Abstract:Background: Colonoscopy, a crucial diagnostic tool in gastroenterology, depends heavily on superior bowel preparation. ChatGPT, a large language model with emergent intelligence which also exhibits potential in medical applications. This study aims to assess the accuracy and consistency of ChatGPT in using the Boston Bowel Preparation Scale (BBPS) for colonoscopy assessment. Methods: We retrospectively collected 233 colonoscopy images from 2020 to 2023. These images were evaluated using the BBPS by 3 senior endoscopists and 3 novice endoscopists. Additionally, ChatGPT also assessed these images, having been divided into three groups and undergone specific Fine-tuning. Consistency was evaluated through two rounds of testing. Results: In the initial round, ChatGPT's accuracy varied between 48.93% and 62.66%, trailing the endoscopists' accuracy of 76.68% to 77.83%. Kappa values for ChatGPT was between 0.52 and 0.53, compared to 0.75 to 0.87 for the endoscopists. Conclusion: While ChatGPT shows promise in bowel preparation scoring, it currently does not match the accuracy and consistency of experienced endoscopists. Future research should focus on in-depth Fine-tuning.