Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 22:22:100599.
doi: 10.1016/j.xnsj.2025.100599. eCollection 2025 Jun.

A comparative analysis between ChatGPT versus NASS clinical guidelines for adult isthmic spondylolisthesis

Che Chung Justin Lin  1   2 , Ewa Zuzanna Krzyż  3 , Sung Huang Laurent Tsai  1   2   4   5 , Ying-Chih Wang  1   2 , Chia-Wei Chang  1   2 , Tung Yi Lin  1   2 , Tsai Sheng Fu  6
Affiliations

A comparative analysis between ChatGPT versus NASS clinical guidelines for adult isthmic spondylolisthesis

Che Chung Justin Lin et al. N Am Spine Soc J. .

Abstract

Background: Isthmic spondylolisthesis is a prevalent condition often diagnosed in adults, especially those with low back pain. The main objective of this study was to evaluate the clinical viability of ChatGPT 3.5 and 4.0 by assessing its capacity to produce recommendations consistent with NASS's Evidence-based Clinical Guidelines for adult isthmic spondylolisthesis.

Methods: To achieve the purpose of this study, we used the 2014 NASS Evidence-Based Clinical Guideline for Multidisciplinary Spine Care and presented its 31 questions to ChatGPT 3.5 and ChatGPT 4.0 separately, evaluating their responses for appropriateness and consistency with the guidelines.

Results: ChatGPT 3.5 and ChatGPT 4.0 demonstrated concordance rates with the NASS guidelines of 45% and 42%, respectively, with ChatGPT 3.5 showing higher accuracy (91%) for questions with definitive recommendations and both versions showing lower concordance (20%) for questions with no direct recommendations.

Conclusions: Future enhancements should focus on enabling ChatGPT to better reflect the latest evidence and clinical complexities, especially concerning issues that involve medical terms.

Keywords: Artificial intelligence in healthcare; Chat GPT; Isthmic spondylolisthesis; Low back pain; NASS guidelines; Spine.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

    1. Lauerman W.C., Cain JE. Isthmic Spondylolisthesis in the Adult. J Am Acad Orthop Surg. 1996;4(4):201–208. - PubMed
    1. Tawfik S., Phan K., Mobbs R.J., Rao PJ. The Incidence of Pars Interarticularis Defects in Athletes. Global Spine J. 2020;10(1):89–101. - PMC - PubMed
    1. Fredrickson B.E., Baker D., McHolick W.J., Yuan H.A., Lubicky JP. The natural history of spondylolysis and spondylolisthesis. J Bone Joint Surg Am. 1984;66(5):699–707. - PubMed
    1. Kreiner D.S., Baisden J., Mazanec D., Patel R., Bess R.S., Burton D. Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care North American Spine Society. 2014. Diagnosis and treatment of adult isthmic spondylolisthesis; p. 1016. - PubMed
    1. Scott Kreiner D., Baisden J., Mazanec D.J., et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of adult isthmic spondylolisthesis. Spine J. 2016;16(12):1478–1485. - PubMed

LinkOut - more resources