Abou Chaar Mohamad K, Grigsby-Rocca Giovanna, Huang Ming, Blackmon Shanda H
Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.
Ann Thorac Surg Short Rep. 2024 Jun 25;2(4):674-679. doi: 10.1016/j.atssr.2024.06.007. eCollection 2024 Dec.
The objective of this study was to compare generative artificial intelligence-initiated care pathways, using ChatGPT, with expert-guided consensus-initiated care pathways from AskMayoExpert (AME) for symptom management of esophageal cancer patients after esophagectomy.
A formal protocol for development of 9 AME care pathways was followed for specific patient-identified domains after esophagectomy for esophageal cancer. Domain scores were measured and assessed through the Upper Digestive Disease tool. These care pathways were developed by experts validated by a consensus-driven methodology. ChatGPT was used to answer specific questions similar to the AME care pathway on April 9, 2023, and March 28, 2024. To compare outcomes, answers were recorded, and algorithms were compared with a survey tool composed of 5 questions.
Both modalities were able to provide a clear definition with multidirectional management options for all 9 domains: dysphagia, generalized dumping, gastrointestinal dumping, pain, regurgitation, heartburn, nausea, physical health, and mental health. When provided with a simple prompt, ChatGPT 3.5 failed to provide a comprehensive stepwise approach for providers, any testing recommendations, or any form of triage process. However, ChatGPT 4.0 provided plans, similar to AME care pathways, when a sophisticated prompt was used.
Generative artificial intelligence-initiated care pathways can be used by physicians as a supplementary tool to guide provider management of patients with complex symptoms after esophagectomy. This technology will continue to advance but is currently insufficient to solely guide clinical management of complex patients with severe symptoms.
本研究的目的是比较使用ChatGPT的生成式人工智能启动的护理路径与AskMayoExpert（AME）的专家指导共识启动的护理路径，用于食管癌患者食管切除术后症状管理。
遵循正式方案开发9条AME护理路径，用于食管癌食管切除术后特定患者确定的领域。通过上消化道疾病工具测量和评估领域得分。这些护理路径由通过共识驱动方法验证的专家制定。于2023年4月9日和2024年3月28日使用ChatGPT回答与AME护理路径类似的特定问题。为比较结果，记录答案，并将算法与由5个问题组成的调查工具进行比较。
两种模式都能够为所有9个领域提供具有多方向管理选项的清晰定义，这些领域包括吞咽困难、全身性倾倒、胃肠道倾倒、疼痛、反流、烧心、恶心、身体健康和心理健康。当给出简单提示时，ChatGPT 3.5未能为医护人员提供全面的逐步方法、任何检测建议或任何形式的分诊流程。然而，当使用复杂提示时，ChatGPT 4.0提供了与AME护理路径类似的计划。
生成式人工智能启动的护理路径可被医生用作辅助工具，以指导食管切除术后复杂症状患者的医护人员管理。这项技术将继续发展，但目前尚不足以单独指导有严重症状的复杂患者的临床管理。
