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临床医生的大语言模型指南:以幻觉为重点的总体视角

The Clinicians' Guide to Large Language Models: A General Perspective With a Focus on Hallucinations.

作者信息

Roustan Dimitri, Bastardot François

机构信息

Emergency Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Medical Directorate, Lausanne University Hospital, Lausanne, Switzerland.

出版信息

Interact J Med Res. 2025 Jan 28;14:e59823. doi: 10.2196/59823.

Abstract

Large language models (LLMs) are artificial intelligence tools that have the prospect of profoundly changing how we practice all aspects of medicine. Considering the incredible potential of LLMs in medicine and the interest of many health care stakeholders for implementation into routine practice, it is therefore essential that clinicians be aware of the basic risks associated with the use of these models. Namely, a significant risk associated with the use of LLMs is their potential to create hallucinations. Hallucinations (false information) generated by LLMs arise from a multitude of causes, including both factors related to the training dataset as well as their auto-regressive nature. The implications for clinical practice range from the generation of inaccurate diagnostic and therapeutic information to the reinforcement of flawed diagnostic reasoning pathways, as well as a lack of reliability if not used properly. To reduce this risk, we developed a general technical framework for approaching LLMs in general clinical practice, as well as for implementation on a larger institutional scale.

摘要

大语言模型(LLMs)是人工智能工具,有望深刻改变我们从事医学各方面工作的方式。鉴于大语言模型在医学领域的巨大潜力以及众多医疗保健利益相关者将其应用于日常实践的兴趣,临床医生了解与使用这些模型相关的基本风险至关重要。具体而言,使用大语言模型的一个重大风险是它们产生幻觉的可能性。大语言模型产生的幻觉(虚假信息)源于多种原因,包括与训练数据集相关的因素以及它们的自回归性质。对临床实践的影响范围从产生不准确的诊断和治疗信息到强化有缺陷的诊断推理途径,以及如果使用不当则缺乏可靠性。为降低这种风险,我们开发了一个通用技术框架,用于在一般临床实践中应用大语言模型,以及在更大的机构规模上实施。

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本文引用的文献

1
A survey on multimodal large language models.
Natl Sci Rev. 2024 Nov 12;11(12):nwae403. doi: 10.1093/nsr/nwae403. eCollection 2024 Dec.
2
Detecting hallucinations in large language models using semantic entropy.
Nature. 2024 Jun;630(8017):625-630. doi: 10.1038/s41586-024-07421-0. Epub 2024 Jun 19.
3
Chat GPT as a Neuro-Score Calculator: Analysis of a Large Language Model's Performance on Various Neurological Exam Grading Scales.
World Neurosurg. 2023 Nov;179:e342-e347. doi: 10.1016/j.wneu.2023.08.088. Epub 2023 Aug 26.
4
Use of GPT-4 to Analyze Medical Records of Patients With Extensive Investigations and Delayed Diagnosis.
JAMA Netw Open. 2023 Aug 1;6(8):e2325000. doi: 10.1001/jamanetworkopen.2023.25000.
5
ChatGPT and Bard exhibit spontaneous citation fabrication during psychiatry literature search.
Psychiatry Res. 2023 Aug;326:115334. doi: 10.1016/j.psychres.2023.115334. Epub 2023 Jul 7.
6
ChatGPT in head and neck scientific writing: A precautionary anecdote.
Am J Otolaryngol. 2023 Nov-Dec;44(6):103980. doi: 10.1016/j.amjoto.2023.103980. Epub 2023 Jul 6.
7
Performance of ChatGPT on a Radiology Board-style Examination: Insights into Current Strengths and Limitations.
Radiology. 2023 Jun;307(5):e230582. doi: 10.1148/radiol.230582. Epub 2023 May 16.
8
ChatGPT and Ophthalmology: Exploring Its Potential with Discharge Summaries and Operative Notes.
Semin Ophthalmol. 2023 Jul;38(5):503-507. doi: 10.1080/08820538.2023.2209166. Epub 2023 May 3.
9
Ethics of large language models in medicine and medical research.
Lancet Digit Health. 2023 Jun;5(6):e333-e335. doi: 10.1016/S2589-7500(23)00083-3. Epub 2023 Apr 27.

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