Cheng Tingting, Li Yu, Gu Jiaqiu, He Yibo, He Guangbao, Zhou Peipei, Li Shuyun, Xu Hang, Bao Yang, Wang Xuejun
Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
School of Clinical Medicine, Qinghai University, Xining, Qinghai, 810000, China.
Perioper Med (Lond). 2024 Nov 21;13(1):111. doi: 10.1186/s13741-024-00469-6.
Day surgery has developed rapidly in China in recent years, although it still faces a shortage of anesthesiologists to handle pre-anesthesia routine before surgery. We hypothesized that ChatGPT may assist anesthesia practitioners in preoperative assessment and answer questions on the concerns of patients. The aims of this study were to examine the ability of ChatGPT to assess preoperative risk and determine its accuracy in answering questions regarding knowledge and management of day surgery anesthesia.
One-hundred fifty patient profiles were generated to simulate day surgery patient presentations that involved complications of varying acuity and severity. The ChatGPT group and the expert group were both required to evaluate the profiles of 150 simulated patients to determine their ASA-PS classification and whether day surgery was recommended. ChatGPT was then asked to answer 131 questions about day surgery anesthesia that represented the most common issues encountered in clinical practice. The performance of ChatGPT was assessed and graded independently by two experienced anesthesiologists.
A total of 150 patient profiles were included in the study (75 males [50.0%] and 75 females [50.0%]). There was no difference between the ChatGPT group and the expert group for the ASA-PS classification and assessment of anesthesia risk in the patient profiles (P > 0.05). Regarding recommendation for day surgery in patients with certain comorbidities (ASA ≥ II), the expert group was inclined to require further examination or treatment. In addition, the proportion of conclusions made by ChatGPT was smaller than that of the experts (i.e., ChatGPT n (%) vs. expert n (%): day surgery can be performed, 67 (47.9) vs. 31 (25.4); needs further treatment and evaluation, 56 (37.3) vs. 66 (44.0); and day surgery is not recommended, 18 (12.9) vs. 29 (9.3), P < 0.05). We showed that ChatGPT had extensive knowledge related to day surgery anesthesia (94.0% correct), with most of the points (70%) considered comprehensive. The performance of ChatGPT was also better in the domains of peri-anesthesia concerns, lifestyle, and emotional support.
ChatGPT can assist anesthesia practitioners and surgeons by alerting them to the ASA-PS classification and assessing perioperative risk in day surgery patients. ChatGPT can also be trusted to answer questions and concerns related to pre-anesthesia and therefore has the potential to provide important assistance in clinical work.
近年来，日间手术在中国发展迅速，尽管在术前麻醉常规处理方面仍面临麻醉医生短缺的问题。我们推测ChatGPT可能会帮助麻醉医生进行术前评估，并回答患者关心的问题。本研究的目的是检验ChatGPT评估术前风险的能力，并确定其在回答有关日间手术麻醉知识和管理问题时的准确性。
生成了150份患者资料，以模拟涉及不同严重程度并发症的日间手术患者情况。要求ChatGPT组和专家组对150例模拟患者的资料进行评估，以确定其美国麻醉医师协会身体状况分级（ASA-PS）并判断是否建议进行日间手术。然后让ChatGPT回答131个关于日间手术麻醉的问题，这些问题代表了临床实践中最常见的问题。由两名经验丰富的麻醉医生独立评估ChatGPT的表现并进行评分。
本研究共纳入150份患者资料（男性75例[50.0%]，女性75例[50.0%]）。ChatGPT组和专家组在患者资料的ASA-PS分级和麻醉风险评估方面无差异（P>0.05）。对于某些合并症（ASA≥II）患者的日间手术建议，专家组倾向于要求进一步检查或治疗。此外，ChatGPT得出结论的比例低于专家（即ChatGPT n（%）与专家n（%）：可进行日间手术，67（47.9）对31（25.4）；需要进一步治疗和评估，56（37.3）对66（44.0）；不建议进行日间手术，18（12.9）对29（9.3），P<0.05）。我们发现ChatGPT拥有与日间手术麻醉相关的广泛知识（正确率94.0%），大部分要点（70%）被认为是全面的。ChatGPT在围麻醉期关注、生活方式和情感支持等领域的表现也更好。
ChatGPT可以通过提醒麻醉医生和外科医生注意ASA-PS分级并评估日间手术患者的围手术期风险来提供帮助。ChatGPT在回答与麻醉前相关的问题和担忧方面也值得信赖，因此有潜力在临床工作中提供重要帮助。
