通过人工智能开展以患者为中心的研究,确定癌症护理的优先事项

IF 22.5 1区 医学 Q1 ONCOLOGY
Jiyeong Kim, Michael L. Chen, Shawheen J. Rezaei, Mariana Ramirez-Posada, Jennifer L. Caswell-Jin, Allison W. Kurian, Fauzia Riaz, Kavita Y. Sarin, Jean Y. Tang, Steven M. Asch, Eleni Linos
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引用次数: 0

摘要

以患者为中心的研究对于弥合研究与患者护理之间的差距至关重要,然而,在健康研究中,患者的观点往往得不到充分体现。目的利用人工智能(AI)和自然语言处理(NLP)分析患者信息的大型数据集,定义患者关注的问题并生成相关的研究主题,并量化这些人工智能生成的主题的质量。设计、设置和参与者本案例系列使用一个自动化框架进行,该框架包括一个两阶段的无监督NLP主题模型和人工智能生成的研究主题建议。该研究基于2013年7月至2024年4月期间斯坦福医疗保健和22个附属中心的乳腺癌或皮肤癌患者的未识别患者门户信息数据。一种广泛使用的大型语言模型(chatgpt - 40 [OpenAI];(2024年4月),通过多个提示工程策略进行使用和指导,完成多层次的任务,包括知识解释和总结(例如,解释和总结nlp定义的主题),知识生成(例如,生成与患者问题相对应的研究思路),自我反思和纠正(例如,在搜索科学文章后确保和修改研究思路),以及自我保证(例如,确认和确定研究思路)。3名乳腺肿瘤学家(J.L.C, a.w.k., F.R)和3名皮肤科医生(K.Y.S, J.Y.T, E.L.)使用5分李克特量表(1代表特别,5代表差)评估人工智能生成的研究课题的意义和新颖性。计算每个主题的意义性和新颖性的平均(SD)分数。结果共分析25 549例患者信息614 464条,其中乳腺癌患者10 665例(女性98.6%),皮肤癌患者14 884例(女性49.0%)。乳腺癌主题的意义性和新颖性的总平均(SD)得分分别为3.00(0.50)和3.29(0.74),皮肤癌主题的总平均(SD)得分分别为2.67(0.45)和3.09(0.68)。当两项得分都低于平均水平(乳腺癌的15分中有5分,皮肤癌的15分中有6分)时,人工智能建议的研究主题中有三分之一是高度有意义和新颖的。值得注意的是,人工智能建议的主题中有三分之二是新颖的(15个乳腺癌主题中有10个,15个皮肤癌主题中有11个)。本案例系列表明,对大量患者信息进行AI/ nlp驱动的分析可以在癌症治疗中产生反映患者观点的高质量研究主题,为未来以患者为中心的健康研究工作提供有价值的指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient-Centered Research Through Artificial Intelligence to Identify Priorities in Cancer Care
ImportancePatient-centered research is essential for bridging the gap between research and patient care, yet patient perspectives are often inadequately represented in health research.ObjectiveTo leverage artificial intelligence (AI) and natural language processing (NLP) to analyze a large dataset of patient messages, defining patient concerns and generating relevant research topics, and to quantify the quality of these AI-generated topics.Design, Setting, and ParticipantsThis case series was conducted using an automated framework involving a 2-staged unsupervised NLP topic model and AI-generated research topic suggestions. The study was based on deidentified patient portal message data from individuals with breast or skin cancer at Stanford Health Care and 22 affiliated centers over July 2013 to April 2024.ExposuresA widely used large language model (ChatGPT-4o [OpenAI]; April 2024) was used and guided through multiple prompt-engineering strategies to perform multilevel tasks, including knowledge interpretation and summarization (eg, interpreting and summarizing the NLP-defined topics), knowledge generation (eg, generating research ideas corresponding to patients’ issues), self-reflection and correction (eg, ensuring and revising the research ideas after searching for scientific articles), and self-reassurance (eg, confirming and finalizing the research ideas).Main Outcomes and MeasuresThree breast oncologists (J.L.C., A.W.K., F.R) and 3 dermatologists (K.Y.S, J.Y.T., E.L.) evaluated the meaningfulness and novelty of the AI-generated research topics using a 5-point Likert scale (1 representing exceptional to 5 representing poor). Mean (SD) scores for meaningfulness and novelty were computed for each topic.ResultsA total of 614 464 patient messages were analyzed from 25 549 individuals, 10 665 with breast cancer (98.6% female) and 14 884 had skin cancer (49.0% female). The overall mean (SD) scores for meaningfulness and novelty were 3.00 (0.50) and 3.29 (0.74), respectively, for breast cancer topics and 2.67 (0.45) and 3.09 (0.68), respectively, for skin cancer topics. One-third of the AI-suggested research topics were highly meaningful and novel when both scores were lower than the average (5 of 15 for breast cancer and 6 of 15 for skin cancer). Notably, two-thirds of the AI-suggested topics were novel (10 of 15 for breast cancer and 11 of 15 for skin cancer).Conclusions and RelevanceThis case series demonstrates that AI/NLP-driven analysis of large volumes of patient messages can generate quality research topics in cancer care that reflect patient perspectives, providing valuable guidance for future patient-centered health research endeavors.
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来源期刊
JAMA Oncology
JAMA Oncology Medicine-Oncology
自引率
1.80%
发文量
423
期刊介绍: JAMA Oncology is an international peer-reviewed journal that serves as the leading publication for scientists, clinicians, and trainees working in the field of oncology. It is part of the JAMA Network, a collection of peer-reviewed medical and specialty publications.
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