在重症监护建议中评估ChatGPT的适当性,一致性和可读性
Kaan Y Balta1, Arshia P Javidan2, Eric Walser3,4
1Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
Journal of intensive care medicine
|August 9, 2024
概括
与3.5相比,ChatGPT 4.0提供了更合适的重症监护建议,但这两种大型语言模型 (LLM) 都缺乏一致性,并可能产生错误信息,需要临床监督.
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
- 自然语言处理自然语言处理.
背景情况:
- 像ChatGPT这样的大型语言模型 (LLM) 越来越多地被用于临床应用.
- 评估连续的LLM版本在产生医疗建议方面的表现至关重要.
研究的目的:
- 在生成适当,一致和可读的重症监护建议方面,比较ChatGPT 3.5和4.0.
- 评估LLM在重症监护机构临床使用的可靠性和安全性.
主要方法:
- 关于重症监护主题的50个临床问题被提出给ChatGPT 3.5和4.0.
- 两位独立的密集医生使用5分利克特级别对LLM生成的响应进行了评分,以适当性,一致性和可读性进行评分.
- 使用Flesch-Kincaid等级水平来评估可读性.
主要成果:
- 与ChatGPT 3.5 (中位数3.0) 相比,ChatGPT 4.0的适当性得分显著更高 (中位数4.0).
- 两种版本之间在响应一致性 (40%对28%) 或可读性 (弗莱什-金凯德等级水平14.3对14.4) 上没有发现显著差异.
- 这两种模型都表现出"幻觉",提供了自信的错误信息.
结论:
- 虽然ChatGPT 4.0显示出更好的适当性,但LLM版本都不能保证一致或完全准确的重症监护建议.
- 幻觉和不一致的存在凸显了在重症监护中无监督使用LLM的风险.
- 临床医生必须具备专业领域的专业知识,以批判性地评估LLM输出,以确保安全有效的实施.
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