Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 2 appraisals
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
Comparing the performance of four mainstream large language models on medical literature review generation: a human expert evaluation in SMILE surgery
PURPOSE: To systematically evaluate and compare the performance of four leading large language models (LLMs) in generating medical literature reviews across topics of varying research maturity, thereby providing insights for their effective and responsible application in academic writing. METHODS: In this comparative study, using standardized prompts, we instructed four leading LLMs (GPT-4, Gemini 2.5 Pro, Grok-3, and DeepSeek R1) to generate literature reviews on nine topics related to small incision lenticule extraction (SMILE) surgery. These topics were categorized into three groups by research maturity: well-researched, controversial, and open. Seven ophthalmology experts evaluated the generated content across four dimensions: quality, accuracy, bias, and relevance, while all references were verified for authenticity. Performance differences among models were evaluated using group comparison tests followed by post-hoc analysis. RESULTS: Significant performance variations were identified across all four models and dimensions (p < 0.001). Specifically, Gemini ranked highest in content quality, accuracy, and bias control. In contrast, DeepSeek, despite its high-quality score, received the lowest relevance score. Grok-3 demonstrated the highest reference authenticity (p < 0.001), whereas GPT-4's was the lowest (p < 0.001). All models showed diminished performance on open topics and exhibited severe reference fabrication ("hallucinations"). CONCLUSION: Rather than excelling universally, LLMs exhibit distinct and task-specific strengths that mandate a task-driven, hybrid strategy in tool selection. Reference fabrication was found to be a pervasive issue across all models, regardless of the task topic, elevating human verification from a best practice to an essential safeguard for academic integrity.
9 May 2026
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Automatic measurement and evaluation of anterior segment anatomical structures via UBM images using a deep learning-based approach
PURPOSE: To develop a deep-learning model capable of measuring essential anterior segment (AS) parameters derived from preoperative ultrasound biomicroscopy (UBM) images of candidates for implantable collamer lens (ICL) surgery. SETTING: Tianjin Medical University Eye Hospital, Tianjin, China. DESIGN: Cross-sectional retrospective study. METHODS: A dataset comprising 1,480 preoperative panoramic UBM images taken from 638 eyes of 320 subjects was collected and was divided into training and testing subsets at a proportion of 7:3. Using the YOLOv8-pose algorithm, the model identified ten anatomical key point coordinates and computed six relevant AS parameters. Both manual and anterior segment optical coherence tomography-based non-contact measurements served as reference standards for evaluating the model's accuracy. The relationship between postoperative vault and preoperative parameters measured by the model was analyzed using multiple linear regression. RESULTS: On the test dataset, the model achieved an intraclass correlation coefficient (ICC) exceeding 0.978, with a mean Euclidean distance of 67.65 ± 54.25 μm across all point locations. The ICC values for anterior chamber depth (ACD), pupil diameter, and sulcus-to-sulcus distance were above 0.980 (95% CI: 0.975 to 0.985), with average relative error below 1.7%. Additionally, postoperative vault at one month was significantly correlated with model-measured parameters, including crystalline lens rise, iris concavity, and ACD (P < 0.001). CONCLUSION: This study introduces a robust program capable of quantitatively measuring AS parameters with accuracy comparable to that of experienced ophthalmologists. The findings provide valuable guidance for ICL sizing and vault prediction.
5 May 2026
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