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患者病史在人工智能辅助医学诊断中的重要性:对比研究。

Importance of Patient History in Artificial Intelligence-Assisted Medical Diagnosis: Comparison Study.

机构信息

Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.

Uchida Internal Medicine Clinic, Saitama-shi, Japan.

出版信息

JMIR Med Educ. 2024 Apr 8;10:e52674. doi: 10.2196/52674.

Abstract

BACKGROUND

Medical history contributes approximately 80% to a diagnosis, although physical examinations and laboratory investigations increase a physician's confidence in the medical diagnosis. The concept of artificial intelligence (AI) was first proposed more than 70 years ago. Recently, its role in various fields of medicine has grown remarkably. However, no studies have evaluated the importance of patient history in AI-assisted medical diagnosis.

OBJECTIVE

This study explored the contribution of patient history to AI-assisted medical diagnoses and assessed the accuracy of ChatGPT in reaching a clinical diagnosis based on the medical history provided.

METHODS

Using clinical vignettes of 30 cases identified in The BMJ, we evaluated the accuracy of diagnoses generated by ChatGPT. We compared the diagnoses made by ChatGPT based solely on medical history with the correct diagnoses. We also compared the diagnoses made by ChatGPT after incorporating additional physical examination findings and laboratory data alongside history with the correct diagnoses.

RESULTS

ChatGPT accurately diagnosed 76.6% (23/30) of the cases with only the medical history, consistent with previous research targeting physicians. We also found that this rate was 93.3% (28/30) when additional information was included.

CONCLUSIONS

Although adding additional information improves diagnostic accuracy, patient history remains a significant factor in AI-assisted medical diagnosis. Thus, when using AI in medical diagnosis, it is crucial to include pertinent and correct patient histories for an accurate diagnosis. Our findings emphasize the continued significance of patient history in clinical diagnoses in this age and highlight the need for its integration into AI-assisted medical diagnosis systems.

摘要

背景

病史对诊断的贡献约为 80%,尽管体格检查和实验室检查可以提高医生对医学诊断的信心。人工智能(AI)的概念最早在 70 多年前提出。最近,它在医学各个领域的作用显著增长。然而,目前尚无研究评估病史在 AI 辅助医学诊断中的重要性。

目的

本研究探讨了病史对 AI 辅助医学诊断的贡献,并评估了 ChatGPT 根据提供的病史得出临床诊断的准确性。

方法

使用《英国医学杂志》(BMJ)中确定的 30 个临床案例,我们评估了 ChatGPT 生成的诊断的准确性。我们将 ChatGPT 仅基于病史做出的诊断与正确诊断进行了比较。我们还比较了 ChatGPT 在纳入病史和体格检查结果及实验室数据后的诊断与正确诊断。

结果

ChatGPT 准确诊断了仅基于病史的 30 个案例中的 76.6%(23/30),与之前针对医生的研究一致。我们还发现,当纳入其他信息时,这一比例为 93.3%(28/30)。

结论

尽管添加其他信息可以提高诊断准确性,但病史仍然是 AI 辅助医学诊断中的重要因素。因此,在使用 AI 进行医学诊断时,纳入相关且正确的病史对于准确诊断至关重要。我们的研究结果强调了在这个时代,病史在临床诊断中的持续重要性,并突出了将其纳入 AI 辅助医学诊断系统的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f7b/11024399/e01cfd793e9f/mededu-v10-e52674-g001.jpg

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