Artificial intelligence: revolutionizing cardiology with large language models
Machteld J Boonstra,
Davy Weissenbacher,
Jason H Moore
et al.
Abstract:Natural language processing techniques are having an increasing impact on clinical care from patient, clinician, administrator, and research perspective. Among others are automated generation of clinical notes and discharge letters, medical term coding for billing, medical chatbots both for patients and clinicians, data enrichment in the identification of disease symptoms or diagnosis, cohort selection for clinical trial, and auditing purposes. In the review, an overview of the history in natural language proc… Show more
“…Additionally, there are many more tasks where LLMs could make significant contributions including, identifying adverse events, enriching risk prediction models, enhancing patient management, as well as improving administrative processes and compliance to guidelines. 26…”
Section: Discussionmentioning
confidence: 99%
“…Additionally, there are many more tasks where LLMs could make significant contributions including, identifying adverse events, enriching risk prediction models, enhancing patient management, as well as improving administrative processes and compliance to guidelines. 26 To harness the benefits of LLMs while mitigating the risks, future research should focus on enhancing the transparency and accountability of these models. Developing standards for the ethical use of AI in medicine, improving the diversity and reliability of training datasets, and implementing robust validation processes are critical steps toward responsible integration.…”
Rationale and Objectives: Large Language Models (LLMs) have the potential to enhance medical training, education, and diagnosis. However, since these models were not originally designed for medical purposes, there are concerns regarding their reliability and safety in clinical settings. This review systematically assesses the utility, advantages, and potential risks of employing LLMs in the field of hematology. Materials and Methods: We searched PubMed, Web of Science, and Scopus databases for original publications on LLMs application in hematology. We limited the search to articles published in English from December 01 2022 to March 25, 2024, coinciding with the introduction of ChatGPT. To evaluate the risk of bias, we used the adapted version of the Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS-2). Results: Eleven studies fulfilled the eligibility criteria. The studies varied in their goals and methods, covering medical education, diagnosis, and clinical practice. GPT-3.5 and GPT-4's demonstrated superior performance in diagnostic tasks and medical information propagation compared to other models like Google's Bard (currently called Gemini). GPT-4 demonstrated particularly high accuracy in tasks such as interpreting hematology cases and diagnosing hemoglobinopathy, with performance metrics of 76% diagnostic accuracy and 88% accuracy in identifying normal blood cells. However, the study also revealed discrepancies in model consistency and the accuracy of provided references, indicating variability in their reliability. Conclusion: While LLMs present significant opportunities for advancing clinical hematology, their incorporation into medical practice requires careful evaluation of their benefits and limitations. Key Words: Hematology; Large Language Models; ChatGPT; Microsoft Bing; Google Bard; PaLM; LlaMA.
“…Additionally, there are many more tasks where LLMs could make significant contributions including, identifying adverse events, enriching risk prediction models, enhancing patient management, as well as improving administrative processes and compliance to guidelines. 26…”
Section: Discussionmentioning
confidence: 99%
“…Additionally, there are many more tasks where LLMs could make significant contributions including, identifying adverse events, enriching risk prediction models, enhancing patient management, as well as improving administrative processes and compliance to guidelines. 26 To harness the benefits of LLMs while mitigating the risks, future research should focus on enhancing the transparency and accountability of these models. Developing standards for the ethical use of AI in medicine, improving the diversity and reliability of training datasets, and implementing robust validation processes are critical steps toward responsible integration.…”
Rationale and Objectives: Large Language Models (LLMs) have the potential to enhance medical training, education, and diagnosis. However, since these models were not originally designed for medical purposes, there are concerns regarding their reliability and safety in clinical settings. This review systematically assesses the utility, advantages, and potential risks of employing LLMs in the field of hematology. Materials and Methods: We searched PubMed, Web of Science, and Scopus databases for original publications on LLMs application in hematology. We limited the search to articles published in English from December 01 2022 to March 25, 2024, coinciding with the introduction of ChatGPT. To evaluate the risk of bias, we used the adapted version of the Quality Assessment of Diagnostic Accuracy Studies criteria (QUADAS-2). Results: Eleven studies fulfilled the eligibility criteria. The studies varied in their goals and methods, covering medical education, diagnosis, and clinical practice. GPT-3.5 and GPT-4's demonstrated superior performance in diagnostic tasks and medical information propagation compared to other models like Google's Bard (currently called Gemini). GPT-4 demonstrated particularly high accuracy in tasks such as interpreting hematology cases and diagnosing hemoglobinopathy, with performance metrics of 76% diagnostic accuracy and 88% accuracy in identifying normal blood cells. However, the study also revealed discrepancies in model consistency and the accuracy of provided references, indicating variability in their reliability. Conclusion: While LLMs present significant opportunities for advancing clinical hematology, their incorporation into medical practice requires careful evaluation of their benefits and limitations. Key Words: Hematology; Large Language Models; ChatGPT; Microsoft Bing; Google Bard; PaLM; LlaMA.
“…Moreover, existing ML risk models rely primarily on structured EHR data (labs, medications, vitals). Advances in natural language processing through large language models present a promising opportunity to enrich model inputs through incorporation of unstructured data (clinical notes, radiology reports) ( 54 ). Prospective clinical implementation will require a multidisciplinary collaboration between data scientists, healthcare informaticists, and clinicians to overcome these challenges.…”
Background and Objective
Machine learning (ML) is increasingly being utilized to provide data driven solutions to challenges in medicine. Within the field of cardiac surgery, ML methods have been employed as risk stratification tools to predict a variety of operative outcomes. However, the clinical utility of ML in this domain is unclear. The aim of this review is to provide an overview of ML in cardiac surgery, particularly with regards to its utility in predictive analytics and implications for use in clinical decision support.
Methods
We performed a narrative review of relevant articles indexed in PubMed since 2000 using the MeSH terms “Machine Learning”, “Supervised Machine Learning”, “Deep Learning”, or “Artificial Intelligence” and “Cardiovascular Surgery” or “Thoracic Surgery”.
Key Content and Findings
ML methods have been widely used to generate pre-operative risk profiles, consistently resulting in the accurate prediction of clinical outcomes in cardiac surgery. However, improvement in predictive performance over traditional risk metrics has proven modest and current applications in the clinical setting remain limited.
Conclusions
Studies utilizing high volume, multidimensional data such as that derived from electronic health record (EHR) data appear to best demonstrate the advantages of ML methods. Models trained on post cardiac surgery intensive care unit data demonstrate excellent predictive performance and may provide greater clinical utility if incorporated as clinical decision support tools. Further development of ML models and their integration into EHR’s may result in dynamic clinical decision support strategies capable of informing clinical care and improving outcomes in cardiac surgery.
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