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探索小儿心血管外科的未来:由聊天生成预训练变换器(ChatGPT)推动的见解与创新。

Navigating the future of pediatric cardiovascular surgery: Insights and innovation powered by Chat Generative Pre-Trained Transformer (ChatGPT).

作者信息

Mehta Rittal, Reitz Justus G, Venna Alyssia, Selcuk Arif, Dhamala Bishakha, Klein Jennifer, Sawda Christine, Haverty Mitchell, Yerebakan Can, Tongut Aybala, Desai Manan, d'Udekem Yves

机构信息

Department of Cardiac Surgery, Children's National Heart Institute, Children's National Hospital, Washington, DC.

Department of Cardiac Surgery, Children's National Heart Institute, Children's National Hospital, Washington, DC.

出版信息

J Thorac Cardiovasc Surg. 2025 Feb 1. doi: 10.1016/j.jtcvs.2025.01.022.

Abstract

INTRODUCTION

Interdisciplinary consultations are essential to decision-making for patients with congenital heart disease. The integration of artificial intelligence (AI) and natural language processing into medical practice is rapidly accelerating, opening new avenues to diagnosis and treatment. The main objective of this study was to consult the AI-trained model Chat Generative Pre-Trained Transformer (ChatGPT) regarding cases discussed during a cardiovascular surgery conference (CSC) at a single tertiary center and compare the ChatGPT suggestions with CSC expert consensus results.

METHODS

In total, 37 cases discussed at a single CSC were retrospectively identified. Clinical information comprised deidentified data from the last electrocardiogram, echocardiogram, intensive care unit progress note (or cardiology clinic note if outpatient), as well as a patient summary. The diagnosis was removed from the summary and possible treatment options were deleted from all notes. ChatGPT (version 4.0) was asked to summarize the case, identify diagnoses, and recommend surgical procedures and timing of surgery. The responses of ChatGPT were compared with the results of the CSC.

RESULTS

Of the 37 cases uploaded to ChatGPT, 45.9% (n = 17) were considered to be less complex cases, with only 1 treatment option, and 54.1% (n = 20) were considered more complex, with several treatment options. ChatGPT correctly provided a detailed and systematically written summary for each case within 10 to 15 seconds. ChatGPT correctly identified diagnoses for approximately 94.5% (n = 35) cases. The surgical intervention plan matched the group decision for approximately 40.5% (n = 15) cases; however, it differed in 27% cases. In 23 of 37 cases, timing of surgery was the same between CSC group and ChatGPT. Overall, the match between ChatGPT responses and CSC decisions for diagnosis was 94.5%, surgical intervention was 40.5%, and timing of surgery was 62.2%. However, within complex cases, we have 25% agreement for surgical intervention and 67% for timing of surgery.

CONCLUSIONS

ChatGPT can be used as an augmentative tool for surgical conferences to systematically summarize large amounts of patient data from electronic health records and clinical notes in seconds. In addition, our study points out the potential of ChatGPT as an AI-based decision support tool in surgery, particularly for less-complex cases. The discrepancy, particularly in complex cases, emphasizes on the need for caution when using ChatGPT in decision-making for the complex cases in pediatric cardiovascular surgery. There is little doubt that the public will soon use this comparative tool.

摘要

引言

跨学科会诊对于先天性心脏病患者的决策至关重要。人工智能(AI)和自然语言处理融入医疗实践的速度正在迅速加快,为诊断和治疗开辟了新途径。本研究的主要目的是就某单一三级中心心血管外科会议(CSC)期间讨论的病例咨询经过AI训练的模型Chat生成式预训练变换器(ChatGPT),并将ChatGPT的建议与CSC专家共识结果进行比较。

方法

回顾性确定了在一次CSC上讨论的37例病例。临床信息包括来自最后一份心电图、超声心动图、重症监护病房病程记录(如果是门诊患者则为心脏病学门诊记录)以及患者总结的去识别化数据。诊断信息从总结中删除,所有记录中可能的治疗方案也被删除。要求ChatGPT(版本4.0)总结病例、识别诊断,并推荐手术程序和手术时机。将ChatGPT的回答与CSC的结果进行比较。

结果

上传到ChatGPT的37例病例中,45.9%(n = 17)被认为是不太复杂的病例,只有1种治疗方案,54.1%(n = 20)被认为更复杂,有几种治疗方案。ChatGPT在10到15秒内为每个病例正确提供了详细且系统编写的总结。ChatGPT正确识别了约94.5%(n = 35)病例的诊断。手术干预计划与约40.5%(n = 15)病例的小组决定相符;然而,在27%的病例中存在差异。在37例病例中的23例中,CSC组和ChatGPT之间的手术时机相同。总体而言,ChatGPT回答与CSC诊断决定的匹配度为94.5%,手术干预为40.5%,手术时机为62.2%。然而,在复杂病例中,我们在手术干预方面的一致性为25%,在手术时机方面为67%。

结论

ChatGPT可作为外科会议的辅助工具,在数秒内系统地总结电子健康记录和临床笔记中的大量患者数据。此外,我们的研究指出了ChatGPT作为基于AI的手术决策支持工具的潜力,特别是对于不太复杂的病例。这种差异,特别是在复杂病例中,强调了在小儿心血管手术复杂病例决策中使用ChatGPT时需要谨慎。毫无疑问,公众很快就会使用这个比较工具。

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