Is Open-Source There Yet? A Comparative Study on Commercial and Open-Source LLMs in Their Ability to Label Chest X-Ray Reports
Felix J. Dorfner, Liv Jürgensen, Leonhard Donle, Fares Al Mohamad, Tobias R. Bodenmann, Mason C. Cleveland, Felix Busch, Lisa C. Adams, James Sato, Thomas Schultz, Albert E. Kim, Jameson Merkow, Keno K. Bressem, Christopher P. Bridge
Introduction: With the rapid advances in large language models (LLMs), there have been numerous new open source as well as commercial models. While recent publications have explored GPT-4 in its application to extracting information of interest from radiology reports, there has not been a real-world comparison of GPT-4 to different leading open-source models.   Materials and Methods: Two different and independent datasets were used. The first dataset consists of 540 chest x-ray reports that were created at the Massachusetts General Hospital between July 2019 and July 2021. The second dataset consists of 500 chest x-ray reports from the ImaGenome dataset. We then compared the commercial models GPT-3.5 Turbo and GPT-4 from OpenAI to the open-source models Mistral-7B, Mixtral-8x7B, Llama2-13B, Llama2-70B, QWEN1.5-72B and CheXbert and CheXpert-labeler in their ability to accurately label the presence of multiple findings in x-ray text reports using different prompting techniques.   Results: On the ImaGenome dataset, the best performing open-source model was Llama2-70B with micro F1-scores of 0.972 and 0.970 for zero- and few-shot prompts, respectively. GPT-4 achieved micro F1-scores of 0.975 and 0.984, respectively. On the institutional dataset, the best performing open-source model was QWEN1.5-72B with micro F1-scores of 0.952 and 0.965 for zero- and few-shot prompting, respectively. GPT-4 achieved micro F1-scores of 0.975 and 0.973, respectively.   Conclusion: In this paper, we show that while GPT-4 is superior to open-source models in zero-shot report labeling, the implementation of few-shot prompting can bring open-source models on par with GPT-4. This shows that open-source models could be a performant and privacy preserving alternative to GPT-4 for the task of radiology report classification.