Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 2 appraisals
Scientific reports
Performance of GPT-based large language models in hepatocellular carcinoma stratification: liver function assessment, BCLC staging, and treatment recommendations.
Large language models (LLMs) like GPT have been proposed to support complex clinical decision-making. This study evaluated the performance of GPT-based LLM in analyzing clinical, radiological, and laboratory data from patients with hepatocellular carcinoma (HCC) to assess liver function, assign BCLC stage, and recommend treatment. Data from 106 HCC patients (82% male, median age 65 [22-86]) were compiled into anonymized integrated reports. Four GPT-versions (4, o1, o3, 5.4) were prompted-using both short and long instructions-to calculate MELD, ALBI, and Child-Pugh scores, assign BCLC stage, and generate treatment recommendations based on current guidelines. Outputs were compared to expert consensus and tumor board decisions. Errors were categorized by type and source. Time and cost analyses compared GPT to clinical staff. All GPT versions achieved high accuracy (> 85%) in liver function assessment, with MELD calculation being the most error-prone. BCLC staging accuracy ranged from 46.2% (version 4) to 84.0% (o3), with misclassification of radiological reports as the main error source. Reasoning-optimized models (o1, o3) performed best for treatment recommendations, achieving an overall accuracy (correct suggestions and acceptable alternatives) of up to 90.6%. In 9-14% of cases, GPT suggestions were retrospectively more guideline-concordant than tumor board decisions. GPT processing was significantly faster and reduced costs by approximately 300- to 1300-fold compared to clinical staff. GPT-based LLMs show potential as decision-support tools for liver function assessment, BCLC staging, and treatment guidance in HCC. Particularly with reasoning-optimized models and detailed prompting, LLMs may serve as valuable adjuncts in multidisciplinary HCC workflows. However, a non-negligible error rate requires expert oversight and further model refinement.
14 June 2026
Read appraisal →Studies in health technology and informatics
Digital GO: A Clinical Decision-Support Dashboard for Gynecologic Oncology Tumor Board
Multidisciplinary Tumor Board (MTB) meetings are essential for coordinated oncologic decision-making but are often hindered by the complexity and fragmentation of patient data. This study presents the development of an interactive digital dashboard designed to streamline data access and visualization during ovarian cancer MTB sessions. The system leverages structured knowledge extracted from unstructured clinical reports using in-house large language model (LLM) pipelines. These outputs are harmonized within a cloud environment through dedicated processing workflows and mapped into a domain ontology, to ensure interoperability. The resulting dashboard, implemented using a dedicated functional module, enables both cohort-level exploration and patient-specific visualization, including longitudinal event timelines. Preliminary results demonstrate the feasibility of integrating LLM-based data extraction with a scalable visualization framework, offering a step toward the digital transformation of multidisciplinary oncology workflows.
24 May 2026
Read appraisal →