Research Appraisalobservational

Performance of DeepSeek V3, DeepSeek R1, ChatGPT 4o, and ChatGPT o1 on the National Health Professional and Technical Qualification Examination (Intermediate Level) in China: Comparative Analysis

JMIR formative researchXue, Jipeng, Wang, Shitong, Yang, Jinan et al.6 Apr 2026DOI

Clinical Snapshot

55CEBM
Evidence: Weakobservational

PICO Framework

P — Population398 multiple-choice questions from Chinese National Health Professional and Technical Qualification Examination (Intermediate Level)
I — InterventionDeepSeek V3 and DeepSeek R1 large language models
C — ComparatorChatGPT 4o and ChatGPT o1 models
O — OutcomesAccuracy rates on examination questions across different medical specialties and question types

Bottom Line

This comparative study demonstrates superior performance of DeepSeek V3 and R1 models over ChatGPT variants on Chinese medical examination questions, achieving over 90% accuracy compared to approximately 70% for ChatGPT models. However, the clinical relevance to Australian practice is limited due to the Chinese-specific context, examination format, and language requirements. The study lacks important methodological details about question selection and fails to address critical implementation considerations such as clinical reasoning quality, safety implications, and cost-effectiveness. While the results suggest potential for AI assistance in medical decision-making, significant validation would be required before considering application in Australian healthcare settings. The marked performance decline in complex case-based questions (section 4) highlights current limitations in AI clinical reasoning capabilities.

Evidence: Weak

Key Findings

  • P Value: P<.001 for comparisons with DeepSeek V3

  • Effect Size: DeepSeek V3: 93%, DeepSeek R1: 93.6%, ChatGPT 4o: 73.3%, ChatGPT o1: 69%

  • Primary Outcome: Overall accuracy on Chinese National Health Professional and Technical Qualification Examination

  • Nnt Or Sensitivity: Performance varied by specialty: DeepSeek models consistently superior in first 3 sections, all models declined in section 4

  • Confidence Interval: Not reported

Clinical Application

Technical feasibility demonstrated but practical implementation barriers not assessed Limited relevance to Australian practice due to language, cultural, and healthcare system differences. Would require validation with Australian medical examinations and clinical scenarios before any consideration for local implementation Limited to Chinese healthcare context and examination system

Abstract

BACKGROUND: In recent years, large language models (LLMs) have undergone swift cycles of refinement and iteration. However, in the realm of clinical medicine, different LLMs' capability of logical reasoning and disease diagnosis needs further investigation. OBJECTIVE: The aim of our study was to evaluate the performance of 4 different LLMs in the National Health Professional and Technical Qualification Examination in China. METHODS: A total of 398 multiple-choice questions of 5 different question types were integrated within the examination with respect to the diagnosis or care of cases. These questions were categorized into different cardiology subspecialties and different clinical disciplines. DeepSeek V3 and R1 were accessed through an application programming interface, while ChatGPT 4o and o1 were queried via its public chat-based interface. We offered the same prompts instructing LLMs to assume the role of a physician and provide answers with explanations at the beginning of each conversation. We assessed different LLMs' performance by the accuracy in the responses to the multiple-choice questions. For the first 3 examination sections, McNemar test was used to compare the accuracy among the models, with post hoc pairwise comparisons performed using partitions of chi-square method and Bonferroni correction (significance set at P<.008). For the fourth section involving partially credit scoring, one-way ANOVA was performed to compare the mean scores among the models, with statistical significance set at P<.05. RESULTS: Both DeepSeek V3 and R1 showed superior performance in the first 3 sections of the Chinese National Health Professional and Technical Qualification Examination, achieving an overall performance of 93% and 93.6%, respectively. ChatGPT 4o and o1 achieved accuracies of 73.3% and 69%, respectively (all P<.001 compared with DeepSeek V3). For the fourth section, the performance of all 4 LLMs markedly declined compared to their results in the preceding sections. Particularly, in the section of gastroenterology and hematology, DeepSeek V3 achieved the highest accuracy, while R1 ranked first in cardiology and neurology. ChatGPT o1 achieved the highest accuracy in the topic of coronary artery disease, with no statistical significance. CONCLUSIONS: DeepSeek V3 and R1 showed remarkable potential in facilitating clinical decision-making in the Chinese professional examination, with both outperforming ChatGPT 4o and o1. Nonetheless, future research should continue evaluating their economic efficiency and susceptibility to hallucination.

References

  1. 1.Xue, J., Wang, S., Yang, J., Guo, X., Shen, J., & Wang, Q. (2026). Performance of DeepSeek V3, DeepSeek R1, ChatGPT 4o, and ChatGPT o1 on the National Health Professional and Technical Qualification Examination (Intermediate Level) in China: Comparative Analysis. JMIR Formative Research. https://doi.org/10.2196/90673
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