对9个大型语言模型在非膜性心房的抗凝固决策中的性能评估
Yujie Wen1, Zhenzhen Deng1, Xiaoyan Wang2
1Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Research and practice in thrombosis and haemostasis
|February 18, 2026
概括
大型语言模型 (LLM) 在指导非膜动 (NVAF) 的抗凝血治疗中显示出不同的准确性. 快速优化显著提高了性能,但LLM还不是独立的决策者.
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
- 医疗信息学 医疗信息学
背景情况:
- 大型语言模型 (LLM) 在非膜动 (NVAF) 抗凝管理中的可靠性尚未得到充分证实.
- 临床决策支持中越来越多地使用LLM,需要评估其在复杂的治疗领域的表现.
- 对NVAF的抗凝固疗法需要精确的风险评估和管理,这是人工智能工具正在探索的领域.
研究的目的:
- 系统地评估九个著名的LLM在指导NVAF患者的抗凝决定中的表现.
- 为了比较与NVAF抗凝相关的各种临床任务中不同LLM的准确性.
- 调查快速优化对LLM在这个临床领域的表现的影响.
主要方法:
- 一个多学科团队开发了100个虚拟NVAF患者病例.
- 促使九个LLM (包括ChatGPT-4o,Gemini 2.5,Claude Sonnet 4) 产生CHA2DS2-VASc和HAS-BLED分数,确定禁忌,并推抗凝策略.
- 使用准确率和利克特尺度对LLM输出与专家共识进行独立评估.
主要成果:
- 在LLM和临床任务之间,绩效差异很大.
- 聊天GPT-4o深度研究导致了CHA2DS2-VASc评分 (100%准确性) 和药物监测.
- 快速优化大大提高了一些模型的HAS-BLED评分准确度,达到高达95%.
结论:
- 对于NVAF抗凝固决策支持的LLM性能存在显著的变化.
- 在这种情况下,快速工程是提高LLM准确性的关键因素.
- 目前的LLM可以作为辅助,但不适合作为NVAF抗凝药的独立决策者.
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