Evaluating the Ability of Large Language Models to Identify Adherence to CONSORT Reporting Guidelines in Randomized Controlled Trials: A Methodological Evaluation Study

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Main Authors: He, Zhichao, Bian, Mouxiao, Zhu, Jianhong, Chen, Jiayuan, Wang, Yunqiu, Zhao, Wenxia, Li, Tianbin, Han, Bing, Xu, Jie, Wu, Junyan
Format: Preprint
Published: 2025
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author He, Zhichao
Bian, Mouxiao
Zhu, Jianhong
Chen, Jiayuan
Wang, Yunqiu
Zhao, Wenxia
Li, Tianbin
Han, Bing
Xu, Jie
Wu, Junyan
author_facet He, Zhichao
Bian, Mouxiao
Zhu, Jianhong
Chen, Jiayuan
Wang, Yunqiu
Zhao, Wenxia
Li, Tianbin
Han, Bing
Xu, Jie
Wu, Junyan
contents The Consolidated Standards of Reporting Trials statement is the global benchmark for transparent and high-quality reporting of randomized controlled trials. Manual verification of CONSORT adherence is a laborious, time-intensive process that constitutes a significant bottleneck in peer review and evidence synthesis. This study aimed to systematically evaluate the accuracy and reliability of contemporary LLMs in identifying the adherence of published RCTs to the CONSORT 2010 statement under a zero-shot setting. We constructed a golden standard dataset of 150 published RCTs spanning diverse medical specialties. The primary outcome was the macro-averaged F1-score for the three-class classification task, supplemented by item-wise performance metrics and qualitative error analysis. Overall model performance was modest. The top-performing models, Gemini-2.5-Flash and DeepSeek-R1, achieved nearly identical macro F1 scores of 0.634 and Cohen's Kappa coefficients of 0.280 and 0.282, respectively, indicating only fair agreement with expert consensus. A striking performance disparity was observed across classes: while most models could identify compliant items with high accuracy (F1 score > 0.850), they struggled profoundly with identifying non-compliant and not applicable items, where F1 scores rarely exceeded 0.400. Notably, some high-profile models like GPT-4o underperformed, achieving a macro F1-score of only 0.521. LLMs show potential as preliminary screening assistants for CONSORT checks, capably identifying well-reported items. However, their current inability to reliably detect reporting omissions or methodological flaws makes them unsuitable for replacing human expertise in the critical appraisal of trial quality.
format Preprint
id arxiv_https___arxiv_org_abs_2511_13107
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Evaluating the Ability of Large Language Models to Identify Adherence to CONSORT Reporting Guidelines in Randomized Controlled Trials: A Methodological Evaluation Study
He, Zhichao
Bian, Mouxiao
Zhu, Jianhong
Chen, Jiayuan
Wang, Yunqiu
Zhao, Wenxia
Li, Tianbin
Han, Bing
Xu, Jie
Wu, Junyan
Computation and Language
The Consolidated Standards of Reporting Trials statement is the global benchmark for transparent and high-quality reporting of randomized controlled trials. Manual verification of CONSORT adherence is a laborious, time-intensive process that constitutes a significant bottleneck in peer review and evidence synthesis. This study aimed to systematically evaluate the accuracy and reliability of contemporary LLMs in identifying the adherence of published RCTs to the CONSORT 2010 statement under a zero-shot setting. We constructed a golden standard dataset of 150 published RCTs spanning diverse medical specialties. The primary outcome was the macro-averaged F1-score for the three-class classification task, supplemented by item-wise performance metrics and qualitative error analysis. Overall model performance was modest. The top-performing models, Gemini-2.5-Flash and DeepSeek-R1, achieved nearly identical macro F1 scores of 0.634 and Cohen's Kappa coefficients of 0.280 and 0.282, respectively, indicating only fair agreement with expert consensus. A striking performance disparity was observed across classes: while most models could identify compliant items with high accuracy (F1 score > 0.850), they struggled profoundly with identifying non-compliant and not applicable items, where F1 scores rarely exceeded 0.400. Notably, some high-profile models like GPT-4o underperformed, achieving a macro F1-score of only 0.521. LLMs show potential as preliminary screening assistants for CONSORT checks, capably identifying well-reported items. However, their current inability to reliably detect reporting omissions or methodological flaws makes them unsuitable for replacing human expertise in the critical appraisal of trial quality.
title Evaluating the Ability of Large Language Models to Identify Adherence to CONSORT Reporting Guidelines in Randomized Controlled Trials: A Methodological Evaluation Study
topic Computation and Language
url https://arxiv.org/abs/2511.13107