Comparative Analysis of Diagnostic Accuracy and Case Difficulty Assessment of Three Large Language Models

July 23, 2026 updated by: Mariam Ahmed Hossam, Cairo University

Comparative Analysis of Diagnostic Accuracy and Case Difficulty Assessment of Three Large Language Models in Endodontics Using Expert Consensus as the Reference Standard

This prospective, blinded diagnostic accuracy study aims to compare the performance of three large language models-ChatGPT (GPT-5.5 Pro), Gemini 3.1 Pro, and Claude Opus 4.7-in endodontic diagnosis and case difficulty assessment. The models will be evaluated against expert consensus as the reference standard using standardized clinical data and periapical radiographs. Diagnostic accuracy, sensitivity, specificity, and agreement with expert consensus will be assessed to determine the potential of LLMs as clinical decision-support tools in endodontics.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This prospective, blinded diagnostic accuracy study aims to compare the diagnostic accuracy and endodontic case difficulty assessment of three LLMs-ChatGPT (GPT-5.5 Pro), Gemini 3.1 Pro, and Claude Opus 4.7-with expert consensus as the reference standard. Adult patients requiring primary endodontic treatment or retreatment will undergo routine clinical examination, pulp sensibility testing, and periapical radiographic assessment. Standardized clinical information and radiographs will be provided to each LLM and to four experienced endodontists independently. Expert consensus, defined as agreement among at least three of four experts, will serve as the reference standard. The primary outcomes are diagnostic accuracy, sensitivity, specificity, and agreement with expert consensus for pulpal and periapical diagnosis and endodontic case difficulty assessment according to the American Association of Endodontists (AAE) criteria. The findings will provide evidence regarding the reliability of LLMs as clinical decision-support tools in endodontics and their potential role in improving diagnostic consistency and treatment planning.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
342

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Probability Sample

Study Population

Systemically healthy adult patients (≥16 years) requiring primary endodontic treatment or retreatment at the Endodontic Department, Faculty of Dentistry, Cairo University, who provide informed consent.

Description

Inclusion Criteria:

  1. Age above 16 years old.
  2. Systemically healthy patient (ASA I or II).
  3. Requiring endodontic treatment or retreatment
  4. Patient's acceptance to participate in the study

Exclusion Criteria:

  1. Medically compromised patients.
  2. Pregnant women.
  3. Traumatic dental injuries
  4. Low quality periapical radiograph

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Diagnostic accuracy of ChatGPT (GPT-5.5 Pro), Gemini 3.1 Pro, and Claude Opus 4.7 for pulpal and periapical diagnosis
Time Frame: At baseline
Diagnostic performance of each large language model compared with the expert consensus reference standard. Accuracy, sensitivity, specificity, and agreement (Cohen's kappa) will be calculated according to the American Association of Endodontists (AAE) diagnostic criteria
At baseline

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Accuracy of ChatGPT (GPT-5.5 Pro), Gemini 3.1 Pro, and Claude Opus 4.7 in endodontic case difficulty assessment
Time Frame: At baseline
Agreement between each large language model and the expert consensus in classifying endodontic case difficulty according to the AAE Endodontic Case Difficulty Assessment Guidelines. Overall accuracy and weighted Cohen's kappa will be calculated.
At baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
January 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 10, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 23, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 29, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 29, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 23, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • New ENDO7.1.1

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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