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Apr 17 2024 University of Cambridge

The clinical knowledge and reasoning skills of GPT-4 are approaching the level of specialist eye doctors, a study led by the University of Cambridge has found.

GPT-4 – a 'large language model' – was tested against doctors at different stages in their careers, including unspecialized junior doctors, and trainee and expert eye doctors. Each was presented with a series of 87 patient scenarios involving a specific eye problem, and asked to give a diagnosis or advise on treatment by selecting from four options.

GPT-4 scored significantly better in the test than unspecialized junior doctors, who are comparable to general practitioners in their level of specialist eye knowledge.

GPT-4 gained similar scores to trainee and expert eye doctors – although the top performing doctors scored higher.

The researchers say that large language models aren't likely to replace healthcare professionals, but have the potential to improve healthcare as part of the clinical workflow.

They say state-of-the-art large language models like GPT-4 could be useful for providing eye-related advice, diagnosis, and management suggestions in well-controlled contexts, like triaging patients, or where access to specialist healthcare professionals is limited.

"We could realistically deploy AI in triaging patients with eye issues to decide which cases are emergencies that need to be seen by a specialist immediately, which can be seen by a GP, and which don't need treatment," said Dr Arun Thirunavukarasu, lead author of the study, which he carried out while a student at the University of Cambridge's School of Clinical Medicine

He added: "The models could follow clear algorithms already in use, and we've found that GPT-4 is as good as expert clinicians at processing eye symptoms and signs to answer more complicated questions.

"With further development, large language models could also advise GPs who are struggling to get prompt advice from eye doctors. People in the UK are waiting longer than ever for eye care.

Large volumes of clinical text are needed to help fine-tune and develop these models, and work is ongoing around the world to facilitate this. Related StoriesStudy reveals crucial insights into the ocular effects of Zika virus infection during pregnancyEye movement reflex reveals genetic association with autismNaturally-occurring material is an effective disinfectant for contact lenses, study suggests

The researchers say that their study is superior to similar, previous studies because they compared the abilities of AI to practicing doctors, rather than to sets of examination results.

"Doctors aren't revising for exams for their whole career. We wanted to see how AI fared when pitted against to the on-the-spot knowledge and abilities of practicing doctors, to provide a fair comparison," said Thirunavukarasu, who is now an Academic Foundation Doctor at Oxford University Hospitals NHS Foundation Trust.

He added: "We also need to characterise the capabilities and limitations of commercially available models, as patients may already be using them – rather than the internet – for advice."

The test included questions about a huge range of eye problems, including extreme light sensitivity, decreased vision, lesions, itchy and painful eyes, taken from a textbook used to test trainee eye doctors. This textbook is not freely available on the internet, making it unlikely that its content was included in GPT-4's training datasets.

The results are published today in the journal PLOS Digital Health. Even taking the future use of AI into account, I think doctors will continue to be in charge of patient care. The most important thing is to empower patients to decide whether they want computer systems to be involved or not. That will be an individual decision for each patient to make."

Dr. Arun Thirunavukarasu, lead author of the study

GPT-4 and GPT-3.5 – or 'Generative Pre-trained Transformers' – are trained on datasets containing hundreds of billions of words from articles, books, and other internet sources. These are two examples of large language models; others in wide use include Pathways Language Model 2 (PaLM 2) and Large Language Model Meta AI 2 (LLaMA 2).

The study also tested GPT-3.5, PaLM2, and LLaMA with the same set of questions. GPT-4 gave more accurate responses than all of them.

GPT-4 powers the online chatbot ChatGPT to provide bespoke responses to human queries. In recent months, ChatGPT has attracted significant attention in medicine for attaining passing level performance in medical school examinations, and providing more accurate and empathetic messages than human doctors in response to patient queries.

The field of artificially intelligent large language models is moving very rapidly. Since the study was conducted, more advanced models have been released – which may be even closer to the level of expert eye doctors. Source:

University of CambridgeJournal reference:

Thirunavukarasu, A. J., et al. (2024) Large language models approach expert-level clinical knowledge and reasoning in ophthalmology: A head-to-head cross-sectional study. PLOS Digital Health. doi.org/10.1371/journal.pdig.0000341.

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Politics

Starmer facing growing backbench rebellion over planned disability benefit cuts

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Starmer facing growing backbench rebellion over planned disability benefit cuts

A senior Labour MP has said the government needs to take “corrective action” over planned disability benefit cuts – as Sir Keir Starmer faces a growing backbench rebellion.

