"AI博士现在会见你":ChatGPT-4治疗建议如何与骨科临床实践指南保持一致?
Tanios Dagher1, Emma P Dwyer, Hayden P Baker
1Department of Orthopaedic Surgery, The University of Chicago, Chicago, IL, USA.
Clinical orthopaedics and related research
|September 9, 2024
概括
聊天GPT-4在推与指南一致的骨科治疗方面显示出高准确性,但有时会与复杂的患者因素作斗争. 医生监督对于以患者为中心的护理至关重要.
科学领域:
- 整形外科手术 整形外科手术
- 人工智能在医学中的应用
- 临床决策支持 临床决策支持
背景情况:
- 像ChatGPT-4这样的人工智能 (AI) 模型在模拟人类智力进行诊断等任务方面表现出有希望.
- 虽然人工智能在医疗检查中表现出熟练,但它使用临床细节和成像来产生骨科疾病的治疗建议的能力尚未得到充分研究.
- 了解AI的优势和局限性对于其安全融入医疗实践至关重要.
研究的目的:
- 评估ChatGPT-4对常见骨科疾病的治疗建议与美国骨科外科医生学会 (AAOS) 临床实践指南 (CPG) 的一致性.
- 将ChatGPT-4的建议与由骨科主治医生开发的治疗计划进行比较.
- 确定ChatGPT-4的建议与已建立的AAOS CPG不同的地方.
主要方法:
- 选择了与现有的AAOS CPG相关的十种常见的骨科疾病.
- 从未识别的患者记录中创建了具有代表性成像的临床图片,涵盖了各种诊断严重程度.
- 聊天GPT-4被提示提供治疗建议,然后与AAOS CPG和主治医生治疗计划进行比较.
主要成果:
- 在90%的病例中,ChatGPT-4的建议与AAOS CPG一致,78%的病例与临床医生一致.
- 该模型实现了与骨折和关节炎 vignettes 的 CPG 100% 的一致性.
- 在手腕道综合征,ACL损伤,旋转部损伤和关节关节骨关节炎中,分歧最频繁地发生,通常是由于难以解释损伤严重程度,患者因素或手术禁忌.
结论:
- 聊天GPT-4可以生成与CPG一致的准确骨科治疗计划.
- 当将复杂的患者因素,疾病严重程度或进展纳入决策时,人工智能模型可能会失效.
- 医生必须在完整的临床背景下批判性地评估人工智能产生的建议,因为以患者为中心的决策仍然是医生的责任.
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