Abstract
OBJECTIVE: This study aims at evaluating if ChatGPT-based artificial intelligence (AI) models are effective in interpreting electrocardiograms (ECGs) and determine their accuracy as compared to those of cardiologists. The purpose is therefore to explore if ChatGPT can be employed for clinical setting, particularly where there are no available cardiologists. METHODS: A total of 107 ECG cases classified according to difficulty (simple, intermediate, complex) were analyzed using three AI models (GPT-ECGReader, GPT-ECGAnalyzer, GPT-ECGInterpreter) and compared with the performance of two cardiologists. The statistical analysis was conducted using chi-square and Fisher exact tests using scikit-learn library in Python 3.8. RESULTS: Cardiologists demonstrated superior accuracy (92.52%) compared to ChatGPT-based models (GPT-ECGReader: 57.94%, GPT-ECGInterpreter: 62.62%, GPT-ECGAnalyzer: 62.62%). Statistically significant differences were observed between cardiologists and AI models (p < 0.05). ChatGPT models exhibited enhanced performance with female patients; however, the differences found were not statistically significant. Cardiologists significantly outperformed AI models across all difficulty levels. When it comes to diagnosing patients with arrhythmia (A) and cardiac structural disease ECG patterns, cardiologists gave the best results though there was no statistical difference between them and AI models in diagnosing people with normal (N) ECG patterns. CONCLUSIONS: ChatGPT-based models have potential in ECG interpretation; however, they currently lack adequate reliability beyond oversight from a doctor. Additionally, further studies that would improve the accuracy of these models, especially in intricate diagnoses are needed.