Division of Plastic, Reconstructive, and Aesthetic Surgery, McGill University Health Centre, Montreal, QC, Canada.
Manhattan Eye, Ear and Throat Hospital, New York, NY, USA.
Aesthetic Plast Surg. 2023 Dec;47(6):2407-2414. doi: 10.1007/s00266-023-03538-1. Epub 2023 Aug 17.
ChatGPT represents a potential resource for patient guidance and education, with the possibility for quality improvement in healthcare delivery. The present study evaluates the role of ChatGPT as an interactive patient resource, and assesses its performance in identifying, triaging, and guiding patients with concerns of postoperative complications following facelift and neck lift surgery.
Sixteen patient profiles were generated to simulate postoperative patient presentations, with complications of varying acuity and severity. ChatGPT was assessed for its accuracy in generating a differential diagnosis, soliciting a history, providing the most-likely diagnosis, the appropriate disposition, treatments/interventions to begin from home, and red-flag symptoms necessitating an urgent presentation to the emergency department.
Overall accuracy in providing a complete differential diagnosis in response to simulated presentations was 85%, with an accuracy of 88% in identifying the most-likely diagnosis after history-taking. However, appropriate patient dispositions were suggested in only 56% of cases. Relevant home treatments/interventions were suggested with an 82% accuracy, and red-flag symptoms with a 73% accuracy. A detailed analysis, stratified according to latency of postoperative presentation (<48 h, 48 h-1 week, or >1 week), and according to acuity of complications, is presented herein.
ChatGPT overestimated the urgency of indicated patient dispositions in 44% of cases, concerning for potential unnecessary increase in healthcare resource utilization. Imperfect performance, and the tool's tendency for overinclusion in its responses, risk increasing patient anxiety and straining physician-patient relationships. While artificial intelligence has great potential in triaging postoperative patient concerns, and improving efficiency and resource utilization, ChatGPT's performance, in its current form, demonstrates a need for further refinement before its safe and effective implementation in facial aesthetic surgical practice.
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ChatGPT 代表了一种潜在的患者指导和教育资源，有可能改善医疗保健服务的质量。本研究评估了 ChatGPT 作为交互式患者资源的作用，并评估了其在识别、分诊和指导接受面部提升和颈部提升手术后出现并发症的患者方面的表现。
生成了 16 个患者档案，以模拟术后患者的表现，模拟了不同严重程度和严重程度的并发症。评估了 ChatGPT 在生成鉴别诊断、询问病史、提供最可能诊断、适当处置、建议在家开始的治疗/干预措施以及需要紧急到急诊就诊的红色症状方面的准确性。
总体而言，在模拟演示中提供完整鉴别诊断的准确率为 85%，在询问病史后识别最可能诊断的准确率为 88%。然而，只有 56%的情况下建议了适当的患者处置。建议的相关家庭治疗/干预的准确率为 82%，红色症状的准确率为 73%。根据术后表现的潜伏期（<48 小时、48 小时-1 周或>1 周）和并发症的严重程度进行了详细分析，并在此处呈现。
ChatGPT 在 44%的情况下高估了指示性患者处置的紧迫性，这可能导致不必要地增加医疗资源的利用。不完善的表现和工具在响应中过度包容的倾向，可能会增加患者的焦虑并影响医患关系。虽然人工智能在分诊术后患者的担忧和提高效率和资源利用方面具有巨大潜力，但 ChatGPT 的表现表明，在其安全有效地应用于面部美容手术实践之前，需要进一步改进。
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