Performance Assessment of ChatGPT-4.0 and ChatGLM Series in Traditional Chinese Medicine for Metabolic Associated Fatty Liver Disease: Comparative Study

Our study results demonstrated that real-time internet connectivity played a critical role in LLM-assisted TCM diagnosis and treatment, while offline models showed significantly reduced performance in clinical decision support. Furthermore, pretraining LLMs with TCM-specific knowledge bases while maintaining internet search capabilities substantially enhanced their diagnostic and therapeutic performance in TCM applications. Importantly, general-purpose LLMs required both domain-specific medical fine-tuning and culturally sensitive adaptation to meet the rigorous standards of TCM clinical practice.