ChatGPT on guidelines: Providing contextual knowledge to GPT allows it to provide advice on appropriate colonoscopy intervals

结肠镜检查 医学 幻觉 知识库 梅德林 医学物理学 结直肠癌 计算机科学 人工智能 癌症 内科学 政治学 法学
作者
Daniel Yan Zheng Lim,Yu Bin Tan,Jonathan Tian En Koh,Joshua Yi Min Tung,Gerald Gui Ren Sng,Damien Meng Yew Tan,Chee‐Kiat Tan
出处
期刊:Journal of Gastroenterology and Hepatology [Wiley]
卷期号:39 (1): 81-106 被引量:36
标识
DOI:10.1111/jgh.16375
摘要

Abstract Background and Aim Colonoscopy is commonly used in screening and surveillance for colorectal cancer. Multiple different guidelines provide recommendations on the interval between colonoscopies. This can be challenging for non‐specialist healthcare providers to navigate. Large language models like ChatGPT are a potential tool for parsing patient histories and providing advice. However, the standard GPT model is not designed for medical use and can hallucinate. One way to overcome these challenges is to provide contextual information with medical guidelines to help the model respond accurately to queries. Our study compares the standard GPT4 against a contextualized model provided with relevant screening guidelines. We evaluated whether the models could provide correct advice for screening and surveillance intervals for colonoscopy. Methods Relevant guidelines pertaining to colorectal cancer screening and surveillance were formulated into a knowledge base for GPT. We tested 62 example case scenarios (three times each) on standard GPT4 and on a contextualized model with the knowledge base. Results The contextualized GPT4 model outperformed the standard GPT4 in all domains. No high‐risk features were missed, and only two cases had hallucination of additional high‐risk features. A correct interval to colonoscopy was provided in the majority of cases. Guidelines were appropriately cited in almost all cases. Conclusions A contextualized GPT4 model could identify high‐risk features and quote appropriate guidelines without significant hallucination. It gave a correct interval to the next colonoscopy in the majority of cases. This provides proof of concept that ChatGPT with appropriate refinement can serve as an accurate physician assistant.
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