Tan Dhesi, chair of the influential Commons defence committee, told the Politics Hub with Sophy Ridge the “disappointing” local election results show the government must listen and learn, particularly over welfare reforms.

The government has proposed tightening the eligibility requirements for the personal independent payment, known as PIP.

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A claimant must score a minimum of four points on one PIP daily living activity, such as preparing food, washing and bathing, using the toilet or reading, to receive the daily living element of the benefit.

Mr Dhesi, the MP for Slough, said “corrective action” needs to be taken but insisted if the government changed tact, it would not be a U-turn as the disability cuts were only proposals.

Tan Dhesi said the government should take 'corrective action' over disability cuts
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Tan Dhesi spoke to Sky’s Sophy Ridge

“A government which is in listening mode should be looking at what the electorate is saying,” he said.

“And we need to make sure that it’s our moral duty, responsibility, to look after the most vulnerable within our community, whether that’s in Slough, whether that’s elsewhere across the country.

“So, I hope that the government will be taking on board that feedback and many of us as MPs are giving that feedback in various meetings happening here in Westminster and then we need to take corrective action.”

Alex Davies-Jones said the government is just consulting on cutting benefits
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Alex Davies-Jones said the government was seeking to ‘protect the vulnerable’

Minister Alex Davies-Jones told the Politics Hub a Labour government “will always seek to protect the most vulnerable” and it wants to “listen to people who have got real lived experience”.

She added she has the “utmost respect for Tan, he’s a great constituency MP and he’s doing exactly what he should be doing, is representing his constituency”.

Sir Keir is facing a rebellion from Labour MPs, with about 40 in the Red Wall – Labour’s traditional heartlands in the north of England – reposting a statement on social media in which they said the leadership’s response to the local elections had “fallen on deaf ears”.

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Several backbench Labour MPs also spoke out against the plans during a debate on PIP and disabled people in parliament on Wednesday.

Ian Byrne, MP for Liverpool West Derby, said he would “swim through vomit to vote against” the proposed changes and said: “This is not what the Labour Party was formed to do.”

Bell Ribeiro-Addy, the MP for Clapham and Brixton Hill, said she feared tightening PIP eligibility would cause deaths, adding: “Lest we forget that study that attributed 330,000 excess deaths in Britain between 2012 and 2019 to the last round of austerity cuts [under the Conservative government].”

Diane Abbott, the longest-serving female MP, accused the government of putting forward “contradictory arguments”.

“On the one hand, they insist they are helping the disabled by putting them back to work,” she said.

“But on the other hand, they say this cut will save £9bn. Well, you can’t do both.”

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However, fellow Labour MP David Pinto-Duschinsky, said MPs cannot “ignore this issue” of health-related benefit claimant figures rising at “twice the rate of underlying health conditions”.

Responding for the government, social security minister Sir Stephen Timms said PIP claims were set to “more than double, from two million to over 4.3 million this decade”.

“It would certainly not be in the interests of people currently claiming the benefits for the government to bury its head in the sand over that rate of increase,” he added.

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US

Tyre Nichols death: Ex-police officers found not guilty of murdering motorist in US

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Tyre Nichols death: Ex-police officers found not guilty of murdering motorist in US

Three former police officers in the US have been found not guilty of murder over the death of motorist Tyre Nichols.

Tadarrius Bean, Demetrius Haley and Justin Smith were acquitted by jurors following a nine-day trial at Tennessee state court.

The former Memphis officers were also found not guilty of aggravated assault, aggravated kidnapping, official misconduct and official oppression.

Mr Nichols, a father of one, died three days after officers punched, kicked and hit him with a baton in January 2023 as he was just yards from his home.

Former Memphis Police Department officers Demetrius Haley, center, Tadarrius Bean, left, and Justin Smith Jr., right, hug each other after they were acquitted of state charges, including second-degree murder, in the fatal beating of Tyre Nichols after he ran away from a traffic stop. Wednesday, May 7, 2025, in Memphis, Tenn. (Chris Day/Commercial Appeal/USA Today Network via AP, Pool)
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The defendants hugged each other after being acquitted of the charges. Pic: Commercial Appeal/USA Today Network/AP

The 29-year-old’s death and a video of the incident – in which he cried out for his mother – sparked outrage in the US including nationwide protests and led to police reform.

Civil rights attorney Ben Crump, who represents Nichols’ family, described the verdicts as a “devastating miscarriage of justice”. In a statement, he added: “The world watched as Tyre Nichols was beaten to death by those sworn to protect and serve.”

Memphis District Attorney Steve Mulroy said he was “surprised that there wasn’t a single guilty verdict on any of the counts” including second-degree murder. He said Mr Nichols’ family “were devastated… I think they were outraged”.

