ChatGPT's Performance in Spinal Metastasis Cases-Can We Discuss Our Complex Cases with ChatGPT?

Stephan Heisinger ¹, Stephan N Salzmann ¹, Wolfgang Senker ²

⁰Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria.

Journal of Clinical Medicine +

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January 8, 2025

View abstract on PubMed

Summary

Artificial intelligence (AI), like ChatGPT-4, shows promise in assisting with spinal metastasis treatment planning, aligning with surgeons on 73% of recommendations. However, its generalized approach requires further refinement for complex cancer care.

Area Of Science

Oncology
Neurosurgery
Medical Informatics

Background

Artificial intelligence (AI), specifically large language models (LLMs) like ChatGPT-4, is increasingly integrated into healthcare.
Personalized treatment planning is crucial for cancer patients with spinal metastases.
The efficacy of AI in assisting complex clinical decision-making for spinal metastasis remains largely untested.

Purpose Of The Study

To evaluate the performance of ChatGPT-4 in treatment planning for spinal metastasis cases.
To compare AI-driven recommendations with those of experienced spine surgeons.

Main Methods

Five spinal metastasis cases from literature were selected.
ChatGPT-4 and five spine surgeons provided standardized treatment recommendations.
Responses were analyzed for agreement, frequency distribution, and rater opinions.

Main Results

ChatGPT-4's recommendations agreed with the majority of human raters in 73% of treatment choices.
Moderate to substantial agreement was observed for systemic therapy, pain management, and supportive care.
Human rater agreement increased when excluding AI, especially for surgical and palliative care decisions, with noted generalized AI responses.

Conclusions

ChatGPT-4 demonstrates potential in aligning with expert surgeons on specific aspects of spinal metastasis treatment.
The AI's generalized recommendations highlight limitations, suggesting a need for training with clinical guidelines.
Further research is essential to optimize AI tools for personalized cancer treatment decision-making.

Keywords:

ChatGPT decision making spinal metastasis spine spine surgery