Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/116987
Title: Leveraging ChatGPT for report error audit : an accuracy-driven and cost-efficient solution for ophthalmic imaging reports
Authors: Xu, Y
Kang, D
Shi, D 
Tham, YC
Grzybowski, A
Jin, K
Issue Date: Dec-2025
Source: Ophthalmology and therapy, Dec. 2025, v. 14, no. 12, p. 3007-3020
Abstract: Introduction: Accurate ophthalmic imaging reports, including fundus fluorescein angiography (FFA) and ocular B-scan ultrasound, are essential for effective clinical decision-making. The current process, involving drafting by residents followed by review by ophthalmic technicians and ophthalmologists, is time-consuming and prone to errors. This study evaluates the effectiveness of ChatGPT-4o in auditing errors in FFA and ocular B-scan reports and assesses its potential to reduce time and costs within the reporting workflow.
Methods: Preliminary 100 FFA and 80 ocular B-scan reports drafted by residents were analyzed using GPT-4o to identify the errors in identifying left or right eye and incorrect anatomical descriptions. The accuracy of GPT-4o was compared to retinal specialists, general ophthalmologists, and ophthalmic technicians. Additionally, a cost-effective analysis was conducted to estimate time and cost savings from integrating GPT-4o into the reporting process. A pilot real-world validation with 20 erroneous reports was also performed between GPT-4o and human reviewers.
Results: GPT-4o demonstrated a detection rate of 79.0% (158 of 200; 95% CI 73.0–85.0) across all examinations, which was comparable to the average detection performance of general ophthalmologists (78.0% [155 of 200; 95% CI 72.0–83.0]; P ≥ 0.09). Integration of GPT-4o reduced the average report review time by 86%, completing 180 ophthalmic reports in approximately 0.27 h compared to 2.17–3.19 h by human ophthalmologists. Additionally, compared to human reviewers, GPT-4o lowered the cost from $0.21 to $0.03 per report (savings of $0.18). In the real-world evaluation, GPT-4o detected 18 of 20 errors with no false positives, compared to 95–100% by human reviewers.
Conclusions: GPT-4o effectively enhances the accuracy of ophthalmic imaging reports by identifying and correcting common errors. Its implementation can potentially alleviate the workload of ophthalmologists, streamline the reporting process, and reduce associated costs, thereby improving overall clinical workflow and patient outcomes.
Keywords: ChatGPT
Cost-effective
Error audit
Imaging reports
Ophthalmology
Publisher: Adis International Ltd.
Journal: Ophthalmology and therapy 
ISSN: 2193-8245
EISSN: 2193-6528
DOI: 10.1007/s40123-025-01248-2
Rights: © The Author(s) 2025
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.
The following publication Xu, Y., Kang, D., Shi, D. et al. Leveraging ChatGPT for Report Error Audit: An Accuracy-Driven and Cost-Efficient Solution for Ophthalmic Imaging Reports. Ophthalmol Ther 14, 3007–3020 (2025) is available at https://doi.org/10.1007/s40123-025-01248-2.
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