新型医疗人工智能大语言模型在疑似脓毒症急诊患者决策支持中的表现

IF 3.2 3区 医学 Q1 EMERGENCY MEDICINE
Sen Jiang, Xiandong Liu, Tong Liu, Yi Gu, Bo An, Chunxue Wang, Dongyang Zhao, Haitao Zhang, Lunxian Tang
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引用次数: 0

摘要

背景:人们正在探索用于疾病预测和诊断的大型语言模型(LLMs);然而,它们在急诊科(EDs)早期脓毒症识别中的功效仍未得到探索。本研究旨在评估MedGo作为临床医生管理疑似脓毒症患者的决策支持工具。方法:本回顾性研究纳入了2023年1月至2024年1月在三级医院急诊科确诊败血症的203例匿名病历(平均年龄79.9±10.2岁)。MedGo在9项败血症相关评估任务中的表现与两名初级(10年经验)急诊科医生进行了比较。评估以5分李克特量表对准确性、全面性、可读性和案例分析技能进行评分。结果:MedGo在大多数指标上的诊断表现与资深医生相当,在准确性、全面性和可读性方面达到了4分的中位李克特评分。结论:MedGo对脓毒症的诊断效果显著,能够有效地支持急诊科临床医生,特别是提高初级医生的表现。我们的研究强调了MedGo作为败血症管理有价值的决策支持工具的潜力,为专门的败血症人工智能模型铺平了道路。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Performance of a novel medical artificial intelligence large language model on supporting decision-making for emergency patients with suspected sepsis.

Background: Large language models (LLMs) are being explored for disease prediction and diagnosis; however, their efficacy for early sepsis identification in emergency departments (EDs) remains unexplored. This study aims to evaluate MedGo, a novel medical LLM, as a decision-support tool for clinicians managing patients with suspected sepsis.

Methods: This retrospective study included anonymized medical records of 203 patients (mean age 79.9±10.2 years) with confirmed sepsis from a tertiary hospital ED between January 2023 and January 2024. MedGo performance across nine sepsis-related assessment tasks was compared with that of two junior (<3 years of experience) and two senior (>10 years of experience) ED physicians. Assessments were scored on a 5-point Likert scale for accuracy, comprehensiveness, readability, and case-analysis skills.

Results: MedGo demonstrated diagnostic performance comparable to that of senior physicians across most metrics, achieving a median Likert score of 4 in accuracy, comprehensiveness, and readability. MedGo significantly outperformed junior physicians (P<0.001 for accuracy and case-analysis skills). MedGo assistance significantly enhanced both junior (P<0.001) and senior (P<0.05) physicians' diagnostic accuracy. Notably, MedGo-assisted junior physicians achieved accuracy levels comparable to those of unassisted senior physicians. MedGo maintained consistent performance across varying sepsis severities.

Conclusion: MedGo shows significant diagnostic efficacy for sepsis and effectively supports clinicians in the ED, particularly enhancing junior physicians' performance. Our study highlights the potential of MedGo as a valuable decision-support tool for sepsis management, paving the way for specialized sepsis AI models.

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来源期刊
CiteScore
2.50
自引率
28.60%
发文量
671
期刊介绍: The journal will cover technical, clinical and bioengineering studies related to multidisciplinary specialties of emergency medicine, such as cardiopulmonary resuscitation, acute injury, out-of-hospital emergency medical service, intensive care, injury and disease prevention, disaster management, healthy policy and ethics, toxicology, and sudden illness, including cardiology, internal medicine, anesthesiology, orthopedics, and trauma care, and more. The journal also features basic science, special reports, case reports, board review questions, and more. Editorials and communications to the editor explore controversial issues and encourage further discussion by physicians dealing with emergency medicine.
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