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When Precision Meets Penmanship: ChatGPT and Surgery Documentation.

Alexander Robinson1, Shaurya Aggarwal1

  • 1General Surgery, Mid and South Essex NHS (National Health Service) Foundation Trust, Chelmsford, GBR.

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|July 19, 2023
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Summary
This summary is machine-generated.

This study shows that ChatGPT-4 can generate surgical operation notes for laparoscopic appendicectomy, achieving 78.8% compliance with guidelines. However, prompt quality impacts output, and secure electronic health record integration is needed for NHS adoption.

Keywords:
appendicectomychatgptlaparoscopic surgerynhssurgical documentation

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Area of Science:

  • Medical Informatics
  • Artificial Intelligence in Surgery
  • Clinical Documentation Improvement

Background:

  • The National Health Service (NHS) aims to enhance surgical documentation through initiatives like 'Getting It Right First Time' (GIRFT).
  • Accurate and comprehensive operation notes are crucial for patient safety and surgical quality improvement.
  • Large language models (LLMs) like ChatGPT demonstrate potential for automating text-based medical tasks.

Purpose of the Study:

  • To evaluate the efficacy of ChatGPT-4 in generating operation notes for laparoscopic appendicectomy.
  • To assess the compliance of AI-generated notes with established GIRFT surgical documentation guidelines.
  • To identify limitations and requirements for integrating AI into clinical surgical documentation workflows.

Main Methods:

  • ChatGPT-4 was prompted to generate operation notes for laparoscopic appendicectomy.
  • Generated notes were assessed against 30 key points from GIRFT recommendations, excluding pre-documented information.
  • The evaluation process was repeated three times to calculate an average compliance score.

Main Results:

  • ChatGPT-4 generated operation notes rapidly, achieving an average coverage of 78.8% (23.66/30) of GIRFT guidelines.
  • The AI's performance exceeded average compliance rates observed with similar Royal College of Surgeons (RCS) guidelines.
  • Output quality was directly correlated with the specificity and quality of the input prompt.

Conclusions:

  • ChatGPT-4 shows significant potential for assisting in the creation of surgical operation notes, offering high guideline compliance.
  • The need for careful prompt engineering and mandatory verification of AI-generated clinical content is emphasized.
  • Secure integration with electronic health records is a prerequisite for the adoption of ChatGPT in NHS surgical settings.