将患者价值纳入大型语言模型 替代品和代理决策的建议
Victoria J Nolan1, Jeremy A Balch1, Naveen P Baskaran2
1Department of Surgery, University of Florida, Gainesville, FL.
Critical care explorations
|August 12, 2024
概括
大型语言模型 (LLM) 通过纳入患者价值观,在支持失能患者的临床决策方面表现有前途. 法律学的建议是可信的,并反映了患者的价值观,特别是当价值观是自由文本叙述时.
科学领域:
- 医学伦理 医学伦理
- 医疗保健中的人工智能
- 临床决策支持 临床决策支持
背景情况:
- 由于临床医师的压力和偏见,对于失能患者的共享决策往往无法尊重患者的价值观.
- 预先指示在完成率和适用性方面存在限制.
- 研究大型语言模型 (LLM),以支持对失能患者的临床决策.
研究的目的:
- 评估LLM在将患者价值观纳入关键护理决策方面的潜力.
- 评估LLM在产生与患者价值观一致的治疗建议方面的表现.
主要方法:
- 模拟了50个具有不同价值配置文件 (数字,文本,自由文本) 的决策失能患者场景.
- 利用预先训练有素的LLM进行治疗提取和基于价值的建议生成.
- 将LLM的成果与领域专家的裁决进行比较.
主要成果:
- 在88%的场景中,LLM准确地提取了治疗方法.
- 在医学可信度方面,LLM建议得分为3.92/5.00,在反映患者价值观方面得分为3.58/5.00.
- 自由文本,非结构化的患者价值叙述得到了最高的分数.
结论:
- 临床临床医学证明了作为支持工具的潜力,以尊重失能患者的愿望.
- 在价值一致的关键护理决策中,LLM可以帮助代理人,代理人和临床医生.
- 进一步的研究可以完善临床决策支持中的LLM应用.
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