METHODS: History and clinical examination of patients consulting at the Otolaryngology-Head and Neck Surgery department were presented to ChatGPT, which was interrogated for differential diagnosis, management, and treatment. The ChatGPT performance was assessed by two blinded board-certified otolaryngologists using the following items of a composite score and the Ottawa Clinic Assessment Tool: differential diagnosis; additional examination; and treatment options. The complexity of clinical cases was evaluated with the Amsterdam Clinical Challenge Scale test.
RESULTS: Forty clinical cases were submitted to ChatGPT, accounting for 14 (35%), 12 (30%), and 14 (35%) easy, moderate and difficult cases, respectively. ChatGPT indicated a significant higher number of additional examinations compared to practitioners (p = 0.001). There was a significant agreement between practitioners and ChatGPT for the indication of some common examinations (audiometry, ultrasonography, biopsy, gastrointestinal endoscopy or videofluoroscopy). ChatGPT never indicated some important additional examinations (PET-CT, voice quality assessment, or impedance-pH monitoring). ChatGPT reported highest performance in the proposition of the primary (90%) or the most plausible differential diagnoses (65%), and the therapeutic options (60-68%). The ChatGPT performance in the indication of additional examinations was lowest.
CONCLUSIONS: ChatGPT is a promising adjunctive tool in LHN practice, providing extensive documentation about disease-related additional examinations, differential diagnoses, and treatments. The ChatGPT is more efficient in diagnosis and treatment, rather than in the selection of the most adequate additional examination.
方法:将在耳鼻咽喉头颈外科咨询的患者的病史和临床检查提交给ChatGPT,被询问进行鉴别诊断,管理,和治疗。由两名盲板认证的耳鼻喉科医师使用以下综合评分和渥太华诊所评估工具评估ChatGPT表现:鉴别诊断;额外检查;和治疗选择。使用阿姆斯特丹临床挑战量表测试评估临床病例的复杂性。
结果:40例临床病例提交ChatGPT,占14(35%),12(30%),和14(35%)容易,中度和疑难案件,分别。与从业者相比,ChatGPT表明额外检查的数量显着增加(p=0.001)。从业者和ChatGPT之间就一些常见检查的适应症达成了重要协议(测听法,超声检查,活检,胃肠内窥镜检查或视频透视)。ChatGPT从未显示一些重要的额外检查(PET-CT,语音质量评估,或阻抗-pH监测)。ChatGPT报告在主要诊断(90%)或最合理的鉴别诊断(65%)中表现最高,和治疗选择(60-68%)。ChatGPT在其他检查指标中的表现最低。
结论:ChatGPT是LHN实践中一种有前途的辅助工具,提供与疾病相关的额外检查的大量文件,鉴别诊断,和治疗。ChatGPT在诊断和治疗方面更有效,而不是在选择最充分的额外考试。