From left Tadarrius Bean, Demetrius Haley, Justin Smith, three former Memphis officers acquitted of state charges, including second-degree murder, in the fatal beating of Tyre Nichols after he ran away from a traffic stop in 2023. Memphis Police Dept. / via AP file
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Former police officers Tadarrius Bean, Demetrius Haley, Justin Smith were accused of second-degree murder. Pic: Memphis Police Dept/AP


But despite the three defendants being acquitted of state charges during the trial in Memphis, they still face the prospect of years in prison after they were convicted of federal charges of witness tampering last year.

Two other former officers previously pleaded guilty in both state and federal court. Desmond Mills Jr. gave evidence as a prosecution witness, while Emmitt Martin was blamed for the majority of the violence.

Sentencing for all five officers is pending.

Protesters march down the street Friday, Jan. 27, 2023, in Memphis, Tenn., as authorities release police video depicting five Memphis officers beating Tyre Nichols, whose death resulted in murder charges and provoked outrage at the country's latest instance of police brutality. (AP Photo/Gerald Herbert)
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Tyre Nichols’ death sparked street protests in January 2023 in Memphis and across the US. Pic: AP

Video evidence showed Mr Nichols was stopped in his car, yanked from his vehicle, pepper-sprayed and hit with a Taser. He broke free and ran away before the five police officers caught up with him again, and the beating took place.

Prosecutors argued that the officers used excessive, deadly force in trying to handcuff Mr Nichols and were criminally responsible for each others’ actions.

They also said the officers had a duty to intervene and stop the beating and tell medics that Mr Nichols had been hit repeatedly in the head, but they failed to do so.

The trial heard Mr Nichols suffered tears and bleeding in the brain and died from blunt force trauma.

The defence suggested Mr Nichols was on drugs, giving him the strength to fight off five strong officers, and was actively resisting arrest.

In December, the US Justice Department said a 17-month investigation showed the Memphis Police Department uses excessive force and discriminates against Black people.

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Federal Reserve warns of impact of Trump tariffs as US interest rates held

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Federal Reserve warns of impact of Trump tariffs as US interest rates held

The US central bank held interest rates as it said Trump tariffs have risked higher inflation and unemployment amid “so much” uncertainty.

The announcement is likely to anger President Donald Trump, who has made the taxes on imports one of his signature policies and had threatened to fire the Federal Reserve chair, Jerome Powell.

On Wednesday, the Federal Reserve, known as the Fed, held rates at 4.25%-4.5%. Unlike the UK, the US interest rate is a range to guide lenders rather than a single percentage.

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It means borrowing costs have remained unchanged for Americans, something Mr Trump had wanted to reduce.

Interest rates have been raised by the Fed to bring down high inflation in the wake of Russia’s invasion of Ukraine and the supply chain crisis brought about by COVID-19 lockdowns.

Fears of inflation rising higher as tariffs make goods on US shelves costlier, and of job losses from reduced spending, led the Fed to remain cautious.

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The full effect of the tariffs is “highly uncertain”, Mr Powell said on Wednesday evening, as those announced so far have been “significantly larger” than anticipated.

US Federal Reserve Chair Jerome Powell speaks during a news conference. Pic: Reuters
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US Federal Reserve Chair Jerome Powell speaks during a news conference. Pic: Reuters

A 90-day pause was announced on the suite of taxes Mr Trump imposed on countries across the world, on top of the 10% base tariff, which has remained in place.

A trade war was kicked off between China as the countries escalated tariffs on each other to nearly 150%. Taxes on cars and some metals entering the US are still subject to a 25% tax.

If these tariffs remain, Mr Powell made the strongest statement yet that goods overall would become more expensive.

“If the large increases in tariffs that have been announced are sustained, they’re likely to generate a rise in inflation, a slowdown in economic growth and an increase in unemployment,” he said.

“The effects on inflation could be short-lived, reflecting a one-time shift in the price level. It is also possible that the inflationary effects could instead be more persistent,” he added.

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Uncertainty over the economic outlook also caused consumer and business sentiment to fall, “largely reflecting trade policy concerns”, Mr Powell said.

Despite Mr Trump appointing Mr Powell to the Fed chair position during his first term, the president has repeatedly spoken out against Mr Powell.

Markets rallied after Mr Trump ruled out ousting Mr Powell at the end of April.

It comes as the UK central bank, the Bank of England, is poised to cut interest rates on Thursday afternoon. The base rate is anticipated to drop to 4.25% before falling to 3.5% by the end of the year.

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