Expert-Validated ChatGPT Support for Arterial Blood Gas Interpretation (ABG-AI RCT)

September 24, 2026 updated by: Semih Musa Coşkun, Izmir Katip Celebi University

Expert-Validated Generative AI Support for Arterial Blood Gas Interpretation in Early-Career Non-Specialist Physicians: A Randomized Controlled Study

This randomized controlled study evaluated whether expert-validated ChatGPT support improved arterial blood gas (ABG) interpretation performance among early-career non-specialist physicians. Participants completed a baseline assessment consisting of 11 standardized clinical scenarios covering five domains of ABG interpretation. Eligible participants who entered the reassessment phase were randomly assigned to either an AI-supported group or a control group.

One week after baseline assessment, participants completed a posttest using the same clinical scenarios. The AI-supported group received expert-validated ChatGPT responses before answering each case, whereas the control group completed the assessment without AI support.

The primary outcome was posttest total ABG interpretation accuracy across 55 scored items, compared between groups after adjustment for baseline accuracy. Secondary outcomes included changes in total accuracy, domain-specific accuracy, case-level performance, and item-level accuracy.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

161

Phase

  • Not Applicable

Contacts and Locations

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

Study Locations

    • Gaziantep
      • Gaziantep, Gaziantep, Turkey (Türkiye)
        • Gaziantep City Hospital

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

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Fewer than five years of postgraduate clinical experience
  • Actively involved in patient care
  • Had not completed specialty training

Exclusion Criteria:

  • Residents
  • Specialists
  • Physicians not actively assessing patients
  • Incomplete, duplicate, or unmatchable pretest-posttest records

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

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control group

Participants completed the 11 ABG cases without receiving any AI response, explanation, or recommendation

Experimental: AI-Supported Group

Before each of the 11 ABG cases, participants viewed the expert-validated ChatGPT response before providing their own answers.

Before each of the 11 arterial blood gas (ABG) cases, participants viewed a standardized ChatGPT response that had been independently validated against the expert reference key by three physician experts. The response addressed five scored domains and included a brief rationale. Participants then provided their own answers to each case.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Posttest Total ABG Interpretation Accuracy
Time Frame: One week after baseline assessment

Total accuracy across 55 scored items, comprising five scored domains for each of 11 ABG cases. Each item was scored as correct (1) or incorrect (0), and total accuracy was calculated as the number of correct responses divided by 55 × 100. The primary analysis compared posttest total accuracy between the AI-supported and control groups, adjusted for baseline total accuracy.

One week after baseline assessment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Total ABG Interpretation Accuracy From Pretest to Posttest
Time Frame: From baseline to one week after baseline assessment

Change in total ABG interpretation accuracy from baseline (pretest) to the one-week posttest was assessed within each study group. Total accuracy was calculated across 55 scored items as the number of correct responses divided by 55 × 100.

From baseline to one week after baseline assessment
Between-Group Difference in Change in Total ABG Interpretation Accuracy
Time Frame: From baseline to one week after baseline assessment

The change in total ABG interpretation accuracy from baseline to posttest was compared between the AI-supported and control groups. Change scores were calculated as posttest accuracy minus baseline accuracy.

From baseline to one week after baseline assessment
Change From Baseline in Primary Acid-Base Disorder Identification Accuracy on an 11-Item Assessment
Time Frame: Baseline and one week after baseline assessment

Accuracy in identifying the primary acid-base disorder was calculated as the number of correct responses across 11 arterial blood gas cases divided by 11 and multiplied by 100. Each response was scored as correct (1) or incorrect (0). The outcome was the change in accuracy from baseline to posttest, calculated as posttest accuracy minus baseline accuracy and expressed in percentage points. Possible change scores ranged from -100 to +100 percentage points, with positive values indicating improved accuracy.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Acute Asthma Exacerbation Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the acute asthma exacerbation case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Item-Level ABG Interpretation Accuracy
Time Frame: One week after baseline assessment

Item-level performance was evaluated across the 55 scored items, comprising five scored domains for each of the 11 ABG cases. The probability of a correct response for individual items was compared between the AI-supported and control groups.

