Diagnostic Performance of ChatGPT to Perform Emergency Department Triage: A Systematic Review and Meta-analysis

Background Artificial intelligence (AI), particularly ChatGPT developed by OpenAI, has shown potential in improving diagnostic accuracy and efficiency in emergency department (ED) triage. This study aims to evaluate the diagnostic performance and safety of ChatGPT in prioritizing patients based on urgency in ED settings. Methods A systematic review and meta-analysis were conducted following PRISMA guidelines. Comprehensive literature searches were performed in Scopus, Web of Science, PubMed, and Embase. Studies evaluating ChatGPT’s diagnostic performance in ED triage were included. Quality assessment was conducted using the QUADAS-2 tool. Pooled accuracy estimates were calculated using a random-effects model, and heterogeneity was assessed with the I² statistic. Results Fourteen studies with a total of 1,412 patients or scenarios were included. ChatGPT 4.0 demonstrated a pooled accuracy of 0.86 (95% CI: 0.64-0.98) with substantial heterogeneity (I² = 93%). ChatGPT 3.5 showed a pooled accuracy of 0.63 (95% CI: 0.43-0.81) with significant heterogeneity (I² = 84%). Funnel plots indicated potential publication bias, particularly for ChatGPT 3.5. Quality assessments revealed varying levels of risk of bias and applicability concerns. Conclusion ChatGPT, especially version 4.0, shows promise in improving ED triage accuracy. However, significant variability and potential biases highlight the need for further evaluation and enhancement. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes