就有关良性前列腺增生症的常见搜索问题开展患者教育的 ChatGPT 的局限性

Paolo M. Muraira, Annie Chen, Lori B. Lerner, Steven A. Kaplan, Kevin T. McVary, Franco M. Muraira, Ricardo R. Gonzalez
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摘要

生成式预训练转换器 4 (GPT-4) 或 ChatGPT 是一种人工智能语言生成器,已在医学领域的多个应用中使用。我们试图评估 ChatGPT 在回答患者提出的有关良性前列腺增生症(BPH)的问题时生成符合指南要求的适当回答的能力。 我们询问了 GPT-4(开放式人工智能),以回答谷歌搜索引擎中有关良性前列腺增生症的 20 个最常见问题。问题被细分为 5 类:病理生理学、诊断、行为矫正、程序干预和药物治疗。参与制定《美国泌尿外科学会良性前列腺增生临床指南》的泌尿科专家从准确性、全面性和时效性三个方面对这些回答进行了评分。 在生成的回复中,70% 是准确的,73% 是全面的,63% 是与时俱进的。有 17% 的 GPT-4 回答不准确、不全面、不当代。得分最高的是诊断(88.9%)、病理生理学(83.3%)和相对医疗(70.4%)子类别。最不准确、不全面和不具时效性的类别是程序性治疗(31.7%)。 当指南专家对良性前列腺增生引起的男性下尿路症状管理进行评分时,GPT-4 在诊断和病理生理学类别中提供了一些准确、全面和最新的信息,其准确性、全面性和时效性超过了 80%。GPT-4 可以作为患者了解良性前列腺增生症诊断和病理生理学基础知识的适当修订工具,但目前的版本在其他子类别(如相对医学治疗和程序性治疗)上未能满足患者的需求。鉴于 GPT-4 无处不在,泌尿外科界必须严格审查所有患者信息来源,找出需要改进的地方。
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Limitations of ChatGPT for Patient Education Regarding Frequently Searched Questions About Benign Prostatic Hyperplasia
Generative Pre-Trained Transformer 4 (GPT-4) or ChatGPT, an artificial intelligence language generator, has been used in multiple applications in medicine. We seek to evaluate ChatGPT’s ability to generate appropriate responses consistent with guidelines when asked patient-generated questions regarding benign prostatic hyperplasia (BPH). GPT-4 (Open AI) was queried to answer 20 of the most frequently asked questions regarding BPH according to Google’s search engine. Questions were subclassified into 5 categories: pathophysiology, diagnosis, behavioral modification, procedural interventions, and medical treatments. These responses were graded by expert urologists involved in generating the AUA BPH Clinical Guidelines on 3 domains: accuracy, comprehensiveness, and contemporaneousness. Of the responses generated, 70% were accurate, 73% were comprehensive, and 63% were contemporary. Seventeen percent of GPT-4 responses were inaccurate, incomprehensive, and noncontemporary. The highest scores were in diagnosis (88.9%), pathophysiology (83.3%), and relative medical treatment (70.4%) subcategories. The most inaccurate, incomprehensive, and noncontemporary category was procedural treatments (31.7%). When rated by guideline experts in management of male lower urinary tract symptoms attributed to BPH, GPT-4 has been shown to provide some accurate, comprehensive, and updated information exceeding 80% accuracy, comprehensiveness and contemporaneousness in the categories of diagnosis, and pathophysiology. GPT-4 can serve as an adequate revising tool for patients to learn the basics about BPH regarding diagnosis and pathophysiology, but the current version fails patients in other subcategories such as relative medical treatments and procedural treatments. Given the rise in GPT-4’s ubiquity, it is imperative that the urologic community critically examines all sources of patient information to identify areas of improvement.
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