# COMPARE: Clinical Optimization with Modular Planning and Assessment via RAG-Enhanced AI-OCT: Superior Decision Support for Percutaneous Coronary Intervention Compared to ChatGPT-5 and Junior Operators

arXiv: https://arxiv.org/abs/2512.10702 · HTML: https://mlsanity.com/paper/2512.10702/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 4 of its 36 references that are in the map.
- First posted on arXiv 11 Dec 2025.

## Builds on (most cited first, 4 of 4)

- [Capabilities of GPT-4 on Medical Challenge Problems](https://mlsanity.com/paper/2303.13375/) (2023)
- [Hallucination is Inevitable: An Innate Limitation of Large Language Models](https://mlsanity.com/paper/2401.11817/) (2024)
- [Reducing hallucination in structured outputs via Retrieval-Augmented Generation](https://mlsanity.com/paper/2404.08189/) (2024)
- [Evaluation of ChatGPT-Generated Medical Responses: A Systematic Review and Meta-Analysis](https://mlsanity.com/paper/2310.08410/) (2023)

## Abstract (arXiv)

Background: While intravascular imaging, particularly optical coherence tomography (OCT), improves percutaneous coronary intervention (PCI) outcomes, its interpretation is operator-dependent. General-purpose artificial intelligence (AI) shows promise but lacks domain-specific reliability. We evaluated the performance of CA-GPT, a novel large model deployed on an AI-OCT system, against that of the general-purpose ChatGPT-5 and junior physicians for OCT-guided PCI planning and assessment. Methods: In this single-center analysis of 96 patients who underwent OCT-guided PCI, the procedural decisions generated by the CA-GPT, ChatGPT-5, and junior physicians were compared with an expert-derived procedural record. Agreement was assessed using ten pre-specified metrics across pre-PCI and post-PCI phases. Results: For pre-PCI planning, CA-GPT demonstrated significantly higher median agreement scores (5[IQR 3.75-5]) compared to both ChatGPT-5 (3[2-4], P<0.001) and junior physicians (4[3-4], P<0.001). CA-GPT significantly outperformed ChatGPT-5 across all individual pre-PCI metrics and showed superior performance to junior physicians in stent diameter (90.3% vs. 72.2%, P<0.05) and length selection (80.6% vs. 52.8%, P<0.01). In post-PCI assessment, CA-GPT maintained excellent overall agreement (5[4.75-5]), significantly higher than both ChatGPT-5 (4[4-5], P<0.001) and junior physicians (5[4-5], P<0.05). Subgroup analysis confirmed CA-GPT's robust performance advantage in complex scenarios. Conclusion: The CA-GPT-based AI-OCT system achieved superior decision-making agreement versus a general-purpose large language model and junior physicians across both PCI planning and assessment phases. This approach provides a standardized and reliable method for intravascular imaging interpretation, demonstrating significant potential to augment operator expertise and optimize OCT-guided PCI.