OpenAI, is an AI system with a chat interface,1 which has been trained on internet textsand fine-tuned on more specific datasets with the help of human reviewers. In a typical “session,” a user enters a query, and GPT-4 generates a natural-language “response” within seconds. GPT-4 has been tested and has shown promising performance in medical examinations.1 Its potential use has also been explored in geriatric patients, as it may assist elderly patients with prolonged admissions with diagnostic difficulties.2 However, GPT-4 has limitations, such as its ability to analyze medical histories related to cognitive impairments.3 ChatGPT, which is an earlier version of an AI chatbot, has been suggested as a resource for providing useful personal information on personal obesity management, healthy lifestyles, and vaccination information for disease prevention.4,5 There has been an increasing number of consultations to geriatricians from other specialties, such as clinical oncologists, regarding medical issues in elderly patients.6 Because GPT-4 is the latest and most advanced form of AI chatbot, it may be able to provide * Address correspondence. Dr. Ling-Yuk Kuk, Department of Medicine, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, China. E-mail address: [kuklingyuk@gmail.com](kuklingyuk@gmail.com) (L.-Y. Kuk). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2024) 87: 148-150. Received August 22, 2023; accepted September 23, 2023. doi: 10. 1097/JCMA.0000000000001032 Copyright © 2023, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/)) more comprehensive suggestions for medical problems or can act as a “clinical consultant.

FAQs

What was the main goal of comparing GPT-4 with a geriatrician in geri-oncology case conferences?

To assess whether GPT-4 could provide management strategies for elderly oncology patients comparable to those from geriatricians, including multidisciplinary care and medication safety considerations.

In the four patient scenarios, what could GPT-4 do well in the first prompt?

In three of four scenarios, GPT-4 offered a multidisciplinary approach and in all three identified medication-related side effects and suggested appropriate medications.

What limitations did GPT-4 show despite follow-up prompt attempts?

GPT-4 was unable to suggest initial medication dosages in the first prompt and was unable to recommend a more humanistic, non-pharmacological approach to anorexia, even with a follow-up prompt.

Sep 29, 2026

Uploaded by Levi