Observational Study on the Accuracy and Completeness of General Artificial Intelligence in the Diagnosis and Therapeutic Recommendations for Failed or Painful Total Hip Arthroplasty

Primary Goal:

This study aims to evaluate the diagnostic and therapeutic accuracy of GPT-4 (an advanced AI language model) compared to three orthopedic surgeons with varying experience levels in cases of failed or painful total hip arthroplasty.

Key Research Questions:

Diagnostic Accuracy:

Does GPT-4 provide correct, partially correct, or incorrect diagnoses compared to human orthopaedic surgeons?

Diagnostic Completeness:

Are GPT-4's diagnostic suggestions complete, partially complete, or incomplete compared to those of orthopedic surgeons?

Treatment Accuracy:

Does GPT-4 recommend correct, partially correct, or incorrect treatments for failed hip arthroplasty?

Treatment Completeness:

Are GPT-4's treatment recommendations fully comprehensive, partially complete, or incomplete compared to those of orthopaedic surgeon?

Study Design:

Participants:

20 anonymized patient cases (ages 18-80) with failed or painful hip arthroplasties, treated at IRCCS Istituto Ortopedico Rizzoli (Bologna, Italy) between 2004-2024.

Cases were selected based on clear diagnostic and treatment records (no ambiguous or incomplete data).

Comparison Groups:

GPT-4 (via ChatGPT interface)

Three orthopedic doctors (with different experience levels: resident, specialist, senior surgeon)

Method:

Each case (clinical summary + X-ray image) is presented to GPT-4 and the three doctors.

They must provide a diagnosis and treatment recommendations.

Two independent evaluators (principal investigator + department head) blindly assess responses for correctness and completeness using a 3-point scale (0=wrong/incomplete, 2=correct/complete).

Statistical analysis compares GPT-4 vs. human performance.

Expected Outcomes:

Determine if AI can match or outperform doctors in diagnosing and treating hip arthroplasty failures.

Assess whether GPT-4 could serve as a supplementary tool in orthopedic decision-making.

Ethical & Privacy Considerations:

No real-time patient data is used-only anonymized past cases.

No personal/sensitive data is shared with OpenAI (GPT-4 is used via a standard web interface).

Study complies with GDPR, HIPAA, and ethical AI guidelines.

Timeline:

Study duration: ~8 months (from ethics approval to final analysis).

Results will be published regardless of outcome.

Why This Study Matters:

First study evaluating GPT-4's role in complex orthopedic diagnostics.

Could influence future AI-assisted clinical decision-making in joint replacement surgeries.