Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Department of Neurological Surgery, Lenox Hill Hospital/Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA.
World Neurosurg. 2024 Jul;187:e769-e791. doi: 10.1016/j.wneu.2024.04.165. Epub 2024 May 7.
Artificial intelligence (AI) has become increasingly used in neurosurgery. Generative pretrained transformers (GPTs) have been of particular interest. However, ethical concerns regarding the incorporation of AI into the field remain underexplored. We delineate key ethical considerations using a novel GPT-based, human-modified approach, synthesize the most common considerations, and present an ethical framework for the involvement of AI in neurosurgery.
GPT-4, ChatGPT, Bing Chat/Copilot, You, Perplexity.ai, and Google Bard were queried with the prompt "How can artificial intelligence be ethically incorporated into neurosurgery?". Then, a layered GPT-based thematic analysis was performed. The authors synthesized the results into considerations for the ethical incorporation of AI into neurosurgery. Separate Pareto analyses with 20% threshold and 10% threshold were conducted to determine salient themes. The authors refined these salient themes.
Twelve key ethical considerations focusing on stakeholders, clinical implementation, and governance were identified. Refinement of the Pareto analysis of the top 20% most salient themes in the aggregated GPT outputs yielded 10 key considerations. Additionally, from the top 10% most salient themes, 5 considerations were retrieved. An ethical framework for the use of AI in neurosurgery was developed.
It is critical to address the ethical considerations associated with the use of AI in neurosurgery. The framework described in this manuscript may facilitate the integration of AI into neurosurgery, benefitting both patients and neurosurgeons alike. We urge neurosurgeons to use AI only for validated purposes and caution against automatic adoption of its outputs without neurosurgeon interpretation.
人工智能（AI）在神经外科中的应用越来越广泛。生成式预训练转换器（GPT）尤其受到关注。然而，将 AI 纳入该领域的伦理问题仍未得到充分探讨。我们使用一种新颖的基于 GPT 的、经人类修改的方法来阐述关键的伦理问题，综合最常见的考虑因素，并提出一个 AI 参与神经外科的伦理框架。
我们向 GPT-4、ChatGPT、Bing Chat/Copilot、You、Perplexity.ai 和 Google Bard 提出了以下提示：“如何将人工智能纳入神经外科的伦理考量？”，然后进行了基于 GPT 的分层主题分析。作者将结果综合为 AI 纳入神经外科的伦理考量因素。我们进行了单独的 Pareto 分析，阈值分别为 20%和 10%，以确定突出的主题。作者对这些突出的主题进行了精炼。
确定了 12 个重点关注利益相关者、临床实施和治理的关键伦理考量因素。对汇总的 GPT 输出中前 20%最突出主题的 Pareto 分析进行精炼后，得出 10 个关键考量因素。此外，从前 10%最突出的主题中，我们提取了 5 个考量因素。开发了一个用于神经外科 AI 使用的伦理框架。
解决与 AI 在神经外科中使用相关的伦理问题至关重要。本文描述的框架可以促进 AI 融入神经外科，使患者和神经外科医生都受益。我们敦促神经外科医生仅将 AI 用于经过验证的目的，并警告不要在未经神经外科医生解释的情况下自动采用其输出。
