Evaluating the Efficacy of Large Language Models in Guiding Treatment Decisions for Pediatric Refractive Error.

IF 2.6 3区医学 Q2 OPHTHALMOLOGY

Ophthalmology and Therapy Pub Date : 2025-04-01 Epub Date: 2025-02-22 DOI:10.1007/s40123-025-01105-2

Daohuan Kang, Hongkang Wu, Lu Yuan, Wenyue Shen, Jia Feng, Jiao Zhan, Andrzej Grzybowski, Wen Sun, Kai Jin

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引用次数: 0

Abstract

Introduction: Effective management of pediatric myopia, which includes treatments like corrective lenses and low-dose atropine, requires accurate clinical decisions. However, the complexity of pediatric refractive data, such as variations in visual acuity, axial length, and patient-specific factors, pose challenges to determining optimal treatment. This study aims to evaluate the performance of three large language models in analyzing these refractive data.

Methods: A dataset of 100 pediatric refractive records, including parameters like visual acuity and axial length, was analyzed using ChatGPT-3.5, ChatGPT-4o, and Wenxin Yiyan, respectively. Each model was tasked with determining whether intervention was needed and subsequently recommending a treatment (eyeglasses, orthokeratology lens, or low-dose atropine). The recommendations were compared to professional optometrists' consensus, rated on a 1-5 Global Quality Score (GQS) scale, and evaluated for clinical safety utilizing a three-tier accuracy assessment.

Results: ChatGPT-4o outperformed both ChatGPT-3.5 and Wenxin Yiyan in determining intervention needs, with an accuracy of 90%, significantly higher than Wenxin Yiyan (p < 0.05). It also achieved the highest GQS of 4.4 ± 0.55, surpassing the other models (p < 0.001), with 85% of responses rated as "good" ahead of ChatGPT-3.5 (82%) and Wenxin Yiyan (74%). ChatGPT-4o made only eight errors in recommending interventions, fewer than ChatGPT-3.5 (12) and Wenxin Yiyan (15). Additionally, it performed better with incomplete or abnormal data, maintaining higher quality scores.

Conclusion: ChatGPT-4o showed better accuracy and clinical safety, making it a promising tool for decision support in pediatric ophthalmology, although expert oversight is still necessary.

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评估大语言模型在指导儿童屈光不正治疗决策中的功效。

导论：儿童近视的有效管理需要准确的临床决策，包括矫正镜片和低剂量阿托品等治疗。然而，儿童屈光数据的复杂性，如视力、眼轴长度和患者特定因素的变化，对确定最佳治疗提出了挑战。本研究旨在评估三种大型语言模型在分析这些折射数据时的性能。方法：使用ChatGPT-3.5、chatgpt - 40和文心一眼分别对100例儿童屈光记录数据集进行分析，包括视力和眼轴长度等参数。每个模型的任务是确定是否需要干预并随后推荐治疗方法（眼镜、角膜塑形镜或低剂量阿托品）。将这些建议与专业验光师的共识进行比较，按照1-5的全球质量评分（GQS）量表进行评分，并利用三级准确性评估对临床安全性进行评估。结果：chatgpt - 40在确定干预需求方面优于ChatGPT-3.5和Wenxin Yiyan，准确率为90%，显著高于Wenxin Yiyan (p)。结论：chatgpt - 40具有更好的准确性和临床安全性，虽然仍需要专家监督，但仍有希望成为儿童眼科决策支持的工具。

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来源期刊

Ophthalmology and Therapy OPHTHALMOLOGY-

CiteScore

4.20

自引率

3.00%

发文量

157

审稿时长

6 weeks

期刊介绍： Aims and Scope Ophthalmology and Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from preclinical, clinical (all phases), observational, real-world, and health outcomes research around the use of ophthalmological therapies, devices, and surgical techniques. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Ophthalmology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of ophthalmic therapies. Open Access All articles published by Ophthalmology and Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Ophthalmology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €5250/$6000/£4300. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor. 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Please follow the link for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Copyright Ophthalmology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0. Contact For more information about the journal, including pre-submission enquiries, please contact christopher.vautrinot@springer.com.