Research Appraisalother

Human versus artificial intelligence: evaluating ChatGPT's performance in conducting published systematic reviews with meta-analysis in chronic pain research

Regional anesthesia and pain medicinePurewal, Anam, Fautsch, Kalli, Klasova, Johana et al.2 Apr 2026DOI

Clinical Snapshot

75CEBM
Evidence: Moderateother

PICO Framework

P — PopulationSystematic review methodology tasks (title/abstract screening, full-text selection, data pooling) from a published meta-analysis on emotional functioning after spinal cord stimulation
I — InterventionChatGPT-4o artificial intelligence system performing systematic review tasks
C — ComparatorHuman-executed systematic review tasks (gold standard)
O — OutcomesAccuracy, sensitivity, specificity, positive predictive value, negative predictive value for screening tasks; accuracy of pooled effect estimates and forest plot generation

Bottom Line

This validation study demonstrates that ChatGPT-4o shows moderate accuracy (68-70%) for systematic review screening tasks but excellent performance in meta-analytic calculations. The AI tool achieved reasonable specificity (66-80%) but concerning sensitivity (55-76%) for study selection, meaning it may miss relevant studies. However, it performed exceptionally well in data pooling and statistical calculations with 100% accuracy for most meta-analytic outcomes. These findings suggest AI could augment systematic review workflows, particularly for computational tasks, but human oversight remains essential for study selection phases. For Australian researchers, this technology could enhance efficiency in evidence synthesis while maintaining methodological rigour required for clinical guidelines and regulatory submissions, provided appropriate quality assurance measures are implemented.

Evidence: Moderate

Key Findings

  • P Value: Not reported

  • Effect Size: Title/abstract screening accuracy 70.4%, full-text screening accuracy 68.4%

  • Primary Outcome: Diagnostic accuracy of ChatGPT for systematic review tasks

  • Nnt Or Sensitivity: Title/abstract screening: sensitivity 54.9%, specificity 80.1%; Full-text screening: sensitivity 75.6%, specificity 66.8%

  • Confidence Interval: Not reported

Clinical Application

Moderate - requires human oversight and verification, particularly for screening tasks Relevant to Australian researchers following NHMRC guidelines for systematic reviews; could support evidence synthesis for TGA submissions and clinical guideline development Researchers conducting systematic reviews and meta-analyses across medical specialties

Abstract

INTRODUCTION: Artificial intelligence (AI), particularly large-language models like Chat Generative Pre-Trained Transformer (ChatGPT), has demonstrated potential in streamlining research methodologies. Systematic reviews and meta-analyses, often considered the pinnacle of evidence-based medicine, are inherently time-intensive and demand meticulous planning, rigorous data extraction, thorough analysis, and careful synthesis. Despite promising applications of AI, its utility in conducting systematic reviews with meta-analysis remains unclear. This study evaluated ChatGPT's accuracy in conducting key tasks of a systematic review with meta-analysis. METHODS: This validation study used data from a published meta-analysis on emotional functioning after spinal cord stimulation. ChatGPT-4o performed title/abstract screening, full-text study selection, and data pooling for this systematic review with meta-analysis. Comparisons were made against human-executed steps, which were considered the gold standard. Outcomes of interest included accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for screening and full-text review tasks. We also assessed for discrepancies in pooled effect estimates and forest plot generation. RESULTS: For title and abstract screening, ChatGPT achieved an accuracy of 70.4%, sensitivity of 54.9%, and specificity of 80.1%. In the full-text screening phase, accuracy was 68.4%, sensitivity 75.6%, and specificity 66.8%. ChatGPT successfully pooled data for five forest plots, achieving 100% accuracy in calculating pooled mean differences, 95% CIs, and heterogeneity estimates (I2 score and tau-squared values) for most outcomes, with minor discrepancies in tau-squared values (range 0.01-0.05). Forest plots showed no significant discrepancies. CONCLUSION: ChatGPT demonstrates modest to moderate accuracy in screening and study selection tasks, but performs well in data pooling and meta-analytic calculations. These findings underscore the potential of AI to augment systematic review methodologies, while also emphasizing the need for human oversight to ensure accuracy and integrity in research workflows.

References

  1. 1.Purewal, A., Fautsch, K., Klasova, J., Hussain, N., & D'Souza, R. S. (2024). Human versus artificial intelligence: evaluating ChatGPT's performance in conducting published systematic reviews with meta-analysis in chronic pain research. Regional Anesthesia and Pain Medicine. https://doi.org/10.1136/rapm-2024-106358
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