Evaluating retrieval augmented generation and ChatGPT's accuracy on orthopaedic examination assessment questions.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Annals of Joint Pub Date : 2025-04-22 eCollection Date: 2025-01-01 DOI:10.21037/aoj-24-49
Jordan Eskenazi, Varun Krishnan, Maximilian Konarzewski, David Constantinescu, Gilberto Lobaton, Seth D Dodds
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引用次数: 0

Abstract

Background: Since the introduction of large language models (LLMs) such as ChatGPT, there has been a race to test its capability in medical problem solving across specialties to varying degrees of success. Retrieval augmented generation (RAG) allows LLMs to leverage subject specific knowledge to provide context, a greater number of sources, and the ability to cite medical literature to increase the accuracy and credibility of its answers. The use of LLM + RAG has not yet been used in the appraisal of artificial intelligence's capability of orthopedic problem solving. The purpose of this study is to assess the performance of ChatGPT + RAG against the performance of ChatGPT without RAG as well as against humans on orthopedic examination assessment questions.

Methods: The American Academy of Orthopaedic Surgeons (AAOS) OrthoWizard question bank was used as the source of questions. After 13 textbooks and 28 clinical guidelines were made available for RAG, text-only multiple-choice questions were presented in a zero-shot learning fashion to ChatGPT-4 + RAG, ChatGPT-4, and ChatGPT-3.5.

Results: On 1,023 questions tested, ChatGPT-3.5, ChatGPT-4, ChatGPT-4+RAG, and humans scored 52.98%, 64.91%, 73.80%, and 73.97%, respectively. There was no statistical difference between orthopedic surgeons and ChatGPT-4 + RAG on overall accuracy (P>0.99). Both orthopedic surgeons and ChatGPT4 + RAG scored better than ChatGPT-4 (P<0.001) and ChatGPT-3.5 (P<0.001). Of the 13 textbooks available to RAG, RAG used AAOS Comprehensive Review 3 Volume 3 for 39.6% of questions, more often than any other resource available to it.

Conclusions: ChatGPT-4 + RAG was able to answer 1,023 questions from the OrthoWizard question bank at the same accuracy as Orthopedic surgeons. Both ChatGPT-4 + RAG and orthopedic surgeons had superior accuracy on these specialty exam questions compared to ChatGPT-4 and ChatGPT-3.5. Artificial intelligence is becoming increasingly accurate in its ability to answer orthopaedic surgery test questions with the guidance of orthopaedic surgery textbooks. RAG enables an LLM to effectively cite its sources after providing an answer to a question, which is an important tool for the integration of LLMs to orthopaedic surgery education and can function as a valuable tool for anyone studying for an orthopedic examination.

评估检索增强生成和ChatGPT在骨科考试评估题中的准确性。
背景:自从引入像ChatGPT这样的大型语言模型(llm)以来,人们竞相测试其在解决不同专业医疗问题方面的能力,并取得了不同程度的成功。检索增强生成(RAG)允许法学硕士利用特定学科的知识来提供上下文、更多的来源以及引用医学文献的能力,以提高其答案的准确性和可信度。LLM + RAG的使用尚未用于人工智能骨科问题解决能力的评估。本研究的目的是评估ChatGPT + RAG与没有RAG的ChatGPT以及人类在骨科考试评估问题上的表现。方法:采用美国骨科医师学会(AAOS) OrthoWizard题库作为问题来源。在为RAG提供13本教科书和28份临床指南后,将纯文本选择题以零学习方式呈现给ChatGPT-4 + RAG、ChatGPT-4和ChatGPT-3.5。结果:在测试的1023个问题中,ChatGPT-3.5、ChatGPT-4、ChatGPT-4+RAG和人类的得分分别为52.98%、64.91%、73.80%和73.97%。骨科医师与ChatGPT-4 + RAG在总体准确率上无统计学差异(P < 0.99)。骨科医生和ChatGPT4 + RAG得分都高于ChatGPT-4(结论:ChatGPT-4 + RAG能够回答来自OrthoWizard题库的1,023个问题,准确度与骨科医生相同。与ChatGPT-4和ChatGPT-3.5相比,ChatGPT-4 + RAG和骨科医生在这些专业考试问题上的准确性更高。在骨科教科书的指导下,人工智能对骨科手术试题的回答能力正变得越来越准确。RAG使LLM能够在回答问题后有效地引用其来源,这是LLM与骨科外科教育相结合的重要工具,对于任何准备骨科考试的人来说都是一个有价值的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Joint
Annals of Joint ORTHOPEDICS-
CiteScore
1.10
自引率
-25.00%
发文量
17
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