聊天GPT提供了不一致的风险分层的患者与无创性胸痛的胸痛
Thomas F Heston1,2, Lawrence M Lewis3
1Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington, United States of America.
PloS one
|April 16, 2024
概括
像ChatGPT-4这样的大型语言模型在医疗保健中显示出希望,但在胸痛患者的风险分层中表现出不一致,需要进一步细化才能获得可靠的临床使用.
科学领域:
- 人工智能在医学中的应用
- 临床决策支持系统 临床决策支持系统
- 在医疗保健中的自然语言处理.
背景情况:
- 像ChatGPT-4这样的大型语言模型 (LLM) 提供了潜在的医疗保健应用.
- 在分析复杂的临床数据时,LLM的可靠性和一致性尚未得到充分证实.
- 这项研究评估了ChatGPT-4在模拟患有急性非创伤性胸痛的患者风险分层方面的表现.
研究的目的:
- 为了评估与验证的临床工具相比,ChatGPT-4的风险分层精度.
- 为了评估ChatGPT-4的风险评估的一致性,当与相同的患者数据呈现时.
- 确定ChatGPT-4在分析胸痛患者复杂临床变量的可靠性.
主要方法:
- 开发了基于TIMI得分,HEART得分和44个随机临床变量的模拟案例研究的三个数据集.
- 聊天GPT-4独立对每个数据集进行了五次评分,以评估一致性.
- 将ChatGPT-4的风险分数与计算的TIMI和HEART分数进行比较,并评估了44个变量模型的协议.
主要成果:
- 聊天GPT-4与TIMI (r=0.898) 和HEART (r=0.928) 平均得分有很高的相关性.
- 观察到显著的不一致性,ChatGPT-4在45-48%的时间内为相同的分数提供了不同的风险评估.
- 对于44个变量诊断的5个ChatGPT-4模型之间的一致性仅为56%,风险得分相关性较差 (r=0.605).
结论:
- 聊天GPT-4的平均分数与既有工具相对相关,但其不一致的输出引起了临床风险评估的可靠性问题.
- 像ChatGPT-4这样的LLM需要进一步的改进和定制,以便在医疗保健中可靠地应用.
- 该研究强调了基于LLM的临床决策支持需要提高一致性,特别是在非创伤性胸痛评估方面.
相关概念视频
01:26Flail Chest-II
168
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
168
01:24Flail Chest-I
180
Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
180
01:27Pneumothorax-II
141
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
141