Roustan Dimitri, Bastardot François
Emergency Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Medical Directorate, Lausanne University Hospital, Lausanne, Switzerland.
Interact J Med Res. 2025 Jan 28;14:e59823. doi: 10.2196/59823.
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.
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。