Large language models (LLMs) are increasingly being explored for their potential to simulate clinical reasoning. Here, we demonstrate our initial experience using the GPT-4o LLM along with prompt engineering and knowledge retrieval to develop EndoGPT, a clinical decision support tool for the management of thyroid nodules. In a pilot study of 50 cases, EndoGPT demonstrated an 83% concordance rate with expert surgeons' assessments and plans. The highest concordance was in diagnosis (93%), followed by the need for an operation (82%) and type of operation (69%). This work suggests that LLM-based assistants may play a useful role in assisting clinicians in the future.

The authors have declared no competing interest.

This study did not receive any funding.

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The institutional review board (IRB) of Columbia University waive ethical approval for this work (Protocol AAAV1151).

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