One week after baseline assessment
Change From Baseline in Acid-Base Compensation Assessment Accuracy on an 11-Item Assessment
Time Frame: Baseline and one week after baseline assessment

Accuracy in assessing acid-base compensation was calculated as the number of correct responses across 11 arterial blood gas cases divided by 11 and multiplied by 100. Each response was scored as correct (1) or incorrect (0). The outcome was the change in accuracy from baseline to posttest, calculated as posttest accuracy minus baseline accuracy and expressed in percentage points. Possible change scores ranged from -100 to +100 percentage points, with positive values indicating improved accuracy.

Baseline and one week after baseline assessment
Change From Baseline in Electrolyte and Anion Gap Assessment Accuracy on an 11-Item Assessment
Time Frame: Baseline and one week after baseline assessment

Accuracy in assessing electrolyte and anion gap findings was calculated as the number of correct responses across 11 arterial blood gas cases divided by 11 and multiplied by 100. Each response was scored as correct (1) or incorrect (0). The outcome was the change in accuracy from baseline to posttest, calculated as posttest accuracy minus baseline accuracy and expressed in percentage points. Possible change scores ranged from -100 to +100 percentage points, with positive values indicating improved accuracy.

Baseline and one week after baseline assessment
Change From Baseline in Clinical Diagnosis Identification Accuracy on an 11-Item Assessment
Time Frame: Baseline and one week after baseline assessment

Accuracy in identifying the most likely clinical diagnosis was calculated as the number of correct responses across 11 arterial blood gas cases divided by 11 and multiplied by 100. Each response was scored as correct (1) or incorrect (0). The outcome was the change in accuracy from baseline to posttest, calculated as posttest accuracy minus baseline accuracy and expressed in percentage points. Possible change scores ranged from -100 to +100 percentage points, with positive values indicating improved accuracy.

Baseline and one week after baseline assessment
Change From Baseline in Clinical Management Decision Accuracy on an 11-Item Assessment
Time Frame: Baseline and one week after baseline assessment

Accuracy in selecting appropriate clinical management was calculated as the number of correct responses across 11 arterial blood gas cases divided by 11 and multiplied by 100. Each response was scored as correct (1) or incorrect (0). The outcome was the change in accuracy from baseline to posttest, calculated as posttest accuracy minus baseline accuracy and expressed in percentage points. Possible change scores ranged from -100 to +100 percentage points, with positive values indicating improved accuracy.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Acute COPD Exacerbation Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the acute COPD exacerbation case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Methanol Intoxication Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the methanol intoxication case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Diabetic Ketoacidosis Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the diabetic ketoacidosis case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Carbon Monoxide Intoxication Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the carbon monoxide intoxication case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Acute Kidney Injury on Chronic Kidney Disease With Hyperkalemia Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the acute kidney injury on chronic kidney disease with hyperkalemia case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Pulmonary Embolism Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the pulmonary embolism case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Panic Attack With Hyperventilation Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the panic attack with hyperventilation case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Diuretic-Associated Metabolic Alkalosis Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the diuretic-associated metabolic alkalosis case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Hypoglycemia Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the hypoglycemia case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment
Number of Participants by Change Category in Upper Gastrointestinal Bleeding With Hypovolemic Shock Case Interpretation Score
Time Frame: Baseline and one week after baseline assessment

For the upper gastrointestinal bleeding with hypovolemic shock case, each participant received one point for each correct response across five predefined assessment domains, yielding a case-specific score ranging from 0 to 5. The posttest score was compared with the baseline score for the same case. Participants were classified into three mutually exclusive categories: improvement (posttest score greater than baseline score), no change (posttest score equal to baseline score), or deterioration (posttest score lower than baseline score). The number of participants in each category was recorded separately for the AI-supported and control groups.

Baseline and one week after baseline assessment

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Coşkun, MD, Gaziantep City Hospital

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 (Actual)

May 20, 2026

Primary Completion (Actual)

June 5, 2026

Study Completion (Actual)

June 5, 2026

Study Registration Dates

First Submitted

September 18, 2026

First Submitted That Met QC Criteria

September 24, 2026

First Posted (Actual)

September 30, 2026

Study Record Updates

Last Update Posted (Actual)

September 30, 2026

Last Update Submitted That Met QC Criteria

September 24, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 0449

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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