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关于大型语言模型在护理中的当前和潜在用途的快速综述。

A rapid review on current and potential uses of large language models in nursing.

机构信息

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Department of Nursing Science, University of Turku, Finland.

出版信息

Int J Nurs Stud. 2024 Jun;154:104753. doi: 10.1016/j.ijnurstu.2024.104753. Epub 2024 Mar 13.

Abstract

BACKGROUND

The application of large language models across commercial and consumer contexts has grown exponentially in recent years. However, a gap exists in the literature on how large language models can support nursing practice, education, and research. This study aimed to synthesize the existing literature on current and potential uses of large language models across the nursing profession.

METHODS

A rapid review of the literature, guided by Cochrane rapid review methodology and PRISMA reporting standards, was conducted. An expert health librarian assisted in developing broad inclusion criteria to account for the emerging nature of literature related to large language models. Three electronic databases (i.e., PubMed, CINAHL, and Embase) were searched to identify relevant literature in August 2023. Articles that discussed the development, use, and application of large language models within nursing were included for analysis.

RESULTS

The literature search identified a total of 2028 articles that met the inclusion criteria. After systematically reviewing abstracts, titles, and full texts, 30 articles were included in the final analysis. Nearly all (93 %; n = 28) of the included articles used ChatGPT as an example, and subsequently discussed the use and value of large language models in nursing education (47 %; n = 14), clinical practice (40 %; n = 12), and research (10 %; n = 3). While the most common assessment of large language models was conducted by human evaluation (26.7 %; n = 8), this analysis also identified common limitations of large language models in nursing, including lack of systematic evaluation, as well as other ethical and legal considerations.

DISCUSSION

This is the first review to summarize contemporary literature on current and potential uses of large language models in nursing practice, education, and research. Although there are significant opportunities to apply large language models, the use and adoption of these models within nursing have elicited a series of challenges, such as ethical issues related to bias, misuse, and plagiarism.

CONCLUSION

Given the relative novelty of large language models, ongoing efforts to develop and implement meaningful assessments, evaluations, standards, and guidelines for applying large language models in nursing are recommended to ensure appropriate, accurate, and safe use. Future research along with clinical and educational partnerships is needed to enhance understanding and application of large language models in nursing and healthcare.

摘要

背景

近年来,大型语言模型在商业和消费者领域的应用呈指数级增长。然而,文献中关于大型语言模型如何支持护理实践、教育和研究的内容存在空白。本研究旨在综合现有文献,探讨当前和潜在的大型语言模型在护理专业中的应用。

方法

采用 Cochrane 快速审查方法和 PRISMA 报告标准,对文献进行快速综述。一名专业的健康图书管理员协助制定了广泛的纳入标准,以涵盖与大型语言模型相关的新兴文献。2023 年 8 月,在三个电子数据库(即 PubMed、CINAHL 和 Embase)中检索相关文献。纳入分析的文献需讨论大型语言模型在护理中的开发、使用和应用。

结果

文献检索共确定了 2028 篇符合纳入标准的文章。经过系统地审查摘要、标题和全文,最终有 30 篇文章纳入了最终分析。几乎所有(93%;n=28)纳入的文章都以 ChatGPT 为例,随后讨论了大型语言模型在护理教育(47%;n=14)、临床实践(40%;n=12)和研究(10%;n=3)中的使用和价值。虽然对大型语言模型最常见的评估是由人类进行的(26.7%;n=8),但本分析还确定了大型语言模型在护理中的常见局限性,包括缺乏系统评估,以及其他伦理和法律方面的考虑。

讨论

这是第一份总结大型语言模型在护理实践、教育和研究中的当前和潜在应用的综述。尽管有很大的应用机会,但这些模型在护理中的使用和采用引发了一系列挑战,例如与偏见、误用和剽窃相关的伦理问题。

结论

鉴于大型语言模型的相对新颖性,建议为护理中应用大型语言模型制定和实施有意义的评估、评估、标准和指南,以确保其适当、准确和安全的使用。需要进一步开展研究并建立临床和教育合作伙伴关系,以增强对护理和医疗保健中大型语言模型的理解和应用。

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