Rittal Mehta, Justus G Reitz, Alyssia Venna, Arif Selcuk, Bishakha Dhamala, Jennifer Klein, Christine Sawda, Mitchell Haverty, Can Yerebakan, Aybala Tongut, Manan Desai, Yves d'Udekem
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引用次数: 0
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 (NLP) 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: 37 cases discussed at a single CSC were retrospectively identified. Clinical information comprised of de-identified data from the last ECG, echocardiogram, ICU progress note (or cardiology clinic note if outpatient) as well as a patient summary. Diagnosis was removed from the summary and possible treatment options were deleted from all notes. ChatGPT (v.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 10-15 seconds. ChatGPT correctly identified diagnoses for about 94.5% (n=35) cases. The surgical intervention plan matched the group decision for about 40.5% (n=15) cases; however, it differed in 27% cases. In 23 out 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.
Conclusion: 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.
期刊介绍：
The Journal of Thoracic and Cardiovascular Surgery presents original, peer-reviewed articles on diseases of the heart, great vessels, lungs and thorax with emphasis on surgical interventions. An official publication of The American Association for Thoracic Surgery and The Western Thoracic Surgical Association, the Journal focuses on techniques and developments in acquired cardiac surgery, congenital cardiac repair, thoracic procedures, heart and lung transplantation, mechanical circulatory support and other procedures.
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